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Inspection on 10/02/09 for Abberleigh House

Also see our care home review for Abberleigh House for more information

This inspection was carried out on 10th February 2009.

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.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Abberleigh House 17 Grove Park Road Weston Super Mare North Somerset BS23 2LW     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: Paula Cordell     Date: 1 0 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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: • • • • 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 31 Information about the care home Name of care home: Address: Abberleigh House 17 Grove Park Road Weston Super Mare North Somerset BS23 2LW 01934621397 01934623162 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr Joseph Conlon,Mrs Jacquetta Miner care home 9 Number of places (if applicable): Under 65 Over 65 9 learning disability Additional conditions: 9 May accommodate up to 9 persons aged 18 years and over with learning disabilities. May include persons aged 65 years and over Date of last inspection Brief description of the care home Abberleigh House is a large Victorian house providing residential care for younger adults with learning disabilities. The home is set in a quiet residential area with a large rear garden, which has goats and hens. Its sister home, Abberleigh Grove, is in the next road and individuals from the two homes share many social events together. Most staff work in both homes as well as in the supported living service run by the homes owner. The home aims to support the individuals to develop their independent living skills in a family environment with a view to moving on to more independent living if appropriate. Staff support individuals to access community facilities and pursue their social, vocational and leisure interests. Respite care is offered to one client at a time. Care Homes for Adults (18-65 years) Page 4 of 31 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 peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit as part of a key inspection. The purpose of the visit was to review the progress to the requirements and recommendations from the visit in February 2007. In addition to monitoring the quality of the care for the people living at Abberleigh House. There have been no complaints received in respect of the service provided at Abberleigh House. The visit was planned using information received between this and the last visit. This included the annual quality assurance assessment that was completed by the provider, Care Homes for Adults (18-65 years) Page 5 of 31 correspondence and surveys. Surveys were sent to staff, professionals and the people living in the home. Five staff and two people receiving a care service returned the surveys. The visit was conducted over six hours. An opportunity was taken to speak with a number of people living in the home and the staff on duty. The providers made themselves available during the visit. Records were viewed relating to the care of the individuals and the running of the home in accordance with the Care Home Regulations and a tour of the home. What the care home does well: What has improved since the last inspection? What they could do better: 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 7 of 31 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 8 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst individuals have information about the service this is not clear about the respite care facility or that individual have to contribute towards the transport costs. This could be misleading to individuals and does not provide an open and transparent service agreement. Individuals can be confident that their assessed care needs are being met. Evidence: The home has a statement of purpose and a service user guide. This information clearly described the service provided to the individuals who live in the home. However, the home has one respite care bed and this information was not included in the statement of purpose. Abberleigh House provides accommodation and personal care to nine individuals with a learning disability. As already mentioned the home provides respite to individuals living in the community. North Somerset County Council work closely with the home in relation to the respite care bed and this is usually planned throughout the year. The Care Homes for Adults (18-65 years) Page 9 of 31 Evidence: provider stated that occasionally the home will be asked to take an emergency placement but the home will ensure that all the required documentation is in place which includes a the local placing authority assessment and care plan. One person was staying in the home for a short period. They said that they liked staying in there and that they had been before. It was evident that the individuals had built good relationships with the person. Staff stated that the individuals enjoyed people staying in the home for short periods and usually this was people they knew from their day services. Care planning information was available for the individuals that stayed in the home for short periods. The assessment process is clearly described in the statement of purpose and the homes policy on assessments. Each person had a copy of the placing authoritys care plan and assessment. The provider completes an assessment of need to ensure that they can meet the needs of the individual. Contracts were viewed for some of the individuals living in the home. These stated that the fees included costs for day care and travel to and from. However, individuals are contributing their Disability Allowance for the running costs of the vehicle. There were no agreements from individuals or their representatives placing authority consenting to this arrangement. In addition it was not included in the statement of purpose. It was difficult to determine whether the present system was equitable as no records are kept of the costs of the running of the vehicle or the frequency individuals use the transport. Care Homes for Adults (18-65 years) Page 10 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals can be confident that their assessed care needs are being met. Staff are knowledgeable about the needs of the individuals however, this is not fully captured in the documentation