Inspection on 29/02/08 for Agnes Court

This inspection was carried out on 29th February 2008.

CSCI found this care home to be providing an Excellent 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.

Other inspections for this house

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

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

CARE HOME ADULTS 18-65 Agnes Court Warwick Road Banbury Oxfordshire OX16 2AB Lead Inspector Nancy Gates Unannounced Inspection 29th February 2008 10:00 Agnes Court DS0000071037.V357995.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 Agnes Court DS0000071037.V357995.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. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Agnes Court Address Warwick Road Banbury Oxfordshire OX16 2AB 01295 673760 01295 sue.northcott@LCDisability.org www.leonard-cheshire.org.uk Leonard Cheshire Disability 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) Susan Northcott Care Home 23 Category(ies) of Physical disability (0) registration, with number of places Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Physical disability (PD). The maximum number of service users to be accommodated is 26. Date of last inspection Brief Description of the Service: Agnes Court is a care home with nursing providing care/support and accommodation for 23 people who have a physical disability. Agnes Court is a purpose built home designed to meet the needs of people with a variety of physical support needs. The home is situated in central Banbury with easy access to the shops, pubs, the cinema, a local park and numerous community facilities. The home has two storeys; the ground floor (divided into two wings) provides the majority of living accommodation whilst the first floor has two bedrooms, a small lounge, offices and an IT/computer suite. People who live in the home access the first floor via a lift. Single rooms with en-suite facilities are provided to each person. Equipment and assistive technology is also available to meet individual need. A team of nurses and support workers, an activities co-ordinator and assistant, a physiotherapy assistant, two chefs, a housekeeping team, administrators and a team of volunteers provide support, overseen by the registered manager. Volunteers provide additional support to enable people to access community facilities. The current range of fees for this service is £865 to £1354.22 per week. Agnes Court DS0000071037.V357995.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 3 star. This means the people who use this service experience excellent quality outcomes. The inspection of the service was a surprise visit and was a ‘key inspection’. The inspector arrived at the service at 9.45 a.m. on a weekday. The total number of hours spent at the home was 10 hours. The time spent at the home allowed for a thorough look at how well the service is doing. The inspection took into account detailed information from an Annual Quality Assurance Assessment, completed by the registered manager and also took into account information that CSCI has received about the service following the registration of the home in October 2007. All information received by the Commission for Social Care Inspection since registration, about this service was also taken into account when producing the key inspection report. Staff and the people who live at Agnes Court were very welcoming. Discussions with four people who live in the home, four staff members, and the registered manager took place within the site visit. We looked around the home including the bedrooms of individuals at their invitation. A number of records were viewed including individuals care plans, staff recruitment records, staffing rotas and maintenance/health and safety records. We looked at how well the service was meeting the standards set by the government. The report includes judgements about the standard of the service. What the service does well: Prospective residents are given information that will help them make an informed choice about whether to live at the home. There is a clear and detailed assessment process to ensure that all prospective residents support/care/nursing needs are assessed. The process ensures that the service is able to meet people needs before they move in. Care and support plans are based on detailed assessments of peoples needs and support the good quality care provided by staff. Consultation with individual’s regarding their support plans is conducted on a regular basis. The Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 6 support provided remains consistent, clearly relating to changing needs and wishes. The people who live at the home are also enabled to take risks, in order that they are as independent as possible. People are encouraged to take part in meaningful activities, and the provision of activities is good. The move to the new location has opened up a large amount of opportunities to be part of the community and has given people the opportunity to exercise more responsibility within their daily lives. We talked with three people who told us that moving to the new home means that they can get to the shops, to the pub to the cinema and to the park really easily, not having to rely on transport being arranged or for it to be a group trip. They told us that a local pub has really welcomed them and that trips to the cinema on a Wednesday afternoon are always available. People who live in the home told us that support is provided to maintain appropriate relationships, with rights and responsibilities respected and recognition is given to the importance of those relationships. Information regarding an advocacy service is available for those who are unable to make decisions and who have limited or no family support. The manager has made a commitment to using the service at appropriate times. We looked at the menus and spoke with the people who live in the home about food and mealtimes. The menus showed that varied and well-balanced options are available. People told us that the food is “really good…we make suggestions and are asked about what we like”. Personal and healthcare needs are appropriately supported. Staff provide personal support in ways, which people prefer, in order that their needs are best met. Staff clearly promote individuals’ physical and emotional health, to keep them healthy and well. Access to additional support from health care professionals is consistent and meets health needs. Medication is stored securely and administration is accurate, ensuring that health and well-being are promoted. Needs arsing from equality and diversity are well met. From the evidence seen, we consider that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. People who live in the home told us that they know how to complain, confirming that they have a copy of the complaints procedure, and know that their concerns will be listened to. Protection of the people who live at the home is assured by the availability of adult protection guidance, appropriate training and staff awareness. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 7 A pleasant and comfortable environment is provided for the people who live at Agnes Court. People’s bedrooms reflect individuality. The design and layout of the home, including adaptations and equipment meet individual need. The home is clean and hygienic, continuing to guard against the risks of infection and ill health. Staff are attentive and respectful promoting communication and independence in relation to need and abilities. Competent and qualified staff work at the home. Training provided to staff ensures that they are competent and qualified to meet individual needs. Staff records indicate that the recruitment process ensures the protection of the people who live in the home. The manager has a good understanding of the needs of the people who live at Agnes Court, providing leadership; guidance and direction to staff to ensure people who live in the home receive consistent and good quality care. The manager’s skills and experience are supported by nursing and management qualifications. Staff described the manager as being very supportive and knowledgeable, defining clear boundaries of nursing and support offered at Agnes Court. 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. Agnes Court DS0000071037.V357995.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 Agnes Court DS0000071037.V357995.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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are given information to help them make an informed choice about the service. The home has an assessment procedure to ensure that prospective residents’ needs are assessed and that the home can meet those needs. EVIDENCE: A statement of purpose and service user guide are in place to inform prospective residents of what is offered at the home. The statement of purpose provides details of the registered provider and the manager including details of qualifications and experience. It provides information regarding the organisation, information about the service on offer, admission to the home, the accommodation provided, how peoples’ views will be listened to, the staffing structure and details of the complaints procedure. The service users’ guide reflects the contents of the statement of purpose with the addition of information about contracts and agreements for residency. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 10 The manager confirmed that a copy of the inspection report would be made available to both the people who live at the home and their families/representatives when available. Prospective residents are encouraged to visit the home before moving in to help them decide if it is somewhere they would like to live. Following the initial visit the registered manager will visit individuals at home, hospital or current residence to fully assess care needs before the person decides to move in. Admissions are not made to the home until a full needs assessment has been completed by the manager. We looked at the admission records for four people and they showed that a clear, standardised admissions process involving the individual and relevant professionals at all stages is completed. This ensures care needs are fully assessed before admission enabling the manager to decide whether the home can provide the care the person needs. Care plans, including nursing needs, are developed from all the available information. The assessments highlight the importance of clear risk management strategies prior to admission and how the strategies can ensure that a person is supported to take risks, whilst remaining within the remit of their care plan. Two people who live in the home told us that they or their family members/representatives had received enough information about the home to help them decide if it was the right place for them. The current scale of fees for this service are £865 to £1354.22 per week. Agnes Court DS0000071037.V357995.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): 6, 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of people who live in the home are appropriately assessed and are recorded within an individual plan. Support provided is consistent and relates to individual changing needs and wishes. People are supported to make decisions about their lives, and are consulted about aspects of life in the home. People are supported to take risks as far as possible to maintain an independent lifestyle. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 12 EVIDENCE: The people who live in the home are provided with a standardised nursing/care/support plan. The documentation provides a framework for recording support needs and offer opportunity for people to describe themselves in relation to their needs. We looked at the care plan files of four people who live at the home. Each file contained assessment information including care plans that describe peoples’ needs and ensure that staff have a clear understanding of those needs. The files contained a number of clear assessments and plans relating to the support needs of individuals, for example, initial assessments, risk assessments, information regarding physical health, emotional health, moving and handling, dietary needs and nursing needs. There are clear accounts and descriptions of individual skills and characteristics, giving a clear account of who people are and how they wish to be supported. The plans whilst clear are based around nursing and care tasks; consideration is being given to adapting the plans to ensure that they are balanced between care and social support needs. Daily records show that staff record nursing and care information and what people have done during the day. All notes seen were non-judgemental, positive and respectful. Reviews are