Inspection on 22/01/08 for Abacus House

This inspection was carried out on 22nd January 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abacus House 16/01/07

Abacus House 15/12/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Abacus House Abacus House 55 Victoria Road Swindon Wiltshire SN1 3AY Lead Inspector Pauline Lintern Unannounced Inspection 22nd January 2008 10:00 Abacus House DS0000064394.V354842.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 Abacus House DS0000064394.V354842.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. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abacus House Address Abacus House 55 Victoria Road Swindon Wiltshire SN1 3AY 01793 511181 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) www.holmleigh-care.co.uk Holmleigh Care Homes Ltd Suzanne Hanratty Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the two bedrooms on the second floor and the single bedroom leading from a single staircase off the rear lounge are not to be used by service user or staff until a fire safety sprinkler system has been installed. 16th January 2007 Date of last inspection Brief Description of the Service: The home is close to Swindon Old Town centre on a busy road. It is one of a number of homes owned by Holmleigh Care. It offers care and accommodation to adults aged between 18 and 65 years who have a learning disability and may have associated needs that challenge. It was first registered in August 2005 for 7 service users. The accommodation is on three floors and all of the bedrooms have an ensuite shower room with a toilet and hand washbasin. On the ground floor, there is a dining room, a kitchen with a separate utility room that leads to a sitting room and a staircase for another bedroom. There is also a small garden and patio to the rear of the home and car parking space. Abacus House is staffed twenty four hours a day including awake staff at night time. The home now has a sprinkler system installed. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The key unannounced inspection took place over six and a half hours. The manager was available to assist during the afternoon. Three people who live at the home were available to meet with us and share their views on the service. Four staff were on duty at the time of our visit. Three staff spoke to us about their recruitment, training opportunities, the needs of the people living at the home and the procedure for safeguarding adults. Prior to the visit to the home we canvassed the views of the people living at the home, their relatives, health care professionals and staff members using our ‘Have Your Say’ survey forms. Their comments are included within this report. We asked the manager to complete an Annual Quality Assurance Audit (AQAA) prior to the visit to the service. As this was a key inspection we examined all outcome groups. This included assessments, care plans, risk assessments, health care needs and medication, complaints and protection, staff recruitment and training and quality assurance. Feedback was given to the manager at the end of the visit. Fees currently charged at Abucus house range between £827.50 and £1,253.14 per week. What the service does well: The home ensure that no one is admitted to the service unless they are confident that the person will be compatible with the other people living at the home and that their needs can be met. Either the manager, deputy or a senior member of staff carry out a full assessment of the potential new person’s care needs. Family members and external agencies involved with the care of the person are fully involved in the assessment process. Potential new people have the opportunity to visit the service and meet the other people living there and the staff before deciding if they wish to move in. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 6 People are empowered to make choices and decisions regarding the way they live their lives. People are given appropriate control over their lives and are supported to make sense of the consequences. Care plans are developed with the input of the person themselves, family, friends and other involved parties. The home runs a good review system where the key worker meets with the person using the service on a monthly basis to monitor actions and outcomes. The people living at the home have the opportunity to meet up at ‘residents’ meetings to share views, raise concerns and make decisions about the running of the home. People are encouraged and supported to undertake supported employment when appropriate. Each person has an activity programme, which is developed to include life skills and choices. Staff demonstrate overall competency and appear to be sufficient in numbers, properly recruited, inducted, supervised and trained. People have access to health care professionals and are supported by staff to attend appointments if necessary. People tell us they know how to make a complaint or raise a concern. Staff receive competency training in safeguarding adults within the first three months of employment. Overall this is a service that is led by the people who live there. What has improved since the last inspection? The safeguarding adults policy was reviewed in May 2007. All staff have access to the local guidance ‘No Secrets’. An assessment of risk is undertaken on each person before they are admitted to the home and kept under review. Essential Life Plan Packs are currently being developed for each individual living at the home. Individual health plans are also being developed. One person requested a double sized bed for their room and this is being actioned. The manager now benefits from having a competent deputy to assist her in the running of the home. They are currently reviewing all documentation and ensuring unnecessary duplication is removed. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 7 There has been an increase in the number of staff who has started their National Vocational Qualification (NVQ). Staff members have received training in equality and diversity. What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 8 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 Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 1,2,4 Quality in this outcome area is adequate. The home’s Statement of Purpose is currently held at the head office and therefore could not be viewed at the time of the visit to the service. No one using the service currently has a service user guide. People have their needs assessed prior to being offered a service. Potential new admissions have the opportunity to ‘test drive’ the service before making a decision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager reported that the home’s Statement of Purpose is currently at the head office. She confirmed that she would send us a copy and that a copy will now be kept at the home. No one living at the home has a Service User Guide. The manager reported that she would ensure this is rectified as soon as possible. It was noted that the newly developed Essential Life Plans might be able to incorporate the Service User Guide, which is person centred and in an appropriate format to suit the needs of the individual it belongs to. