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Inspection on 16/09/08 for 76 Highlands Road
Also see our care home review for 76 Highlands Road for more information
This inspection was carried out on 16th September 2008.
CSCI found this care home to be providing an Good service.
The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.
Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: 76 Highlands Road 76 Highlands Road Fareham Hampshire PO15 6BZ The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janette Everitt Date: 1 6 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area
Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information
Document Purpose Author Inspection report CSCI
Page 2 of 34 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 34 Information about the care home
Name of care home: Address: 76 Highlands Road 76 Highlands Road Fareham Hampshire PO15 6BZ 01329230121 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Community Integrated Care Name of registered manager (if applicable) Miss Georgina Finch Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) The maximum number of service users to be accommodated is 3 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home 76 Highlands Road is a registered care home, providing personal support and accommodation for three young adults with learning disabilities. It is a bungalow set back from the main A27 road to Portsmouth in Fareham. Community Integrated Care (CIC) are the registered providers, and the manager, is in the process of applying to CSCI for registration to become the registered home manager. Knighstone Housing Association own the home which comprises of three single bedrooms, a communal lounge, dining room, kitchen and a laundry/staff sleep in room. An enclosed garden is situated to the rear of the property. Care Homes for Adults (18-65 years) Page 5 of 34 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 34 How we did our inspection: This is what the inspector did when they were at the care home The site visit to 76 Highlands Road, Fareham took place on the 16th September 2008. The manager, support workers and residents assisted the inspector throughout the visit. The visit to the home formed part of the process of the inspection of the service to measure the service against the key national minimum standards. The home sent us their Annual Quality Assurance Assessment (AQAA) in April 2008 following a reminder letter to return this. The focus of this visit to the home was to support the information stated in the AQAA and other information received by the CSCI since the last inspection visit of September 2006. A service annual review was undertaken in May 2008, where surveys were distributed to service users, staff, relatives and care manages. The outcome of this review was that the home continued to provide good outcomes for service users and in general there was a high level of satisfaction identified in the surveys returned to CSCI. Documents and records were examined and staff working practices was observed where this was possible. The inspector looked around the home and spoke with most of the residents who were at home that day. Those spoken to expressed
Care Homes for Adults (18-65 years) Page 7 of 34 satisfaction about their home and were very satisfied and complimentary about the lives they live and were happy to show us their home. Surveys had been distributed to service users and staff, care managers, GP and other visiting professionals. Six staff surveys were returned to the CSCI and two from service users. The surveys returned from staff indicated that they have good training opportunities, and feel they have support from the manager. People living in the home returned surveys that were completed with the help of staff; they say they are Happy living in the home, where they have choices and autonomy over their lives. What the care home does well The home provides a clean, homely well maintained home for the service users. The home has a relaxed atmosphere and there was good interaction between the staff and the three service users. The assessments provide good information about the service users needs and wishes and these are recorded in graphic format to enable the service users to participate and have a better understanding of their planned care. Care plans record the service users likes
Care Homes for Adults (18-65 years) Page 8 of 34 and dislikes and their preferred interests and hobbies. Plans are reviewed monthly with the service user and the key worker. Risk assessments have been undertaken for the activities of daily living and social activities and these support the service users to take risks as part of an independent lifestyle. Service users can choose what they do each day and their interests are taken into account when arranging outings and holidays. Service users are encouraged to integrate into the community regularly. Menus are planned with the service users who participate in the preparation of the meals within a risk assessment. Menus indicated that service users have choice of a well-balanced diet. Service users say they enjoy the food provided. Records indicate that service users health care needs are met. Staff support service users to voice their concerns and this was supported by the surveys returned that indicated they would know what to do if they had concerns or issues. It was evident during the inspection that the manager and her staff have a good rapport with the service users and are familiar with their needs and behaviours that are indicators of how they feel.