undertaken on a regular basis, confirmed by the people who live in the home and within written information. Regular meetings are held with the people who live in the home, and issues are discussed with the registered manager. People told us that they are consulted on important issues and can join other forums within the Leonard Cheshire Disability organisation. Risk assessments relevant to the needs of individuals are held within care/support documentation. Risk assessment is included within the initial assessment process and the ongoing review of needs. New activities are assessed and identified risks are recorded. Staff support people to minimise risks as much as possible. Four people who live at the home told us that they are supported to make decisions “about all sorts of things” and staff are available to help when needed. People confirmed that if assistance has been given then it is recorded in support plans. Information regarding advocacy services are available to people who live at the home and a clear commitment has been made to use the service at appropriate times. Arrangements for managing and storing confidential information for the protection of all household members and staff are satisfactory. Agnes Court DS0000071037.V357995.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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people who live in the home are offered a variety of social, therapeutic and recreational activities, which aim to meet their needs, improve well-being and establish positive networks of support in the wider community. People are supported to maintain appropriate relationships, and their rights and responsibilities are respected. People who live in the home are offered a healthy diet and mealtimes are unhurried. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 14 EVIDENCE: Following the re-location of the home Agnes Court is situated on a main road in central Banbury, which has provided people with the opportunity to access shops, pubs, the cinema, a local park and additional community facilities with ease and at times independently of others who live in the home. We talked to three people who told us that moving to the new home means that they can get to the shops, to the pub to the cinema and to the park really easily, not having to rely on transport being arranged or for it to be a group trip. They told us that a local pub has really welcomed them and that trips to the cinema on a Wednesday afternoon are always available. The move to the new location has clearly opened up a large amount of opportunities to be part of the community and has given people the opportunity to exercise more responsibility within their daily lives. A part-time activities co-ordinator is responsible for the supervision of the activities assistant and the volunteers who implement various activities programmes for individuals and groups of people. People who live in the home are offered opportunities for further education. Activity suggestions are invited from individuals and an activities programme is circulated in the home and prominently displayed. Regular group activities are available such as the newspaper discussion group, craft sessions, film club and art groups. Volunteer’s work with the activities co-ordinator to find and access individually designed activities. The home is open to receiving friends, relatives and members of the local community. There are communal areas such as the main lounge and the kitchen/dining area and an additional small lounge with kitchen facilities on the first floor that people can use to receive guests. People can also receive visitors in their own rooms. A person who recently moved to the home has a young family and the small guest lounge on the first floor provides privacy for family time away from the main hub of the home. This clearly demonstrates that staff recognise the importance of continued family relationships in supporting an individual’s needs and providing space for private time as a family. We looked at the menus and spoke with the people who live in the home about food and mealtimes. The menus showed that varied and well-balanced options are available. Dietary needs can be supported by a dietician if required. People who live in the home told us that the food is “really good…we make suggestions and are asked about what we like”. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 15 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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of the people who live in the home are appropriately supported. Needs and wishes are respected. Access to additional support from health care professionals is consistent and meets individuals’ health needs. Medication is stored securely and administration is accurate, ensuring that health and well-being are promoted. EVIDENCE: We looked at six care/support plans. Personal and healthcare needs are clearly described. The plans hold clear guidance of how people wish their needs to be supported and it is clear that families are consulted when a person is unable to communicate their needs. Nursing needs are clearly described. The majority of people who live in the home are wheelchair users who need support and advice from a physiotherapist; a physiotherapist and a physio Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 16 assistant are employed by the organisation, allowing needs to be supported on a daily or as required basis. All of the people who live in the home have their own GP, and support and advice is available from other health professionals, such as the speech and language therapist, dentist and optician, as needed. We talked with a number of people who live in the home and all said that they were happy with the support provided. Medication administration and recording is managed by the nursing staff and is of a good standard. Individuals are offered the option of managing the administration of their medication with support and after the completion of a risk assessment. Nurses manage medication for all other household members. Medication is stored within locked cabinets, at the correct temperature and within the nurses’ room/office. A local pharmacist supplies the home with medication stored within a dispensing system. All medication entering and leaving the home is recorded to ensure the safety of the people who live at the home. Medication administration records are supplied by the pharmacist to support accurate administration and recording. Recording is accurate, no omissions were noted. Controlled drugs are stored and administered within a safe system. The home has a policy to guide staff in relation to the care of a dying person or in the event of an individual’s death, ensuring liaison with the individual, relevant healthcare services in the community, and family members when needed. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 17 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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are provided with the information about how to complain, and are confident that their concerns will be listened to. The people who live in the home are protected from abuse as far as possible through the home’s adult protection guidance, appropriate training and staff awareness. EVIDENCE: No formal complaints have been received at the home or at the CSCI since the registration of the service in October 2007. The people who live in the home told us that they know how to complain, confirming that they have a copy of the complaints procedure. The procedure clearly explains the process and the timescales for response to a complainant. A whistle blowing and a Safeguarding/Protection of Vulnerable Adults policy and procedure are in place. We looked at training records, which showed that all staff have received training regarding the Protection of Vulnerable Adults. Staff confirmed that they have attended training and were able to describe on how to respond to incidents or allegations of abuse. The home has facilities for storing individuals’ money if required. Small amounts of cash may be held on behalf of an individual (with their permission), all transactions are recorded i.e. balance, money taken out, money returned. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 18 Individuals have also been provided with wall-mounted safes in their rooms and will be supported to store and manage their money in the near future. The manager confirmed that all staff (existing or prospective) complete a Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) check before working unsupervised in the home. This ensures that staff are suitable to support people. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 19 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): 24, 25, 26, 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An attractive, clean and safe environment has been created, providing people with a comfortable and homely place to live, suiting the individual needs of the people who use the service. EVIDENCE: Agnes Court is a purpose built home designed to meet the needs of people with a range of physical support and care needs. The home is located on a main road in central Banbury, which has provided people with the opportunity to access shops, pubs, the cinema, a local park and additional community facilities with ease and at times independently of others who live in the home. We looked at all areas of the home and noted that it was warm, homely and are satisfied that the home is kept safe and secure. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 20 People who live in the home confirmed that they were consulted throughout the design and build of Agnes Court to ensure that the new facilities offered would meet their needs as far as possible. Entrance to the home is via a reception area, which leads to two wings. Both wings of the home have large and comfortable communal areas (a lounge and dining room); the communal areas lead to the bedroom ‘wings’. The nurses’ room/ office and the managers’ office are situated on the ground floor close to reception, allowing the manager, nurses and staff to be accessible. A small courtyard garden is at the rear of the home; access can be through communal areas and from individual’s bedrooms. All areas seen within the main areas of the home on the day of the site visit were clean and comfortable, providing living areas, which are light, well heated (under-floor) whilst also providing good ventilation. An activity room is also available providing kitchen facilities that are height adjustable ensuring that people have the opportunity to make hot and cold drinks and cook light meals whenever they wish or as part of an activity programme. The first floor has two further bedrooms and a small lounge with kitchen facilities (which can be used for people to receive guests), the staff room, an IT suite for the people who live in the home, two meeting rooms and a number of small offices. A lift provides access to the first floor. All bedrooms are spacious and have an en-suite facility with equipment available that meets individual need. Assistive technology has been included in all if the bedrooms allowing people to independently open and close, doors, windows, curtains and to turn lights on an off. Additional switches allow people to turn TV’s etc. on and off. The bedrooms provide people with a comfortable personal space and contain good quality furniture, linens and floor covering. The rooms reflect the personal tastes of the individuals, containing personal belongings that give the rooms individual identity. The people who live in the home did not raise any concerns regarding cleanliness or comfort offered. People spoken with were very happy with their room and the shared space that is available at Agnes Court. The home’s laundry and separate sluicing facilities are located away from food preparation areas. Washing machines are able to wash laundry at appropriate temperatures, however the laundry room can become very hot and at times housekeeping staff stated that they are unable to use the room due to the high temperatures. The manager stated that as a temporary measure fans will be provided whilst a long-term solution can be found. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 21 Hand washing and drying facilities are provided. The domestic supervisor continues to be responsible for the home’s housekeeping staff, and on the day of the site visit the home was clean. Staff confirmed that they receive instruction on the home’s infection control policies and procedures within induction describing the importance of frequent hand washing; disposable aprons and gloves are also available for staff to reduce the risk of cross infection. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 22 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): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Agnes Court has an appropriate level of staffing to support the needs of the people who live at the home. Recruitment procedures ensure the protection of the people who live at the home. Staff skills, appropriate training and the supervision of staff meets the needs of the people who live in the home. EVIDENCE: Job descriptions are in place for all staff defining clear roles and responsibilities to support the people who live at the home. Agnes Court has an appropriate level of staffing to support the needs of the people who live at the home. There is always a registered nurse on duty alongside the required number of care staff. The on site staff team comprises of the manager, qualified nurses, support workers, a physiotherapy assistant, Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 23 an activity co-ordinator, an activity assistant, a housekeeping team, 2 chefs, a maintenance person and a transport co-ordinator. We observed the staff team to be attentive and respectful, promoting communication and independence. We talked to five staff members and all were clearly knowledgeable regarding the needs of people who are supported at the home and have a clear understanding of their job roles. We looked at six staff files, which contained the information required for recruitment and for the protection of the people who live and work at the home. The manager confirmed that two written references are obtained before the commencement of employment. Criminal Record Bureau checks, including POVA first are completed centrally within the organisation, appointments confirmed following the receipt of acceptable references and CRB check. All new employees undertake a induction programme, which includes a number of courses to ensure the safety of household members i.e. first aid, fire safety, health and safety, food handling and hygiene, protection of vulnerable adults. An induction pack is provided; reviews with new staff are regularly completed to ensure that staff are competent to support the needs of the people who live at the home. The manager confirmed that all staff are provided with a copy of the General Social Care Council (GSCC) codes of practice on appointment. Internal and external training opportunities are offered to all staff, relating to the identified needs of the people who live at the home. Training records confirmed that the staff group have a mix of skills and knowledge to support individuals’ needs. Information received from the manager shows that of the 28 permanent and 9 bank staff 16 staff are qualified to NVQ level 2 or above, indicating that 43 have achieved the required standard of qualification. The 16 members of staff who have achieved the qualification are permanent members of staff. NVQ training continues to be encouraged to ensure that the people who live in the home are supported by staff who have a recognised care qualification. Records showed that supervision is being undertaken for all staff. Supervision notes record performance, progress and action required within an individuals work role. Training and development issues are identified within the supervision format. Appraisals will be conducted every year. Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 24 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): 37, 38, 39, 40, 41, 42 & 43 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed and staff work as team, which benefits people who live in the home. The views of the people who live in the home are sought on all aspects of the management of the home. The organisation has systems in place to monitor the quality of care and to ensure that standards are being maintained. Health and safety practices safeguard the people who live at Agnes Court Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 25 EVIDENCE: The manager has worked for the Leonard Cheshire organisation for a number of years and has a good understanding of the needs of the people who live at Agnes Court, ensuring that the best interests of the people who live in the home remain the most important factor in planning and developing the service. The manager’s skills and experience are supported by nursing and management qualifications. A team of qualified nurses ensures that the home is appropriately managed in the absence of the manager. Staff described the manager as being very supportive and knowledgeable, defining clear boundaries of nursing, care and support offered at Agnes Court. The registered manager has regular meetings with the nurses, care supervisors, physiotherapists and with relatives of people who live in the home who cannot easily communicate to ensure continuity of support. The manager is visibly present and is available for advice and support to relatives. She continues to encourage innovation, especially regarding activities. Regular visits to the home are completed by a representative of the organisation to look at the quality of care/support. Reports of these visits are held at the home. An annual quality assurance survey of the views of the people who live in the home is completed in addition to the regular meetings held with individual’s staff and the manager. Health and safety is promoted; training is provided to staff in induction and staff receive regular training/updates. Records held in relation to health and safety viewed at the site visit are accurate and up to date, promoting the safety of all household members. Generic and individual risk assessments are in place for all identified risks, inclusive of safe working practice. The procedure for recording and reporting of incidents and accidents is satisfactory. A business and financial plan is available for the service and relevant insurance cover is in place. Agnes Court DS0000071037.V357995.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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 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 4 25 4 26 4 27 4 28 4 29 4 30 4 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 3 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 4 3 3 3 3 3 3 Agnes Court DS0000071037.V357995.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Agnes Court DS0000071037.V357995.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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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