relating to meeting needs and keeping people safe. Evidence: Three care files were seen during the course of the visit as a means to determine the outcomes for people living at Abberleigh House. This included talking with staff and the individuals living in the home. Each person had a profile giving an overview of their support needs, including their likes and dislikes. The information was clear and demonstrated that the service was tailored to the individual. These had recently been reviewed and updated. Individuals had two care files one containing letters, placing authority assessments and care plans and the monthly and six monthly reviews. The other was a health Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: action plan which will be discussed later in this report. The reviews were completed on the placing authoritys care plan. What was lacking was specific plans of care drawn up by the home that clearly described how the home was intending to support individuals. The goals that had been identified lacked specific details on how they were to be met. For example one goal stated for the individual to loose weight another was to take regular exercise however there was no clear direction for staff or the individual to follow. Whilst staff described how the individuals were being supported one member of staff was unaware that the individual was being supported to loose weight. If goals are not specific there is a risk that staff will not be consistent in their approach or that they are being implemented. A member of staff stated that they had read the care files when they first started as part of the induction but had rarely read them since. This indicates that the care files are not a working document. The provider acknowledged that there was some work to be done in this area in expanding the care plans and making them more accessible. Some information could be archived for ease of reading. It may be beneficial to review the present recording of care to ensure it is line with current best practice for supporting individuals with a learning disability for example Essential Lifestyle Planning (ELP), Planning for Alternative Tomorrows with Hope (PATH) or MAP. Each person had information about basic areas of risk in the care profile and separate risk assessments. These lacked full details on how the home ensures their safety. Risk assessments covered topics like usual household risks, accessing the community, swimming, bathing to name a few these were broad statements and only described the level of staff support for example always supported or supervised or independent in this area. These should be expanded and broken down more to fully detail how the home is minimising the risks including detailing what the risks are. Individuals were involved in the running of the home and confirmed that regular meetings take place and that they were involved in choosing the decor, menu and activity planning. Surveys from individuals confirmed they could choose to do what they want during the day, in the evenings and at weekends and staff were available to support them. Where individuals can at times challenge the service there was a lack of information on the triggers, the behaviour that is exhibited and what staff should do to support them. Staff said that the majority of the time all the individuals get on reasonably well. From talking with staff, the deputy manager and the provider it was evident that individuals are treated in a respectful manner and are encouraged to be active members of the household. Individuals are encouraged to be as independent as Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: possible. Three individuals have moved on from Abberleigh House into supported living. Individuals in surveys received prior and conversations during the visit confirmed that they liked living in Abberleigh House. Observations was that the individuals could have access to all parts of their home and good relationships had been built with each other and the staff that were on duty. Individuals were obsereved actively sought out the provider to say hello and to talk about what was going on both in the home and the day centre. Care Homes for Adults (18-65 years) Page 13 of 31 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. Individuals are encouraged to lead active lifestyles based on choice and supported to maintain contact with friends and family. Individuals are involved in the running of the home. Individuals are offered a healthy diet. Evidence: From reading care records, the staff handover record, talking to staff and individuals it was evident that individuals are supported to lead active lifestyles both in the home and the community. Each person has a structured timetable of activities during the day from Monday to Friday with attendance at the local day centre, part time employment paid or voluntary or attendance at the local college. Day care was funded by the local placing authority. The level of daily activities was not captured in the records for individuals or the daily handover record. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: Individuals confirmed that they went out five day a week to the above. Activities are organised every Wednesday evening where individuals are supported to go to the pub, play skittles, bingo, arts and crafts in the home or on some evenings visit individuals living at Abberleigh Grove. Staff stated that Abberleigh Grove has more communal space and an activity room so social evenings are organised there. Staffing is flexible to suit the needs of the individuals and the activities in the home. Three nights a week three staff work in the home at all other times there are two staff. Records were maintained of the staff working in the home confirming this. The provider said that individuals are supported to go on holiday some go with relatives and others have enjoyed an activity holiday in Cornwall. It was not clear who would be offered a holiday this year. Individuals confirmed that last year trips were organised in the summer to places of interest including Paignton Zoo, Crickets and Thomas and trips out to country pubs. The daily handover record captured other activities including everyone sitting together and chatting, assistance with room cleaning and going out locally. Staff stated that the everyone has an opportunity to go out and adequate staff are available