Care Homes for Adults (18-65 years) Page 9 of 34 What has got better from the last inspection The annual service review reported in April 2008 that the requirement from the last inspection report with regards to the Medication Administration Records (MAR) has been complied with the MAR sheets are now recorded appropriately. Moving and handling facilitators have been trained for the home. The home has introduced person centered meetings which are held with service users and families and have proved to be successful. The home has recruited more staff and the team work well together providing a good service for the three service users. Service users meet all applicants before the selection process. A new kitchen has been fitted and new handrails installed in the bathroom to help two service users with balance. Communication between families and staff has greatly improved. The manager is in the process of reviewing and updating all assessment and care planning documentation and taking old information for archiving. Care Homes for Adults (18-65 years) Page 10 of 34 What the care home could do better The medication procedures need to be reviewed. Medication needs to be audited and all medications no longer needed must be returned to the pharmacist and records kept of this. The MAR charts need to be reviewed so that they reflect the medication that is currently being prescribed and administered and that PRN (as needed) medication is not overstocked due to poor stock rotation and ordering. A training matrix could be created stating the dates training has taken place and by whom to enable the manager to monitor that all mandatory training it taking place at the appropriate intervals. Care Homes for Adults (18-65 years) Page 11 of 34 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Janette Everitt 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 12 of 34 Details of our findings
Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 13 of 34 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. The service users care needs are assessed to provide information on the needs and aspirations of the service user before they move into the home. Evidence: The service users have been in residence for a number of years and the home has not admitted a person for some years. The manager told us that she would go and assess the person prior to them moving into the home but it would be undertaken on a phased introduction to the home to ensure the person likes the home and that they would be compatible to live with the existing people living in the home. The manager told us that the care manager and family and any other professionals involved in the persons care would be involved with the admission and care needs assessments are shared with the home. The manager is in the process of reviewing the three assessments. She has completed one and this contains up to date comprehensive information about the service user.
Care Homes for Adults (18-65 years) Page 14 of 34 Evidence: All service users have a copy of the Statement of Purpose in their care records and this can be produced in other formats such as graphic, braille or makaton. The service users could not communicate to us about their moving into the house as all three had moved in some years previously and would be unable to communicate their feelings at that time. There was evidence in the care plans of a care needs assessment that had been undertaken by the referring social worker. Care Homes for Adults (18-65 years) Page 15 of 34 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Care plans provide clean information on the changing needs of the service users. Service users are supported to make decisions, taken risks as part of an independent lifestyle. Evidence: The care needs assessment is used as a basis for the care plans. The care plans are person centered and provide detailed information on all aspects of the resident’s needs. This includes communication, medical history, personal hygiene, safe environment, social relationships, medication, cooking etc and generally how they prefer to spend their days. All assessments and care plans were last reviewed in April 2008. Each service user has a folder that contains daily evaluation of how they have spent the day and any other information relevant to their care and routines. There were behaviour charts in this folder and the records documented the activities the residents had undertaken both outdoors and indoors, their general mood and any incidents that may have occurred.
Care Homes for Adults (18-65 years) Page 16 of 34 Evidence: There was evidence that any health related contacts with the primary care team were recorded with outcomes. The records detailed how the service users like their daily routines set out and with one service user this is very prescriptive and the care plan must be followed. Communication methods are recorded and for one service user who uses the Makaton system a list of signs and symbols frequently used were in the care plan. There was evidence in the care plans of regular review by the care managers and this had been done in recent months for all service users. Service users and relatives are invited to the review meetings and service users also have individual monthly meetings with their key worker, at which time they are able to identify and communicate their wishes to them. The staff on duty were observed to be very familiar with the service user’s routines and how they like to spend their days. There was good relationships between staff and service users and constant communication exchanged throughout the visit. Risk assessments for all aspects of their daily living and social activities were included in the care plans. Assessments stated the risks and the actions required to manage those risks whilst allowing the service user as much Independence as possible. Risk assessments include those for challenging behaviour, environment and travel. Care Homes for Adults (18-65 years) Page 17 of 34 Lifestyle
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Staff treat service users with respect, support them to participate in daily social activities and provide a well balanced diet. Evidence: The home does not have a structured activities programme for the service users. During this visit it was observed that service users were able to choose what they wished to do during the day. The manager told us that what the service users choose to do each day is decided on an ad-hoc basis and it is discuss with them in the morning. The AQAA told us that a more structured activities programme for each service user needs to be put in place to increase the service user’s social interaction. The service users interests were recorded in the care plans and their interests are taken into account when arranging their social activities. Social activities are discussed
Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: at the one to one monthly review meetings with the key workers and this is when information can be gained to develop the activities programme for each service user. Members of staff take service users out to the local shops and on outings either by taxi or if a driver is available, by the homes vehicle. The service users have to go out in turn as it is not always possible to go out together. A service users survey returned said that he has an active social life and understands he has to takes in turns to go out with other service user. Two service users have contact with their families on a monthly basis. Visitors and relatives do attend the home and one relative comes a long distance and the staff take the service user to the railway station to meet their mother when she visits. This always generates a great deal of excitement in the service user, who cannot verbally communicate with others. All visits by relatives and friends are recorded in service user’s records. Two of the service users had been away on holiday this year and two members of staff had accompanied them. The third service user had enjoyed day trips as a break from the normal daily routine. The service user spoken with told us that he had thoroughly enjoyed his holiday. The service users are encouraged to integrate into the local community life as much as possible. Two of the service user had been invited to a birthday party of a service user from another home, which they were looking forward to attending to during the proceeding week-end. A service user has joined the ‘Pathfinder’ organization and another enjoys an arts and crafts class in the community. Responses from service users on returned surveys said’ I can do what I want in the house and I like going to my favourite places like the zoo, shopping and have a varied choice of activities’. The other survey said ‘I have an active social life and go out a lot’. The service users are encouraged to become involved with the general domestic duties of the home, one being more keen to help with domestic chores than the other. Food preferences are recorded in the service user’s care plans. The manager told us the staff are very familiar with their food preferences and menus are planned around their likes and dislikes. Mealtimes are flexible and one service user was having breakfast late out of choice and following their bath, the other two residents had just finished theirs. Menus seen by us indicated that service user were provided with a choice of a wellbalanced diet. The AQAA said that the home obtains advice from the GP and dietician with regards to healthy eating. One service user told us that he was having cold meat and salad for lunch because that was his ‘favourite’. One of the service users will help prepare the meals but a support worker told us that it is mainly preparation of cold foods he helps with, as the risk would be too high if he became involved with hot food
Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: preparation, because of his poor balance. A risk assessment had been completed. The staff spoken to at the time of this visit and observations throughout the visit, indicate that staff are very familiar with what service users like to do and eat and that there is a respectful relationship between service users and staff. All staff have received training in food handling and hygiene.There are now no special diets required in the home. One service user needs the food to be cut very small but no longer needs food pureed. Fresh fruit and vegetables were available for service users. Care Homes for Adults (18-65 years) Page 20 of 34 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Service users receive personal support how they prefer and healthcare support appropriately. Medication is not well managed and needs to be accurately recorded. Evidence: The care plans record the service users preferences for their preferences for how they receive personal support from the staff. The staff are of mixed gender and there is no documented objections for cross gender care and the manager told us that the one lady who has communication problems responds better to having a male carer and would let the staff know if she were not happy. One service user was over heard being asked who he wished to assist him with his bath that day. The AQAA states that all service users’ health care is monitored regularly with reviews and health checks. Care plan records evidenced that the service users have consultation with other health professionals from the primary care team. Service users are registered with the local GP and two are able to walk to the surgery with the support of a support worker. The GP will visit the home if requested. Care Homes for Adults (18-65 years) Page 21 of 34 Evidence: Service users have access to the chiropodist, the dentist attends the home annually but service users do attend the hospital for more serious dentistry. The service users do not receive chiropody service but the manager told us that any problems they can have access to a chiropodist. One of the other homes in the group has a member of staff trained in foot care who will visit the home if necessary. The home has access to the community learning disability team who would support the service users if requested. The AQAA states that one service user has received a lot of input from psychiatrist and the community team and various multidisciplinary meetings have taken place with successful outcomes. The care plans evidence that the speech and language therapist has been involved with this service user for a period of time because their swallow was not good, but this has become less of an issue and the service user has a care plan in place to identify the consistency of the food must be and how to manage any risks involved with not having a pureed diet. The AQAA stated that one service user had been referred to the continence nurse to support continence management. A care plan was in place to evidence that this was now managed well and less of a problem. The service users are reviewed by the psychiatric team annually. The