Inspection on 27/07/06 for AALPS Midlands

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 AALPS College, Midlands (Riverside House) The Rhydd Hanley Castle Worcestershire WR8 0AD Lead Inspector Jean Littler Unannounced Inspection 27th July 2006 12:30 AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service AALPS College, Midlands (Riverside House) Address The Rhydd Hanley Castle Worcestershire WR8 0AD 01684 311756 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Wider Options (3) Ltd Mr Alexander Niven Care Home 4 Category(ies) of Learning disability (4) registration, with number of places AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Residents must be at least 16 years of age when admitted and must be discharged before their 26th birthday. Residents must have Autism Spectrum Disorder or other learning disabilities that are compatible with this condition. The four registered beds are based in the Brook House unit. Arrangements to meet the continuing health care needs of any resident must form part of the contractual arrangements with their funding authority prior to their admission. The service must provide the residents with a significant amount of structured life skills coaching with the aim of the residents moving on to a more independent and normal living environment. At all times a suitably qualified and experienced member of staff must be identified as the person in charge. N/A Date of last inspection Brief Description of the Service: Aalps College Midlands is situated on a thirty acre site in a rural area between Worcester and Malvern. The service is for young people with Autism and complex needs. The service is owned and managed by Wider Options (3) Ltd. who already operate a similar service as well as services for children with learning disabilities elsewhere in the country. The first unit, Brook House, has been registered for four residents. The other units are not yet registered but refurbishment work is nearing completion. The finished service will comprise of eight units accommodating either three or four young people. The final maximum occupancy capacity will be for twenty-nine residents aged between sixteen and twenty-five years of age. The service aims to provide a clear educational focus and the communal buildings and grounds are due to be equipped accordingly e.g. five teaching rooms, a hydro pool, gymnasium, I.T. suite and cafeteria. A rural studies centre is also planned for 2007. Information about the service is available from the Home. The fees range between £1500 and £3000. Residents are expected to pay for their personal items such as toiletries and clothes. They can use their personal allowance to buy things they choose while shopping or on an outing, but all normal costs of food, transport and activities will be covered as part of the service. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on a weekday between 12.30 and 6pm. The service was inspected against the majority of the National Minimum Standards for 18-65 year olds. The supplementary standards for 16-18 year olds have not been assessed as no resident in this age range has been admitted yet. The first unit to open ‘Brook House’ was registered on 8th March 2006. The providers monthly visit reports to the Commission, registration information and other communication with the Home have been considered as part of the assessment process. The inspector toured Brook House, was introduced to both residents and observed staff interacting with them. Records were sampled and one resident’s assessment and support arrangements were closely examined. The registered manager and the deputy who was on duty in Brook House assisted with the inspection process. The deputy and one of the life skills instructors were interviewed in private. What the service does well: What has improved since the last inspection? What they could do better: The Terms and Conditions document that residents’ representatives sign on their behalf could contain clearer information about what residents will have to pay for themselves. This can then be mirrored in staff guidance. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 6 Health care planning could be further developed. The manager needs to ensure that a suitably qualified and experienced member of staff is identified as the person in charge at all times. The records relating to staff who have been recruited could be made more robust in some areas. Some areas of infection control management could be further improved. The additional facilities that are planned on the site are not yet available. When these open they should further increase the quality of life of the residents. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Clear and helpful information about the service is being given to potential residents and their representatives in appropriate formats. The residents that have been admitted to the Home have had their needs carefully assessed and the manager has confirmed these can be met. Both men seemed appropriately placed. The residents have been given the opportunity to visit the Home and then to move in on a trial basis. EVIDENCE: The providers developed a Statement of Purpose for the Home prior to applying for registration. This has since been revised as the service developed and the information could be made more specific. It contains information about how the service will operate, which meets the requirements of regulation 4. It has been made available to all interested parties. The providers also developed a Young Persons’ Guide prior to registration. A welcome pack has also been developed and personalised for each resident. It contains some pictures of the Home, the manager and the resident’s keyworker and basic information about the service in simple text with some symbols to assist their comprehension. A detailed assessment tool has been developed. This is being used to assess if the service can meet any prospective resident’s needs. Information is being AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 9 obtained from relatives, social workers and staff at any current school or care home. Staff have also visited the prospective residents at their previous placement to see how they prefer to be supported. A resident’s file that was sampled provided evidence that a comprehensive assessment had been carried out before a staged transition took place. The resident then moved in on a trial basis for eight weeks. The manager is aware of the need to ensure that a formal agreement about funding, to meet a potential resident’s current and anticipated health care needs to be in place prior to their admission when the resident is funded by a local authority other than Worcestershire. Contracts are being agreed between the funding authority and the providers, however a Term and Conditions document is also in place. This has been agreed between the Home manager and the current residents and their representatives. The manager agreed to review this and see if the information about the items residents will be expected to pay for can be made clearer. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Effective care planning and reviewing systems are in place to ensure staff are aware of the residents’ complex care needs. The residents are being assisted to make decisions about their lives and take reasonable risks on a daily basis. EVIDENCE: The personal records of one of the two residents were sampled. These showed that his needs had been fully assessed and detailed care planning guidance and risk assessments developed. Staff reported that handovers and meetings are used to ensure they are all working in a consistent manner. Daily reports are being completed reporting on activities, health and general wellbeing. Initial aims have been developed to support the resident to become more independent in the areas of numeracy, literacy, independence and communication skills. Staff are reporting on participation levels in their daily notes but methods to formally assess progress are still being considered. Consideration should be given to how residents can become more involved in planning their care in the future and to how care information can be provided in a more accessible format. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 11 It is very positive that physical intervention is not currently being used. Positive intervention strategies have been developed in consultation with representatives and the organisation’s psychologist and behavioural therapist. Reports have been completed when incidents have occurred. The forms contain many tick box sections but very little room for the details of an event to be explained. One report seen indicated a member of staff had been injured but no other details. The layout of these should be reviewed and consideration given to how their effectiveness as a management tool can be increased e.g. the inclusion of sections where senior staff can record if procedures were followed and if any action was taken as a result of the incident. To give an overview monthly summary reports are being collated from the daily records. These are being shared with the resident’s representatives. Families are also being emailed a weekly report. Feedback showed the relatives value this proactive approach to communication. A first formal review meeting has been held recently with the resident’s family and representatives after eight weeks. A report had been prepared for this meeting and an action plan agreed during it. Actions agreed at meetings are going to be linked back into the care planning process. Care plans and records showed the resident is being supported to make decisions at a suitable level for his current abilities e.g. what clothes to wear or what food to eat. As the resident’s needs become better known it is expected that the ability to make informed choices will be further developed. Appropriate risks are being taken so the resident can enjoy life e.g. going into the community, going swimming. Restrictions are in place but these seemed to be balanced e.g. residents can only access to the laundry room with staff support. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Positive arrangements are in place to provide residents with active and enjoyable experiences each day. They are being encouraged to develop their life skills and self-confidence. Residents are being well supported to maintain links with their families and to mix in the community. Mealtime arrangements offer choice whilst encouraging a healthy diet. EVIDENCE: The two residents have different activity plans but sometimes attend activities together. The plans have been developed from knowledge of their assessed needs and interests. Each resident is going out at least daily for trips into the community or for activity sessions e.g. swimming. The activity arrangements are being considered when the rota is being planned. Two vehicles have been provided and there are enough staff on duty at peak times for the residents to go out on separate trips at the same time. Most community activities are nonsegregated to give the residents the opportunity to mix regularly with local people. In-house activities include structured sessions for arts and crafts, cooking, numeracy and literacy. Examples of areas included are coin and food AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 13 label recognition. Input from a speech and language therapist is available through the organisations institute, and visual communication systems are being developed. The teaching and communal on site facilities are due to be opened in phases over the next year. These include a ball pool, hydro pool, gym and rural studies centre. The grounds are already being used for games and growing vegetables. Existing hobbies and interests are being supported and residents have their chosen games, videos and music collections in their bedrooms. Daily routines are built into the activity plan to provide a sense of security e.g. making their beds and own breakfast each morning. Choices are being offered where possible within the routine. Activity information is being reinforced through visual prompts such as Widget symbols. All residents are being supported to stay in regular contact with and visit their families. Keyworkers are designated for each resident and they have a responsibility to ensure relatives are consulted about care issues. Staff are assisting with transport back to the family home and one relative comes to watch her sons swimming sessions. One family reported that this weekly contact with staff also helps ensure good