to support them outside the home. Two of the individuals go out in the community independently. One person attends church on a regular basis. From conversations with staff and the provider it was evident that the care is tailored to the individual with a commitment to meeting the cultural and diverse needs of each person. This is clearly described in the aims and objectives of the home and the statement of purpose. From talking with the individual on respite care it was evident that they continued to take part in the activities that they were doing at home including attendance at Clubs and their day care. Some of the individuals attend clubs in the evenings. It was evident it was an opportunity to meet with friends. Individuals are encouraged to participate in the daily running of the home including household chores. Individuals confirmed that they were actively involved in cleaning their bedrooms and assisted with cooking and the washing up. It was evident that they were happy to help and felt valued. From talking with individuals and staff it was evident that people are encouraged to maintain contact with friends and family. Records were maintained of the contact that is maintained. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: A daily log/handover record is kept in the hallway so that staff can record who is coming on duty, any visitors, the name of the person staying for respite care, meals provided and group or one to one activities offered. There was no individual diary which captured what the individuals were doing or how they were being supported on a daily basis including their emotional wellbeing. Menu planning is completed with the individuals on a weekly basis. Individuals spoken with said they enjoyed the food. Individuals were observed being asked what they wanted in their sandwiches for the following day. Care Profiles included individuals likes and dislikes. As mentioned there was a lack of guidance for staff to follow with weight reducing diets with clear goals for the individual. Individuals were seen helping themselves to tea and coffee. A fruit bowl was available for individuals to help themselves. Care Homes for Adults (18-65 years) Page 16 of 31 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. Individuals can be confident that their personal and health care needs are being met. Individuals can be confident that safeguards are in place in relation to the medication administration however this would be enhanced if the guidance for staff was expanded. Evidence: Individuals have an health action plan which has been developed in response to a requirement from the visit in February 2007. These describe how individuals should be supported to stay healthy. This includes information about appointments attended with health professionals. Information was clear and evidenced that individuals have access to a wide range of health professionals including a GP, dentist, opticians and other health professionals who support people with a learning disability. Health matters were responded to promptly. The home does not complete individual daily diaries so it was difficult to ascertain other than from conversations with the staff, the deputy and the individuals the frequency of personal care that was being delivered. Staff stated that bathing is Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: completed mainly in the evening as individuals leave the house early for day care. Seven of the individuals are independent in this area and two people require support. It would be good practice for staff to complete daily diaries for all individuals so that there is a record of all care delivered including monitoring a persons general wellbeing. There is a risk where staff only record the significant changes that this could contain only negative aspects of a persons wellbeing. The home maintains a record of accidents and incidents. It was evident that the home was taking appropriate action in the event of an emergency occurring. Staff records seen confirmed that they had attended training in first aid and manual handling. The home has a policy on medication. This was reviewed on this occasion. It was noted that this did not include what staff should do in the event of an error, an omission or where medication is lost. The home uses a monitored dosage system which is supplied by a local pharmacist. Records were maintained of all medication entering the home, disposal and administration. Medication records sampled were all in good order including the signatures of staff. Each person has a homely remedy policy of over the counter medication that they can take. Staff have received medication training from an external company who provide the medication. Staff confirmed that medication training had been given to them as part of their induction. Care Homes for Adults (18-65 years) Page 18 of 31 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. Individuals can be confident that their concerns would be listened and acted upon. Individuals are assured that their rights and wellbeing are being promoted. Individuals have responsibility for their own finances, however the lack of record keeping could put people at risk. Evidence: The home has a complaints procedure. Completed surveys from individuals living in the home confirmed that they were aware of the procedure. One individual said that if they were unhappy they would speak with the staff and the provider. Individuals were observed talking to staff when they came home from their day activities it was evident that they felt confident to talk to both the provider and the staff. Staff had a good understanding of the needs of the individuals and how these were communicated. The Commission for Social Care Inspection has not received any complaints. Each person has a section in the care file for recording concerns and complaints. There was no central record which would make it easier to audit complaints. This should be rectified detailing the nature of the complaint, the actions taken to address the concern and the outcome. From talking with the provider, the deputy and staff it was evident that they were aware and promoted good values in relation to supporting individuals with a learning Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: disability including their rights, making decisions and having control over their day to day lives. Staff