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 10 One health care professional felt that “They could improve by ensuring all information is service user friendly”. There have been two recent new admissions to the home. One person confirmed that they have settled in well. The other person reported that they “hadn’t yet settled in but was getting on ok”. One person’s case file showed that they had their needs assessed before being offered a place. The transition period was longer than anticipated as extra staff needed to be recruited to ensure their needs would be met. The manager reported that the extra transition time was beneficial as it enabled the person to get to know everyone well before they moved in. The manager reported that they ensure compatibility with the other people living at the home before anyone moves in. Daily notes showed that many visits to the service for meals and cups of tea took place along with staff visiting the person in their previous placement. The manager reported that they are currently following the previous placements guidelines for the possibility of absconding. Staff who spoke to us knew the procedure to follow in the event of someone absconding. The home has a ‘missing persons’ policy in place. Everyone living at the home has a residency agreement. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 6,7,9 Quality in this outcome area is good. People have a care plan, which reflects their assessed needs. We observed people making decisions about the way they live their life. Within this area the home are providing excellent outcomes for the people using the service. People are supported to take risks to enable them to be as independent as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of the inspection process we case tracked two people. Both had care plans, which reflected their assessed needs. The manager explained that they are currently working to one person’s previous placements care plan rather than make unnecessary changes for the person. This is being kept under review at the monthly key worker meetings and this will be amended as changes needed are identified. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 12 Monthly key worker reports demonstrate that they have considered the environment, behaviours, communication, personal care support, physical and mental health needs, daily living skills, diet, activities, family contact and medication. There is also a section, which reminds the key worker to ask ‘how the person is feeling about their lifestyle’ at the time of the meeting. These meetings are very good practice as it provides the person at the centre of the service a regular opportunity to ensure they are satisfied with the outcomes provided to them. During the site visit people using the service were observed making decisions for themselves. One person had decided they did not wish to attend an appointment that day and they rang and cancelled it. They then appeared ‘worried’ that they had done this however staff members were observed reassuring them that it was their choice whether they attended or not. The staff also explained the consequence of not attending with sensitivity. When asked in our surveys, do you make decisions about what you do each day? Two people responded yes, one person said sometimes and two said usually. Care plans include a 13 Step Risk Management Plan although these have not all been completed yet. The manager confirmed they are in the process of completing them now. These plans include a summary risk assessment and a management plan. They identify behaviours, which may be of concern and put strategies in place to minimise any potential risks. A good practice recommendation was set at the last inspection with regard to when restrictions and controls are placed on people using the service. The reason why such controls are necessary should be recorded and where possible the person is asked to agree them. This recommendation does not appear to have been met, however people are currently having restricted access to the front door. This was discussed with the manager who agreed to address this. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12,13,15,16,17 Quality in this outcome area is good. People using the service are able to access appropriate activities within the local and wider community. Links with family and friends are encouraged. Generally people’s rights are respected however one person’s right to privacy may be being jeopardised. People told us they enjoy the food at Abucus house. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One person told us that they have just visited a local charity shop where they are hoping to start supported employment. They explained that this would include sorting out the clothes that comes in. They confirmed that they were Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 14 looking forward to starting. This will be the third work placement they have accessed. The home has an activity plan for each person living there. The plans include life skills and are developed with full participation form the person using the service. The manager reported that they are hoping to encourage more independence for people when accessing the local community. One relative commented in our survey; “ I think they have done very well with my relative, their independence has improved”, and a staff member stated, “ We support the clients well in their choices, education and leisure”. People told us they enjoy going to the Gateway club and attending the London road club in the evenings. One person confirmed they enjoy going out on their own and will often get the bus to meet their relative. Some people attend day services in Gloucester, which they tell us they enjoy. Another person told us they started college in September two nights a week. They are studying maths and English. For leisure they report that they also go to the Gateway