communication links are in place. Relatives have been involved in supporting the residents to personalise their bedrooms and are being invited to review meetings. Because of their condition the residents have difficulty developing friendships, however it is positive that these first two residents are interacting with each other in a positive way. Food is being purchased locally and prepared by staff on each shift with some involvement from the residents. The lunchtime meal was seen to be relaxed with the staff eating with the residents around the kitchen table. The residents chose their desert and helped to clear away afterwards. The sample of menus seen showed healthy food is being provided based on known preferences. Lots of fresh fruit is being offered. One week showed eggs in different forms were given for lunch four days running. Currently the menus are reviewed during the provider’s monthly monitoring visits. Consideration should be given to further developing the monitoring process. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents’ personal and health care needs are being met in a flexible and personalised manner. Medication is being safely managed and administered by competent staff. EVIDENCE: A ratio of at least one to one staffing is provided, which allows the residents to be supported with their personal and health care needs in a very personalised manner at a speed that suits them. Routines are being kept as flexible as possible but there is a need for some structure to the day e.g. the day usually starts at 8.30am and supper is provided at 9pm. One resident settles himself in bed with his television on and night staff turn this off before midnight. The care records seen showed health issues such as weight are being monitored. A healthy diet and regular exercise are being built into daily routines. The residents are being registered with local health practices for GP and dental treatment etc. It is very positive that work with one resident led to him coping with a visit to the doctors surgery for the first time in many years. The manager agreed to discuss access to annual health checks with the GP, and to develop health action plans. Links are in place with health professionals already involved in the residents’ care e.g. psychiatrists. The organisation has a team of specialists based at their institute whose support can be accessed AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 15 when needed. Input from the behavioural therapist has been set up for care planning and periodic on site surgeries. The medication is stored in an appropriate cabinet situated inside a locked office. The key is being held by the senior in charge and a spare is locked away. The manager agreed to review this arrangement and ensure only those with permission to give medication can access the spare key. The cabinet was tidy and each resident’s medication clearly identified. A monitored dose system is in use and staff have attended training about how to use this system. More in-depth accredited training is due to be introduced along with a competency pack. No new staff will be given permission to administer medication until they are trained and have passed the competency monitoring process. The records seen showed medication doses have been given as prescribed. Records have been made when medication has come into the building and the supplying pharmacist is providing a carbonated returns book. To reduce the risk of any errors residents’ photographs are in with the records and two staff are involved in administration. Where hand written entries are added to the administration charts the author and a worker checking the details should both sign this record. The GP has been consulted about homely medications. No ‘as required’ medication is being used. The manager intends to carry out spot checks on the system to ensure high standards are maintained. Medication will be reviewed regularly by the GP or by the psychiatrist involved. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Suitable arrangements are in place to enable complaints to be made both informally and formally. A framework is in place to help protect the residents from any form of abuse. EVIDENCE: A complaints procedure is in place. No complaints have been received since the service opened. A system is in place to record any complaints that are received and these will be monitored by the manager, and by the provider’s representative during the monthly visits. The staff spoken with said they would report any concerns promptly and felt the standards of care and staff conduct in the Home are high. Staff training is being provided in adult and child protection. An Abuse and Whistle Blowing policy are in place and staff are being made aware of these and having to sign that they have read them. Protection is also being covered in the induction and during supervision sessions. Clear guidance is in place about how to respond positively to residents’ complex behaviours. The manager is aware of the need to report any concerns in line with the local multi-agency protocol. No Vulnerable Adult issues have arisen since the service opened. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents have a comfortable domestic style home that is clean, modern and well maintained. Their bedrooms provide them with private bathroom facilities and enough space to relax and to store and use their personal possessions. EVIDENCE: Brook House is the first unit to be opened in the complex. It is a detached house in the grounds of the main house and in close proximity to the communal facilities. The house has been completely refurbished and redecorated. Fire Safety and Environmental Health inspections were carried out prior to registration. The garden area has been fenced in to protect residents from the building work that is continuing at other parts of the site. A large patio area with garden furniture is at the rear of the house providing some privacy. Raised beds have been built and the residents are already growing some vegetables. Maintenance and gardening staff are working on the site so they can respond quickly to any requests for work. The house has four bedrooms each with an en-suite bathroom with an over the bath shower facility. The bedrooms are a good size and the