Inspection on 09/08/07 for Adrian House

This inspection was carried out on 9th August 2007.

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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Adrian House 15/10/09

Adrian House 19/09/06

Adrian House 01/11/05

Adrian House 02/06/05

Adrian House 26/01/05

Adrian House 14/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Adrian House 15/17 Spencer Place Chapeltown Leeds West Yorkshire LS7 4DQ Lead Inspector Carol Haj-Najafi Key Unannounced Inspection 9th August 2007 10:00 Adrian House DS0000001407.V346659.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 Adrian House DS0000001407.V346659.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 Older People and 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. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Adrian House Address 15/17 Spencer Place Chapeltown Leeds West Yorkshire LS7 4DQ 0113 249 0341 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) Adrian Maguire Adrian Maguire Care Home 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (9) of places Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th September 2006 Brief Description of the Service: Adrian House is a family run home which was registered before the introduction of the Residential Care Homes Act as a care home for men with a mild learning disability. The accommodation is in two joined terrace houses with large garden in the Chapeltown area of Leeds, close to bus routes and local amenities. The home is three storeys high with bedrooms on the first and second floors and no lift. All bedrooms, which can offer single occupancy, are in excess of the minimum size requirements. None have en suite facilities. Communal areas are on the ground floor. The proprietor/manager has lived in the house with his family for many years. The adult members of the family, with the assistance of a paid part time care worker provide support. Most of the residents are over 65 and have lived like members of the proprietor’s extended family. The standard fee charged by the home is £333 per week. This information was provided on 9 August 2007, during the inspection. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors carried out a site visit that started at 10.00am and finished at 4.00pm. During the inspection process all of the key standards were looked at to try and find out what it was like to live at the home. The last key inspection was carried out in September 2006. An annual quality assurance assessment (AQAA) was completed by the home and this information was used as part of the inspection. Surveys were sent to people who live at the home and relatives; responses from the surveys have been included in the inspection report. Four surveys were received from people who live at the home, all of which were completed with help from staff. Feedback was given to the manager at the end of the visit. During the visit the inspectors looked around the home, spoke to people who live at the home, staff and the manager. Care plans, risk assessments, healthcare records, meeting minutes, and staff recruitment records were looked at. What the service does well: The admission process for the respite service is good. People’s needs are appropriately assessed before they stay at the home so they can be sure that their needs can be met. Everyone works hard to make sure people receive a good quality service and person centred care. They had very good knowledge about the people who live at the home and how they look after them. The manager, his wife and family live at the home and spend a lot of time with people who live there. They have clear views about making sure they offer a personal service and they operate like an extended family. The home is well managed. Care needs are clearly identified for people receiving a respite service and this demonstrates that their care needs are met. People at the home were very positive about the care they received and said they were happy living at the home. They said they go out when they want, choose when to go to bed and staff were very good. Daily routines include visiting the bookmakers, the local café, mini mart, health centre and a neighbour’s house. They talked about how much they enjoyed recent trips to the coast, which included Morecambe and Scarborough. Detailed records were available for any incidents when people had raised concerns. There was also evidence that the manager had contacted other professionals to seek guidance and advice. This makes sure any events can be monitored and are dealt with appropriately. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 4 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Previous inspections and procedures indicate that a thorough admission process is carried out to make sure the home can meet the needs of people who move into the service. The admission process for the respite service is good. People’s needs are appropriately assessed before they stay at the home so they can be sure their needs can be met. EVIDENCE: Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 9 Four people were living at the home at the time of the inspection. They had all lived at the home for over two years so there was very little recent evidence for many aspects of this outcome group. The admission process was looked at during previous inspections and the relevant National Minimum Standards were met. Sometimes people stay at the home for respite care. The manager talked about the admission process for people receiving respite care, which is coordinated with social services. He explained that comprehensive assessments are completed by social workers or care managers before people start using the service. People are gradually introduced to the service and the amount and type of introductory visits are determined through the assessment process. One respite person’s file was looked at. There were assessments and very detailed accounts of all visits to the home. A file for a person who was looking at moving into the home long term and had been receiving respite care was also looked at. This had very good information about the person’s needs and details of respite stays. Although the admission process was not complete there was evidence that several people had already been involved, this included the person and their relative, the respite coordinator, a speech therapist, social worker, and a day centre manager. The manager talked about providing respite and a long term service and said this generally worked well. There had been some difficulties which had caused tensions in the house but there were good records of how this had been dealt with and how people who live at the home had been consulted about future respite stays. The manager spoke about a recent request to admit a man as an emergency, which he refused on the grounds that it would have an impact on the well being of the other people living in the house. The AQAA states as part of the admission they hold a house meeting so the people who live at the home can give their opinion about any future admissions to the home. A log of any respite stay is sent to the social worker after each period. These are good care practices that demonstrate the home uses a person centred approach. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Everyone works hard to make sure people receive a good quality service and person centred care. Care needs are clearly identified for people receiving a respite service and this demonstrates that their care needs are met. Care needs are not clearly identified for people who live at the home so it was less evident that their needs were being met. EVIDENCE: Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 11 Three people’s care records were looked at. A different format was used for people who live at the home and those who stay at the home for respite care. One file, for a person receiving respite care, had very good information about how their needs should be met and potential risks. Records explained what they liked and disliked, and there was details that confirmed care plans were being followed and people had engaged in activities that were recommended in their plans of care. Two files, for people who live at the home, had good information but it was difficult to find which was up to date information. Also some information was missing. Care plans had been regularly reviewed and there had been a focus on important care needs but other important areas had been overlooked. For example people who live at the home had been concerned about the future of the home and a care plan was written to make sure people were reassured and involved in things that were related to the home. However, information about anxieties when out and about in the community had not been included in care plans. The men who live in the home have lived together for many years. As this changes and new support staff are introduced the care plans need to be together in one place in each file so that anyone assisting with their care can read them at a glance. The manager agreed to look at using the respite care planning format for people who live permanently at the home. Detailed daily logs were kept for people on respite care but there was less recent information recorded in the files of people who lived in the home permanently. With the help of the manager this was found in the computer records, although the information was still very limited. The manager was asked to make sure sufficient information was written for people who live at the home. Only three people work at the home (including the manager and his wife who live on the premises) and all were spoken to during the inspection. They all had clear views that the care was person centred and they operate similar to an extended family. They all had very good knowledge about the people who live at the home and how they look after them. The AQAA states the home has improved in the last twelve months by increasing contact with other professionals and obtaining different views, help and advice, and this has helped have a better understanding of people’s individual needs. They also feel this has improved the running of the home. The AQAA states the services of an advocate are provided for any person living at the home who wishes to discuss any problem or concerns they may have. At Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 12 the inspection the manager confirmed that in the past, an advocate from age concern had visited people who live at the home and they were trying to organise for them to visit again. The AQAA states Adrian House holds regular house meetings so everyone is given the choice to give their views concerning the running of the home. The staff identify risks and use a common sense approach which does not restrict independence. For example, one person with limited vision always goes out with a friend he has lived with for many years and both continue to enjoy their walks around the local community. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 14 12, 13, 14, 15, 16 & 17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People have a varied and fulfilling lifestyle that is based on their wishes and individual needs. They get a lot of pleasure being part of their local community. EVIDENCE: People at the home were very positive about the care they received and said they were happy living at the home. They said they go out when they want, choose when to go to bed and staff were very good. They talked about how much they enjoyed recent trips to the coast, which included Mablethorpe and Scarborough. The AQAA states people who live at the home maintain contact in the local community by having regular walks, visiting shops and local cafes. There is a range of in- house activities including snooker, dominoes and cards. Examples were given of how the home supports people to maintain religious beliefs which includes accompanying people to their place of worship. Leisure activities are similar to those of many people of a similar age. One person likes to paint, do jigsaws and listen to music. All four people went out on the day of the inspection. One person went to their work placement, working on a farm. The others went for their daily walk around the local community. People living at the home said they went out every day. Daily routines include visiting the bookmakers, the local café, mini mart, health centre and a neighbour’s house. The staff said it was apparent when they were out that they were well known and they often returned home with snippets of local gossip. During the daily outing one person likes to reorganise the refuse bins in the area after refuse collectors have been. People on respite care continue to follow their normal lifestyle whilst staying in the home. For example one helps at a burger bar. Four surveys from people who live at the home were returned; staff helped them to complete the forms. All surveys state they always make decisions about what they do each day and they could do what they wanted during the day, in the evening and at weekends. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 15 One relative survey was returned and this was very positive about the care that is provided at Adrian House. The survey states the home always meets the needs of the person living there, the home always helps the person to keep in touch and they are always kept up to date with important issues. They also state the home has been very supportive and since the person moved in he is much happier and is able to communicate better. Meals are planned on a daily basis and everyone eats together. A range of options is available in the fridge and pantry, which people choose from on a daily basis. Examples were given of turkey, ham, fish, salad, steak pies and cheese. People who live at the home said the food was good. Food records were looked at and the meals were varied. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home has good systems in place to make sure healthcare needs are met and people receive the right support from healthcare professionals. EVIDENCE: Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 17 Each file had good information about healthcare and appointments people have attended. Records confirmed that people had attended regular healthcare appointments. Health support is provided from the local health centre. People go to see the GP on their own or with staff if there is something of concern or they ask for support. The district nursing service visited one person who returned to the home after a spell in hospital. Another person is receiving the support of the community mental health team. There was also evidence that the home requested support when health needs changed. For example a letter stated that request had been received for help with sight loss. There had been some problems accessing a dental service but the manager had pursued this and successfully registered people with a dental practice. A healthcare professional was visiting the home on the day of the inspection. They said they thought the home was relaxed and informal and provided a good service and people who lived at the home were ‘excellently happy’ and well cared for. Staff talked about providing a very personalised service and talked about treating people as individuals and recognising individuals needs. Because of the small amount of medication each person has their medication dispensed in labelled packets. The permanent people prefer staff to look after their medication and make sure they receive their tablets. The pharmacist provides medication administration (MAR) sheets for recording the medication given. These were seen to be up to date. A medication returns book is signed by the delivery driver for any medicines returned to the pharmacy. Medication is held in a locked cupboard. One of the people using the respite service manages his own medication. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are able to express their views and feel they are listened to. Systems are in place to protect the people who live at the home. EVIDENCE: People said they talk to the manager and staff if they are unhappy. Surveys from people who live at the home state they know who to speak to if they are unhappy and they know how to make a complaint. The relative survey states that they know how to make a complaint about the home if they need to. The home’s complaints procedure was displayed on the wall in the office/dining room. Complaints made by a person on respite care had been referred to the social worker and recorded in the care plan. The complaint was unfounded. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 19 In depth records were available for any incidents when people have raised concerns. There was also evidence that the manager had contacted other professionals to seek guidance and advice. To make sure the number and nature of complaints can be properly monitored, the home should keep a separate log of any complaints. The AQAA provides examples when staff have listened to peoples concerns and acted to help put things right. For example one person had raised concerns about transport and this was resolved, others were concerned about dental care and this had been resolved. The manager and his wife were familiar with adult protection procedures and had covered basic safeguarding adults training when they completed NVQ awards. The manager agreed to look at completing more in depth safeguarding adults training. The financial records were examined. These were held in a hard back book and income and expenditure was easy to follow. Receipts were held in the safe for purchases made on behalf of each person. Delays in the payment of benefits, due to postal strikes, meant that the records were a couple of weeks behind. A separate book is used to record personal allowances each person signed for or made their mark when they received their money. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The standard of cleanliness and hygiene in the home is high. The accommodation is basic but meets the needs of the people who live there. The manager continues to make progress to improve the facilities. EVIDENCE: Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 21 The gardens were neat and new gates had been fitted. There is a rolling programme of redecoration. All areas of the house seen were clean and free from any unpleasant odours. The manager said that the health and safety officer visited recently and had recommended a fence around the cellar area. Since the last inspection the kitchen, bathrooms and the TV lounge have been decorated and a new large flat screen TV has been purchased. New curtains have also been purchased. One bedroom has been decorated and a new vanity unit has been installed. Two people who live at the home choose to share a room. The manager said he periodically offers the option of having single rooms but as yet both people have declined. All other rooms are single. The windows in the bedrooms on the top floor need to be fitted with restrictors to prevent them being opened fully and reduce the risk of accidents. A ground floor room, which was previously family living quarters, is being considered for a respite care room subject to alterations to install an en suite facility. A first floor room is available for visitors and can be used as a second lounge, although people do not tend to use it. Bathrooms and toilets are basic but adequate. The manager and staff give a great deal of time and thought when purchasing new furniture and have consulted people to ensure it suits everyone. The living room has been made to look homely with pictures and ornaments, and furniture has been rearranged making this area look more homely. Surveys from people who live at the home state the home is always clean and fresh. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People have a very good relationship with everyone who works at the home. People are supported by a skilled and knowledgeable team who successfully provide individualised quality care. Staff have not completed up to date safe working practice training therefore some practices could be unsafe. EVIDENCE: Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 23 The manager, his wife and family live at the home and spend a lot of time with people at the home. A part time care worker works in the home when required helping with cleaning, sitting and talking to the men and going out with them on trips to the coast. Surveys from people who live at the home state staff always treat you well and they always listen and act on what you say. AQAA states a new employee works at the home and the people who live at the home recommended the person as their choice. The recruitment records for the new employee were looked at. This is the first person to be employed by the home for many years and provided an opportunity for them to try out their recruitment and selection procedure which was developed a couple of years ago. All the information had been obtained including a police check and references. An application form had been completed but it did not have a full employment history. The manager agreed to amend the form to make sure full employment history was obtained in the future. An induction checklist that covers the building, and policies and procedures had been completed. The member of staff was already known to the men and spent the first weeks as a companion. She said the manager and his wife had spent time with her making sure she understood her role and responsibilities. The induction training should be more formalised and induction records should provide evidence of training that relates to care. The manager has completed his NVQ level four and his wife has completed NVQ level 3 and her nurse training, although she has not kept her nurse registration live. They are experienced within the care field. They have not completed training to make sure their safe working practice knowledge and skills are up to date. They agreed to look at training in fire safety, moving and handling, food hygiene, first aid and infection control. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 25 37, 38, 39, 40 & 42 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is well managed and it successfully meets the needs of the people who live there. EVIDENCE: The manager and his wife have many years of experience in the home and are fully committed to the well-being of the people who live there. The manager has the manager’s award and is an NVQ assessor. The Commission receives regular information about the home. Reports update the Commission about events in the home and because the reports are very detailed, these demonstrate that the home analyses situations, actively monitors the quality of service and looks how it can improve. The AQAA states relevant policies and procedures were in place and were in the process of being reviewed. It also states equipment has been serviced or tested as recommended by the manufacturer or regulatory body. Electrical circuits were tested in November 2005, Fire equipment was serviced in November 2006 and gas appliances were tested in June 2007. Health and safety records were looked at. Fire alarm tests, emergency lighting, and door closures were recorded weekly on a rolling rotation. The annual Landlords Gas safety check was completed a few weeks before the visit. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 26 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. Where there is no score against a standard it has not been looked at during this inspection. 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 X 2 3 3 3 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 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 1 36 X CONDUCT AND MANAGEMENT Standard No Score 37 4 38 4 39 3 40 3 41 X 42 3 43 X 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Adrian House Score 3 3 3 X DS0000001407.V346659.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No 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 YA6 Regulation 15 Requirement Care plans must contain details of all care needs to make sure care needs are being properly met There should be sufficient information recorded in the daily records to make sure care needs can be properly monitored. The windows in the bedrooms on the top floor need to be fitted with restrictors to prevent them being opened fully and reduce the risk of accidents. Staff must attend safe working practice training to make sure their practices safeguard everyone living and working at the home. Timescale for action 31/10/07 2 YA6 17 30/09/07 3 YA24 13 30/09/07 4 YA35 13 31/10/07 Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 28 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 YA22 YA23 OP29 YA35 Good Practice Recommendations The home should keep a separate log of any complaints to make sure the number and nature of complaints can be properly monitored. Staff should attend more in depth safe guarding adults training to make sure they have they a good understanding of local adult protection procedures. Employment application forms should have a section that encourages candidates to include previous dates of employment. Inductions should be more formalised and cover areas that relate to care Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. Extracts may not be used or reproduced without the express permission of CSCI. Adrian House DS0000001407.V346659.R01.S.doc Version 5.2 Page 30 - 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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