have had training on these areas including relationships. The provider has completed training on the Mental Capacity Act. Policies and procedures relating to safeguarding were in place as noted at the last visit. Staff receive training from the provider who has attended a train the trainer course specifically on abuse with North Somerset Council. Staff were aware of the policy and the importance of reporting poor practice and concerns to the senior management team. Staff receive training on supporting individuals that may at times challenge. As mentioned previously staff are knowledgeable on the support needs of the individuals but this could be better recorded relating to support the person needs and the triggers. Finances were not looked at on this occasion. The home is looking to implement a better recording system which safeguards both the individual and the staff and enables a full audit to be completed. This was in response to recommendations that were made in January 2009 when a visit was conducted at Abberleigh Grove. This should include a review of the homes financial policies which does not guide staff sufficient on the process or the expectations in relation to ensuring there are financial safeguards. Care Homes for Adults (18-65 years) Page 20 of 31 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. Abberleigh House provides a homely and safe place to live which is meeting the needs of the individuals. Evidence: Abberleigh House is in a residential area in keeping with the local neighbourhood in an elevated area. The home is within easy walking distance to the town centre and close to local amenities. Abberleigh House is decorated and furnished to a good standard. Communal areas were spacious. Individuals have access to a large lounge and an open plan dining room/kitchen. There is also a small computer room that individuals can access with games and puzzles. Each person has a bedroom which has been decorated and personalised to suit the individual. There are two ground floor bedrooms and one with an ensuite. The homes written policy states that individuals can have keys to the front door and their bedroom. Presently two individuals have keys. Locks are not automatically provided on bedroom doors but will be provided if they should wish. This should be kept under review periodically with consideration to installing a lockable device so that if people Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: change their mind this can be remedied promptly. It was noted that there was damp in bedroom 3 and the windows to the rear were starting to deteriorate badly. This must be investigated and the appropriate action taken to address the issue. Adequate bathing and toilet facilities are situated throughout the home. The home was clean and free from odour. Both staff and the individuals living in the home are actively involved in the household chores. From records it was evident that there was a prompt response to repairs in the home. There is an ongoing decoration programme. The provider stated that this financial year the kitchen is being renovated with new units and decoration being undertaken. In addition the provider stated that there is a plan to build an activity shed in the garden for the use of the individuals living in the home. The home has policies relating to infection control. Good systems were in place relating to health and safety as evidenced in conversations with the provider, staff and observations. The home has risk assessments and guidance for staff relating to food hygiene. There is a very large garden to the rear of the property, mainly laid to lawn. A small area houses some chickens and some goats which the individuals help to look after. Care Homes for Adults (18-65 years) Page 22 of 31 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. Individuals are supported by competent and adequate staff. Evidence: In the main the home is staffed with two members of staff with additional staff being employed three times a week to support individuals with their social activities. There is an expectation that staff will work in Abberleigh House, Abberleigh Grove and supporting individuals in the community which is called Abberleigh Care. Twenty staff in total work for the company. Staff spoken with on this occasion and when visiting Abberleigh Grove viewed working as the different areas as being positive and offered them variety in their day to day role. From talking with staff it was evident that they were aware of the needs of the individuals living in Abberleigh House. Recruitment information was viewed for three members of staff. All information was in place to demonstrate that a thorough recruitment process had been undertaken. Staff personnel files are held in the home of the provider for security reasons. Evidence of staff training was held in the home including induction. A member of staff stated that they have been impressed with the level of training that has been offered Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: including the homes induction. The home presently does not complete the Learning Disability Qualification as part of the homes induction. This was discussed with the provider during the visit at Abberleigh Grove and it is evident that the provider is exploring how this can be introduced. Training records provided evidence that staff have recently completed food hygiene, manual handling and first aid. In addition to statutory training staff have completed training relevant to their roles and the people they support. This has included epilepsy, mental health, autism, supporting individuals that challenge, relationships and safeguarding training to name a few. Staff stated that the provider delivers some of the training during team meetings. The home has responded to a recommendation to ensure that the training records capture the level of training that is available. Supervision records are held in the providers home along with the recruitment information. This was made available during the visit. It was noted that at least four members of staff have not had more than one supervision in the last twelve months. The National Minimum Standards recommends that staff have at least six formal supervisions per year. Staff are supervised by the senior management team which includes the providers, deputy managers of Abberleigh House, Abberleigh Grove and Abberleigh