two occupied so far AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 18 have been nicely personalised. Furniture with lockable sections has been provided and the residents can lock their rooms if they want to. Staff can override these locks in an emergency. There is a suitably equipped staff office and a laundry room. The communal lounge and kitchen/diner meet the minimum space requirements but are quite small for the needs of people with autism and for the number of staff who will be on duty. The manager has considered this when selecting the residents for this unit and only plans to admit three residents for the foreseeable future. The fourth bedroom, which is on the first floor, has been turned into a music room. Another room downstairs has been turned into a snoozelen. Both rooms are positive additions to the shared space. The house has been comfortably furnished and is bright and modern. Consideration should be given to fitting a handrail on the stairs as they are quite steep. Personal care equipment is currently on display in bathrooms. More storage would allow this to be kept out of sight. The care staff are doing the cleaning but they have access to a carpet shampooer and the windows are being cleaned professionally. The house was clean and systems to manage infection control are in place e.g. protective clothing for staff and colour-coded equipment for use in the kitchen and bathrooms. Pump soap and paper towels should be provided in the laundry. Suitable hand washing facilities should be available to staff in areas were intimate care is being given. Sterilising gel should also be considered. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. New staff are being checked prior to starting to help protect the residents. The residents are benefiting from a good level of staffing and one-to-one attention. A training programme is in place and staff are being well supported to meet the residents’ needs. EVIDENCE: The team of eight staff for the Brook House unit have been in post for some months prior to the first resident moving in. This allowed them to attend all of the planned training, help develop procedures and recording system and gel as a team before starting the transitional work with the potential residents and their families. One to one staffing is the minimum provided during the waking day. Often additional staff are also on duty during the day to provide extra support for activities and transitional work with potential residents. At night there is a worker on a waking night duty and another sleeping-in and on call. A senior member of staff is also on call in case of emergency. There are three deputies based in Brook House and one is usually on duty for all or part of each day. When a deputy is not on duty no formal arrangements have been in place to identify the person in charge. The manager is currently living on site and has been available to provide support, however this is not a AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 20 long-term arrangement. Because of the complex needs of the residents a condition was agreed with the providers as part of the registration process that at all times a suitably qualified and experienced member of staff would be identified as the person in charge. The manager needs to ensure that evidence is kept showing that this condition is being complied with or the providers could be subject to prosecution. A training co-ordinator has recently been appointed who will have the task of ensuring staff attend refresher training when needed. All staff are working through a Skills for Care comprehensive induction with a focus on Autism. They are attending core training such as health and safety and fire safety as well as specialist courses including positive approaches to challenging behaviour and Autism. Staff are expected to gain an NVQ 3 care award. Five staff currently hold a relevant qualification. The numbers of staff employed will be continually increasing over coming months as more residents are admitted so the percentage of qualified staff will vary. The Learning Disability Award Framework is due to be introduced in the autumn when the current review of this award framework is completed. Two staff files were sampled to check the recruitment process. These showed that the process is well organised and clear records are being maintained. Job descriptions and contracts are in place. Staff are having to complete application forms and be interviewed by the manager and one other. A discussion was held about how the interview process and how records could relate more directly to the job specification. Two written references had been obtained prior to both staff starting work. In one worker’s case the reference from the previous employer had been completed by a worker other than the manager and a home address had been put as the contact point on the application form. The reference had been followed up with a phone call to the employer so it had been verified but the details of this could have been clearer to show the manager or HR department had been contacted. The manager agreed to ensure that greater detail is recorded in the future. To take account of the need to check into the reason staff left previous work with vulnerable people the manager has interviewed existing staff about this. For all new staff from September 06 reference requests will be sent to all relevant employers in the last ten years. A CRB check had been returned for both workers before they started. The PoVA and PoCA lists are both being checked, as staff will have access to vulnerable adults and possibly also residents under the age of eighteen. Recently new staff have started their induction training ready for the other units to open before their full CRBs have been returned. In these cases a risk assessment should be held on each file showing how the worker will be monitored while on site until all satisfactory checks have been received. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 21 One of the deputy managers and one of the life skills instructors were interviewed in private during the inspection. Both reported that suitable staffing levels are being maintained. They felt the training provided has been good quality and has helped equip them for their role. They are receiving regular supervision sessions with their line manager and have attended regular staff meetings, which they found supportive. Both seemed capable workers who are positive about their work with the residents and their relatives. Team morale was reported to be high with staff feeling empowered and valued. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The Home is being well run by a competent manager who prioritises the residents’ wellbeing. Appropriate management and record keeping systems are in place. Policies are in place that are being kept under review. The quality of the service is being monitored and the residents’ and staffs’ health and safety is being promoted. EVIDENCE: The manager holds relevant qualifications and has many years experience of managing services for people with special needs. The staff reported that he is professional and approachable. Throughout the process of opening the Home he has demonstrated a sound understanding of his legal responsibilities and a commitment to providing a high quality service. The manager’s hours are supernumerary to the care staff and the service is supported by administration, auxiliary and maintenance staff. Systems in place such as shift handovers, staff meetings and supervision sessions provide time for information to be shared and for the staffs’ abilities to be monitored. The AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 23 manager has been carrying out unannounced monitoring checks on the unit and formally reporting these. The staff team are getting used to having the quality of their work checked in this manner and having to raise standards when shortfalls are noted. A provider’s representative has also been carrying out monthly monitoring visits to the Home since the first resident moved in. The reports have been provided to the Commission. The organisation has a Quality Assurance manager and formal auditing and consultation arrangements will be built into the management arrangements. The effectiveness of these systems will be assessed again at the next key inspection when they have been fully operational for a significant period of time. Feedback is already being requested routinely from residents’ representatives and outside agencies. A sample of comment forms were seen and they contained positive comments e.g. ‘We feel the care our son receives is excellent and all staff seem enthusiastic and very caring’. A service development plan is in place for June 06 for the coming year. Records are being stored in an office area that is secured when not in use. The sample of records seen were up to date, they contained useful and appropriate information that was accurate and well ordered. It is positive that to date relatives have retained responsibility for their children’s finances. Records relating to one resident’s personal allowance showed this was being spent appropriately and balanced weekly. The manager agreed to develop some guidance for staff on what this money can be used for so consistency is maintained. This should link into the financial information in the Terms and Conditions of Residency. Corporate polices and procedures are in place in line with the National Minimum Standards for Care Homes for adults and 16-18 year olds. The staff and manager have spent time reviewing these prior to the admission of the first resident. Changes have been made as a result of this to make the information relate more specifically to this service. Health and safety servicing and maintenance checks are being routinely carried out. The deputies are recording daily visual checks of the premises. Accidents are being recorded and these will be monitored as part of the quality assurance process. Staff have attended safety training including food hygiene, first aid and fire evacuation. Fire drills have been held weekly and a record kept of who was present and how long the evacuation took. The manager agreed to monitor these to ensure all staff attended a drill at the frequency detailed in the fire management assessment. The fire officer has a copy of this risk assessment and visited the Home in April 06 to approve the arrangements in place. Risk assessments are being completed routinely for hazards identified in the environment or relate to the residents’ care. Consideration should be given to providing staff with further infection control training. AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 4 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 3 3 3 3 3 X AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 25 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA17 Good Practice Recommendations Develop a more robust system to review the meals provided. Consider taster sessions to expand the range of known preferred foods that can be offered. Discuss with the GP access to annual health checks for each resident. Develop person centred health action plans for each resident. Where hand written entries are added to the medication administration charts the author and a worker checking the details should both sign this record. Review the management arrangements for the spare medication key. Consider fitting a handrail on the stairs. Provide storage in bathrooms for protective clothing and intimate care supplies. DS0000066276.V301742.R01.S.doc Version 5.2 Page 26 2 YA19 3 YA20 4 YA29 YA27 AALPS College, Midlands (Riverside House) 5 YA30 6 YA34 Provide pump soap and paper towels in the laundry. Ensure staff have easy access to appropriate hand washing facilities after assisting with intimate care. Consider providing hand sterilising gel. Keep evidence of how staff who start prior to full employment checks being in place are being supervised. Keep evidence that employer references have been obtained from official sources and verified. Develop guidance for staff on what residents’ personal allowance money can be used for so consistency is maintained. This should be linked into the financial information in the Terms and Conditions of Residency. 7 YA40 YA41 AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Worcester Office The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI AALPS College, Midlands (Riverside House) DS0000066276.V301742.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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