previous report identified that medication administration records (MAR) were not being recorded consistently. The annual service review (ASR) stated the home had complied with the requirement made from this finding. The medication procedures were viewed. There were no service users choosing to self-medicate their medicines. The home uses a monitored dosage system (MDS) supplied by the local pharmacist. The manager told us that staff have received medication training but this is not certified. The manager told us that the pharmacist who supplies the medication is going to visit the home to train staff and issue them with certificates when they have completed workbooks. No dates have been set for this training to date. The ordering, receiving and disposal of medication is organized by the deputy manager. The medication is stored securely in locked cupboards. Each service user has a cupboard in which their medication is stored. There was evidence in one cupboard of medication, some of which was out of date, ready to be returned to the pharmacist. The returns medication records could not be found and therefore there was no evidence that these had been listed. The other cupboards evidenced over stocking of some medications. Medications that had not been used for some considerable time were still stored in the cupboards although the service user was no longer being prescribed that medication. Medication that had been dispensed as a liquid and was prescribed on a PRN (when needed) basis did not state the date on which is was opened and therefore the expiry date of this medication, once opened, was unknown. The manager was advised to consult with the pharmacist to gain information about the expiry dates of the medicines once they are opened. Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: Generally the medication was not being managed well and rotation of stock was poor. The manager said she does not audit this system but that she would in future. The medication administration records (MAR) sheets were viewed. These had been recorded appropriately, except for the last person to administer the medicines, who had omitted to sign for the medication that had been given to a service user later that minoring. The manager acknowledged this error and spoke to the member of staff immediately. Some of the service user’s MAR sheets demonstrated that some medication had been prescribed on a regular basis but was only being given as and when needed. Some medication was still being prescribed that had not been needed for some considerable time. The records demonstrated that the medication needs to be reviewed to reflect the service users current medication needs and should be reviewed by the GP so that medications are prescribed appropriately to avoid unnecessary ordering, delivery and waste. Service users spoken to and from surveys returned from them indicate that they feel well supported in their healthcare needs and general well being. Observations through out the day demonstrated that the staff are very familiar with the service user’s healthcare needs and were communicating about doctor’s appointments and general health issues with service users. Care plans also document the healthcare needs, and risk assessments were in place in relation to their healthcare. Care Homes for Adults (18-65 years) Page 23 of 34 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Staff support service users to voice any concerns. Service users are protected from neglect and abuse. Evidence: The home has a complaints procedure, a copy of which is kept in each of the service users file and is in easy read format and Makaton. The service user surveys returned to us and completed by staff indicated that the service users would let the manager or staff know they were unhappy either vocally or by certain behaviours displayed. No complaints have been recorded in the complaints log since the last inspection. The home has a copy of the No Secrets document and is in a pictorial format to enable the service users to understanding how they would report abuse. The manager told us that staff have received training in abuse and the procedures to follow should there be any safeguarding issues. Staff receive this training at induction and refresher training is undertaken on the computer e learning programme. Records of this were shown to us. Two staff members spoken to at the time were aware of the procedures to follow should abuse be suspected. The AQAA stated that one safeguarding adult investigation had taken place in the past year and this had been unsubstantiated. Care Homes for Adults (18-65 years) Page 24 of 34 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. The service users live in a clean, homely and safe environment. Evidence: At the time of this visit the home, which is a large bungalow in a residential area, was clean, and homely and tastefully decorated. Service users have single accommodation and the service user’s gave permission for us to visit their rooms, one service user keen to show us his collection of model cars and steam engines. The rooms were observed to be very clean and well decorated. The manager told us that the service users do have input into the choice of colour and that two of the service users had chosen the colour schemes for their rooms. The rooms were very personalised with individual evidence of the service user’s hobbies. The large communal area accommodates the lounge and dining area and was open and bright. The area was well decorated and homely and all furniture and fixtures were in a good state of repair. The home has an enclosed garden at the rear of the property that has seating for service users, which is used in the better weather. Service users communicated to us through the visit and from the surveys returned that they were very happy living in the home. Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: The home’s kitchen is domestic in appearance and is accessible to service users with supervision from the support workers. Risk assessments for service users use of kitchen appliances were contained in their files.The manager told us that there is a plan for improvement for areas of the home and funding is in place to re-arrange the cupboards in the hallway to provide more storage space. She said that the home gets a quick response from the organisation when repairs or redecoration needs to be done. Care Homes for Adults (18-65 years) Page 26 of 34 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. Service users are supported by sufficent numbers of staff, who have been recruited through robust procedures and trained appropriately to meet the needs of the service users. Evidence: The staff rotas that were viewed demonstrated that there are always two support workers on duty during the day and a sleep-in person during the night, this member of staff is always the support worker that has been on duty the previous evening and the proceeding morning. On the day of this visit there were two staff on duty, the three service users were staying at home that morning and it was apparent that there were sufficient staff on duty. The support worker said that additional staff come on duty if staff are accompanying a service user out into the community. The manager is usually supernumerary to staff numbers and was not on duty on the day of this visit but did attend the home to assist with the inspection. The support workers also take on the domestic duties and service users are encouraged to become involved and help clean the home. Since the new manager has been in post the home has recruited a number of new
Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: staff. The manager told us that the service users do get involved when new staff are being selected and they meet them before they go through the selection process. The home have seven permanent staff employed to date. The manager told us that agency staff are not often used in the home now that there are sufficient permanent staff. The staff are of mixed gender and the manager says this enables the service users to choose who they wish to assist them with their personal care. The Annual Service Review (ASR) of April 2008 identified that 28 of care staff had achieved their NVQ level 2 or above. A further two have undertaken this and the other two support workers have been nominated to commence this and the manager told us she is waiting the funding to be approved from the head office to enable the staff to commence the course. A sample of newly recruited support worker’s personnel files was viewed. These demonstrated that all the relevant checks for the protection of the service users such as Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks with two written references and proof of identity had been received for all new staff before they commenced employment the home. There was evidence in the personal files that staff have received a variety of appropriate training. The manager told us that the training is done via e learning, a computer generated training programme. The manager told us that her staff have not had appraisals to date but staff receive supervision every 6-8 weeks. Records of this were seen. The manager has had an appraisal from her line manager and acknowledges that she has not appraised any of the staff as yet, but plans to do so in the coming year. She said that training on appraisals was being made available to all support staff to enable them to understand the benefits of the appraisal system. We were told by the manager that the home has two moving and handling facilitators that provide the training to staff annually. Staff spoken with and four surveys returned from staff indicate that they feel well supported and that they consider they receive appropriate training. Care Homes for Adults (18-65 years) Page 28 of 34 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. The manager runs the home in the best interests of the service users who are protected by the safe working practices operated there. Evidence: The current manager is in the process of registration with the CSCI. She has worked for the organisation for some years and has been managing the home for the past year. The manager is currently undertaking the NVQ level 4 in management and leadership. The manager told us in the AQAA that the home now has an established management team who work well in providing a good service to the three service users who live in the home. The two staff members on duty at the time of this visit said that the manager is very supportive and is always available. This was supported by the surveys returned by staff who indicated that they regularly received support and supervision from the
Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: manager. The home has a quality assurance system in place. There are six monthly person centred reviews with service users and family at which time care needs and issues are discussed. The manager said that the service manager attends the home monthly to audit systems in the home and talk to service users. These reports are kept in the home. The manager also completes a core standards audit report. Service users meetings are held and the service users have meetings with their key workers monthly. The policies and procedures that have been developed through the organisation were dated 2004 and need to be reviewed. Fire records seen indicated that checks on fire safety equipment were undertaken at the appropriate intervals. The servicing of the fire system and equipment was evidenced through the records to be up to date and current. The AQAA states that the home has appointed health and safety representatives within the staff team The accident book was seen and indicated that all accidents are recorded. Care Homes for Adults (18-65 years) Page 30 of 34 Are there any outstanding requirements from the last inspection? Yes ï£ No ï Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 31 of 34 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set
No Standard Regulation Description Timescale for action 1 20 13 The registered person must 30/11/2008 ensure clear procedures in place for the ordering recording, handling, safekeeping and disposal of medications. All medications out of date or no longer required must be returned to the dispensing pharmacist and records of this maintained. You must do this to ensure that all out of date medication and medication no longer required is not being stored in the home. 2 20 13 The registered person must 30/11/2008 ensure that all service users medication regimens are reviewed by the GP to reflect their current medication needs. You must do this to ensure
Care Homes for Adults (18-65 years) Page 32 of 34 that the repeat prescriptions reflect what the service user is currently being prescribed and does not generate the delivery of medication no longer needed by the service user. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website.
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