Care. Staff stated that they felt supported in their role and there was a good level of support from both the providers and the deputy manager. Staff meetings are held every three months and the senior management meet up every month. Both staff spoken with during this visit said they enjoyed working in the home. It was evident that they were committed to the homes vision and aims of the service. Care Homes for Adults (18-65 years) Page 24 of 31 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. Individuals benefit from a well managed service with good measures of safety in place to protect the individuals. Evidence: Abberleigh House is privately owned. The providers Dr Conlon and Mrs Miner have a dual role in managing this home and Abberleigh Grove. Abberleigh Grove is situated five minutes walk away. Doctor Conlon is the registered manager and holds a number of qualifications in psychology and education. He has been the registered manager of Abberleigh House since it opened in 1989. Mrs Miner holds qualifications in education, a certificate in management and is a National Vocational Qualification Assessor. The day to day management is cascaded down to a deputy manager. The deputy manager position is being reviewed as this post becomes vacant over the next month. A member of staff spoke highly about the senior management structure and the support that was given to them on a day to day basis. It was evident that the providers were involved in the care and visited the home on a frequent basis. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: Staff described a relaxed working atmosphere with good support mechanisms in place. It is evident that staff and the individuals in the home have a good rapport with each other and the owners of the home. Staff are encouraged to contribute their ideas and question practice. Senior management regularly spend time discussing principles of care with the staff group. It is evident that the senior staff team are regularly reviewing the quality of the care provision. The home has a policy on quality assurance. However, it is not clear how the views of the individuals, their relatives and significant stakeholders are sought on a more formal level in relation to the quality of the care provided. The home completed the quality assurance assessment as required by the Commission for Social Care Inspection prior to this visit. The information in the assessment was minimal and did not fully capture the service provided at Abberleigh House. There were no clear measures that detailed the quality of the service being provided or what improvements the home was planning to make. However, it was clear that the individuals would be encouraged to make choices about their lifestyles. It is strongly recommended that more information is recorded as this will provide evidence on how the home service is supporting people in the home. The home has a good rolling programme of maintenance and clear records are maintained. The home has a current gas and electrical testing certificate. Electrical appliances are checked annually. A fire log book is maintained which details the checks on the equipment and staff participation in training and fire drills. Staff confirmed the had recently attended fire training. Water temperatures are controlled to prevent burns and scalds. Risk assessments were seen relating to the environment which included radiators. Risk assessments had been kept under review and covered all areas in the home. The home was awarded an award from North Somerset County Council in respect of good food hygiene measures being adopted. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R 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 27 of 31 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 Requirement 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 Requirement Timescale for action 1 5 5 The statement of purpose 11/04/2009 must be expanded to include the respite care service. This will ensure that individuals have full information prior to making a decision to move to the home. 2 5 5A Contracts of care must include details of the fees and what is not included. Ensuring an open and transparent service. 10/04/2009 3 6 15 Care plans and risk 11/04/2009 assessments to be expanded and developed to reflect the individual. Ensuring a consistent approach. 4 20 13 For the policy on medication to be review and expanded to ensure that it includes guidance for staff in the event of a medication error, 11/03/2009 Care Homes for Adults (18-65 years) Page 28 of 31 omission or where medication is lost. Ensuring clearer guidance for staff. 5 24 24 Investigate the damp in bedroom 3 and take appropriate action to alleviate. Making this area more pleasant to live. 11/05/2009 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 1 5 Individual should be consulted on the contribution of their disability living allowance for the use of the homes transport. This should be equitable and based on usage. Where individuals lack capacity then their representatives and the local placing authority should be consulted. Review the care planning tool to ensure based on current good practice guidelines for supporting people with a learning disability. A daily record should be maintained of how the individuals are supported demonstrating that their assessed care needs are being met including activities that they participate in. For the home to maintain a daily diary for each person capturing all aspects of care deilivery and a record of the persons general wellbeing. For the home to review the financial policy to include the role of staff and safeguards that are put in place to protect the money belonging to individuals. To implement an audit tool in respect of money belonging to the people living in the home. Replace windows where needed. For staff to have at least six formal supervision sessions per year. 2 6 3 13 4 18 5 23 6 7 8 23 24 36 Care Homes for Adults (18-65 years) Page 29 of 31 9 39 for the providers to develop a questionnaire for individuals using the service, their relatives and other stakeholders in seeking the views on the quality of the care provided. Care Homes for Adults (18-65 years) Page 30 of 31 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. Copyright © (2009) 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. 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