social club and also enjoy going out for a drink with friends. They also reported they enjoy buying and listening to CD’s in their room and researching things on their pc. The manager explained that one person living at the home chooses not to attend any clubs, day services or colleges preferring to just pop out for a coffee with staff members or to do some shopping. Last year the home made group holiday arrangements, however staff report that this year there are plans for individual holidays of their choice. One person has reported that they would like to have a holiday on a barge this year. Evidence demonstrates that links with family and friends is encouraged. One relative told us they have daily contact with the home. Daily diaries show that the staff team supports regular home visits. The home has it’s own transport, which is available for all of the people living at the home. One the day of the visit arrangements were being made for one person to visit their family. The home has recently had a pay phone installed in the lounge. The manager reported that they have had to put some restrictions on its use to ensure that it is fair. People have a number of free calls allocated to them for the week. One person expressed concern that they felt that staff members listened in on their calls and always wanted to know who they were talking to. Staff members told us that each person living at the home has a key to their bedroom however one person reported that although they have been given a key they are unable to use it due to a problem with the locking device. This was resulting in the person not feeling happy that staff could just wander in and out of their room. They commented “Staff go in my room all the time and Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 15 don’t ask”. Discussion with the manager confirmed that she is aware that there is a problem with the lock and that a request has been submitted to the maintenance team. A requirement has been made to ensure this work is completed as soon as possible to ensure the person’s right to privacy is respected. Overall the manager and staff team respect people’s rights to access facilities and lifestyle opportunities. One health care professional commented in our survey; “In my experience the home has become more flexible around accommodating a resident’s wishes for more independence. However it is not clear how supportive the home is of pursuing the resident’s wishes for more independent living, this of course is not solely down to the staff team but includes the care manager”. The home runs a four weekly menu, which is chosen by the people living at the home. People are encouraged to participate in household tasks and meal preparation. One person told us they sometimes cook the evening meal for the rest of the people using the service. One person’s care plan identifies that they are not safe to be left alone in the kitchen, so staff need to support them with making drinks or snacks. Menus sampled appeared to offer varied and healthy balanced meals. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 18,19,20 Quality in this outcome area is good. People are offered the level of personal support they require. Staff ensure that health care needs are met, but medication records occasionally fail to demonstrate that all medication has been given. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans identify the amount of support people living at the home require. For example one case file states that the person will require support when washing their hair at times they choose. The level of personal support needed is kept under review and is an area discussed at the monthly key worker reviews. Another care plans states that the person does not like the light off at night and reminds staff of this. Each person has a weight chart to enable staff to monitor that people living at the home remain a healthy weight. One person’s care plan identified that they Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 17 need to follow a healthy eating plan. Evidence shows that this has been encouraged and appointments have been made with the dietician. Daily notes evidence that each person using the service has access to healthcare professionals such as consultant psychiatrist, dentists, optician, chiropodist, doctors and clinical psychologists. We received comments relating to healthcare from relatives and healthcare professionals including: The care staff is prompt in attending to the health needs of the users and follows professional advice given. Healthcare needs are always met. They provide good quality support. I hope they continue to maintain the high level of input to the individuals in their care. The home has taken on the idea of working with the multidisciplinary team. The home meets the personal needs of people, all are treated as individuals and are all equal. The manager is currently developing individual health plans for each person using the service. These are in a person centred format and includes a section; “This is what I think and feel about going to the doctors”. This identifies if people have any fears or concerns with regard to visits to the doctor or hospital and ensure staff can be prepared for any appointments, whilst minimising any stress for the person living at the home. Behavioural management is monitored with input from the Consultant Psychiatrist. As mentioned earlier in this report the home are currently completing individual 13-step risk management plans to ensure behaviours are managed safely. The manager confirmed that all staff members are trained in physical intervention techniques and attend regular refresher courses. The AQAA returned to us sates that there has only been one occasion when physical intervention was used in the past twelve months. We looked at the arrangements for managing medication in the home. Overall medication is managed well however there were a couple of unexplained gaps on the MAR sheets. This made it difficult to determine whether the medication had been given or not as it was not dispensed in a blister pack. It would also be good practice for any handwritten entries on the MAR sheet to be signed ideally by two staff members and dated. No staff member is allowed to administer medication until they have attended the training. It appears that medication training is not available very frequently, which can result in staff being unable to administer medication for a long time. The manager confirmed that this could result in difficulty when trying to work a flexible rota system. It is strongly recommended that all staff receive medication training within the first three months of their employment. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 18 It is also recommended that the manager carry out regular three monthly ‘in house’ medication refresher training to ensure staff maintain their competency. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 22,23 Quality in this outcome area is good. Overall this is a service where people are listened to and a service rarely complained about. People are protected from any form of abuse where possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People told us they could talk to various individuals if they need to raise concerns. These include their key worker, the manager, family and their care manager. One person said they would always go to their mother in the first instance. Another person reported they would go to “someone above the staff who is in charge”. One person commented in our surveys that they would go to the manager to complain. Overall people appear to know how to make a complaint if they need to. The home has a complaints log although no complaints have been recorded in the past twelve months. It is recommended that the complaints log records actions, timescales and outcomes to enable the manager to monitor any emerging trends or patterns. The complaints procedure needs to be included in the service user guide and in an appropriate format to meet the needs of the person. The home holds ‘resident’s meetings’, where people using the service can raise concerns and discuss issues. One person told us they attend the meetings and find them ‘useful’. The manger explained that the residents meeting had Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 20 provided a safe forum for some people to raise some issues in the past. Minutes from the meetings also demonstrate that various issues are discussed. The last meeting took place on 16/05/07. The manager reported that she is planning to increase the frequency of the meetings to every two months. Staff members confirmed that they have attended training in safeguarding adults. Staff who spoke to us appeared to be confident in the procedures to follow if they suspected any form of abuse might be taking place. Three staff confirmed they have a copy of the local protocols for safeguarding adults. The home has a ‘whistle blowing’ policy, which staff was able to explain to us. The majority of the people using the service have their money kept by the home on their behalf. Each person signs a money transaction record when they are in receipt of funds and when money is taken out. It was evident that staff are supporting the people using the service to budget and understand the need to manage their finances so that they have enough money to last them for the week. One person told us they have enough money to buy what they like, which was mainly CD’s. The finance records for two people were sampled and both balanced with the amount of money in the money tins. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 24,25,30 Quality in this outcome area is adequete. The service is providing a homely, comfortable and safe environment for the people who live there. The home is clean and hygienic. Insufficient storage space remains an issue. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the visit to the home we toured the premises and found it to be comfortable, homely and safe for the people living there. It was noted that there still remains a shortage of storage places and shelving in individual bedrooms. This results in people having to leave their belongings on the floor or in boxes in their bedrooms, which could give the feeling that the home is ‘temporary’ and not provide the feeling of permanence and security. This was a recommendation at the previous inspection and therefore a requirement has now been made to ensure this is rectified as soon as possible. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 22 A feature of this home is that all bedrooms have an ensuite facility, which promotes people’s privacy. People told us they are happy with their bedrooms. One person had previously requested a double size bed and the manager confirmed that they are in the process of arranging this. Another person commented that they would really prefer to have their own flat and be able to go out with their ‘mates’ all the time. The manager reports that there are monthly maintenance audits carried out and records kept of maintenance requirements. There appears to be a delay in work being completed after requests have been made by the home. The registered manager should monitor that maintenance work is carried out in a reasonable timescale to ensure the home remains safe, comfortable and bright. The manager confirmed that there are parts of the home that would benefit from a redecoration programme. All water temperatures are checked and recorded weekly. Records show an average of 41c from hot water outlets. Windows have restrictors to safeguard the people living at the home. Risk assessments are in place for windows and the environment. Radiators have thermostat controls. The home runs ‘in house’ training days covering infection control. There was adequate supply of protective clothing located around the home such as gloves and aprons. Anti-bacterial hand wash is available in hand washing areas. The manager reported that the Environmental Health Office (EHO) provide ‘on going’ training called ‘Safer Food- Better Business’. The manager confirmed that the EHO would return in six weeks to ensure the home is working within the guidelines. Data is available for all toxic materials held at the home. All toxic materials are stored securely. The home has a day and night cleaning rota, which is signed and dated on completion. As documented in individual care plans the people living at the home are supported to take responsibility for their own environment with regard to cleaning and tidying up. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 32,34,35,36 Quality in this outcome area is good. Competent and qualified staff support people using this service. People are protected by the home’s recruitment policy and procedures. Staff members have the opportunity to attend training to ensure they have the skills to carry out their tasks. Staff tell us they receive regular supervision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The three staff members who spoke to us confirmed that there are sufficient numbers of staff on duty. The rota shows four staff on duty at all times during the day, which was evident during the visit to the service. During the night hours one member of staff sleeps in and there is also a waking staff member on duty. The staff team consists of male and female staff, which ensures any gender issues can be managed. The manager reports that the staff team includes different age groups and cultural backgrounds, which compliments the Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 24 various ages and interests of the people living at the home. Discussion with the manager indicates that equality and diversity issues are addressed positively. All new staff members undertake a week’s induction period when they complete all mandatory training such as fire awareness, basic food hygiene, manual handling and health and safety. One member of staff commented on their induction and reported in their survey “Because we have service users with mental health problems, we were not fully equipped to deal with their particular needs, mental health training was not provided”. However overall the six staff surveys returned to us confirmed that staff felt their induction covered everything they needed to now to do the job when they started. Evidence shows that further training is also accessed, which includes safeguarding adults, infection control, Autism, Epilepsy and Positive Behaviour Management. The manager confirmed that all staff have attended training in equality and diversity. At the time of the inspection four staff were currently completing their National Vocational Qualification (NVQ) level 3 and two staff have completed their level two. Following discussion with the manager we recommend that it would be good practice for staff members to attend Person Centred Planning training, which should also provide positive ideas for the development of the Essential Life Plan Packs. The manager reported that she has attended training relating to the Mental Capacity Act. She confirmed that an overview into the Act is given to new staff during their induction. Evidence shows that new staff members are recruited, trained and supervised properly. All relevant police checks are completed prior to safeguard the people living at the home. Staff personnel files show that two satisfactory references are sought and identification is confirmed. Staff are provided with a contract of employment. Staff told us they receive regular one to one supervision with their line manager. Supervision records and staff surveys further confirm this. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 37,39,42 Quality in this outcome area is good. People benefit from a well run home. People using this service have the opportunity to raise concerns and share ideas. The health, safety and welfare of people living at Abucus House are promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has the Registered Manager’s Award (RMA) and has nearly completed the NVQ level 4 in care. The manager now has a newly recruited deputy, who can support her in her role. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 26 The manager states in the Annual Quality Assurance Assessment that in the last twelve months the home has become more ‘service user led’, and increased activities for the people living there has in turn increased their independence. This appears to be a developing service, which aims to provide positive outcomes for the people living there. The home submits monthly management audits to the Commission. The new Essential Life Plan Pack will include a section where the person using the service’s can share their views on how they see the service provision. The manager completes regular ‘in house’ audits to ensure the smooth running of the home and the safety of the people living there and the staff. Various health and safety records were sampled as part of the inspection process and all appeared in order. Records show that regular fire checks, drills and instruction are carried out. The home has a current fire risk assessment and benefits from having a sprinkler system installed. Portable electrical equipment was checked 5/11/07. The manager reported that the Gas Safety Certificate is held at the head office. Hot food is regularly probed to ensure it is served at a safe temperature. Fridge and freezer temperatures are recorded. All accidents and incidents are recorded properly. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 27 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 2 2 3 3 X 4 3 5 X 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 2 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 28 No 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. 1. Standard YA16 Regulation 12(4)(a) Requirement The registered manager must make suitable arrangements to ensure the locking device on one bedroom door is repaired or replaced to ensure the privacy of the person whose room it is. The registered person must ensure sufficient storage space and shelving is available to all the people living at the home. Timescale for action 02/04/08 2. YA25 23(2)(m) 02/04/08 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. 2. 3. 4. Refer to Standard YA1 YA1 YA20 Good Practice Recommendations It is recommended that a copy of the updated Statement of Purpose be kept at the home. It is recommended that people living at the home have an individual copy of the service user guide, which is in a format, which make sense to them. It is recommended that all hand written entries on the medication administration records are dated and signed by two staff members. It would be good practice for all new staff to receive DS0000064394.V354842.R01.S.doc Version 5.2 Page 29 YA20 Abacus House 5. 6. 7. 8. 9 YA20 YA35 YA22 YA24 YA6 medication training within the first three months of their employment. It is recommended that any gaps on the medication administration records are explore and recorded. It is recommended that staff have access to Person Centred Planning training. It is recommended that the complaints log is further developed to include actions, timescales and outcomes. It is recommended that the home have a planned maintenance and renewal programme for the fabric and decoration of the premises with records kept. It is recommended that when controls or restrictions are placed on any service user the reason why such controls are necessary is recorded and where possible the service is asked to agree them. This recommendation remains unmet. Abacus House DS0000064394.V354842.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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