Inspection on 12/07/06 for Apsley House

This inspection was carried out on 12th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Apsley House 22/11/05

Apsley House 06/06/05

Apsley House 13/12/04

Apsley House 06/07/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Apsley House 103 Queens Park Road Heywood Rochdale OL10 4JR Lead Inspector Jenny Andrew Key Unannounced Inspection 12th July 2006 13.45 Apsley House DS0000058327.V291508.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 Apsley House DS0000058327.V291508.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. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Apsley House Address 103 Queens Park Road Heywood Rochdale OL10 4JR 01706 360309 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) Mrs Linda Bell Mrs Janet Kinsella Mrs Janet Kinsella Mrs Linda Bell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 4 service users, to include; up to 4 service users in the category of LD (Learning Disability) The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 22nd November 2005 Date of last inspection Brief Description of the Service: Apsley House is a privately owned, small care home accommodating 4 younger adults with learning disabilities who need support to lead independent lives. The home is a spacious end of terraced house near to the centre of Heywood with good access to a range of community facilities and public transport links. A park is situated close by. All 4 bedrooms have en-suite facilities and are situated on the first and second floor levels of the home. As there is no lift, the home is unsuitable for anyone with mobility difficulties. This is published in the statement of purpose. Car parking space is available at the side of the house and there is a small garden area to the rear. The weekly fees are dependent upon the assessed needs of the individual. No additional extra charges are made. The provider makes information about the service available upon request in the form of a Service User Guide and Statement of Purpose, which is given to new residents. A copy of the Commission for Social Care (CSCI) inspection report is held in the office. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over four and a half hours. The inspector looked around parts of the building, checked the records kept on residents to make sure staff were looking after them properly as well as looking at how the medication was given out. The files of the staff were also checked. In order to obtain as much information as possible about how well the home looked after the service users, the deputy manager and 3 service users were spoken to. In addition comment cards were sent out before the inspection to relatives, residents and professional visitors to the home. Of these 2 service user, 2 relative/visitors and 1 care manager questionnaires were returned. Other information, which has been received about the service, over the past year, has also been used as evidence. What the service does well: The managers and staff team were giving good care and support to the service users. The 3 service users spoken to said they liked the staff that worked there and said they could talk to them about anything they were worried about. Other comments made on comment cards which had been returned were “I like the fact I can choose what I want to do”, “there’s things to do I never used to do at home” and “I like the staff and the people I live with”. Before new service users came to live at Apsley House, the home made sure they had all the right details about them, so that they were clear that the home was the right place for them to live and that their needs would be met. Each service user needed different help and support and the care plans showed exactly what each person could do for themselves and what they needed support with. They also had goals to work towards and staff supported the service users in working towards meeting their goals, which had made them able to do more things for themselves. The home was good at making sure service users’ health was well looked after and the service users felt safe and cared for. Service users were going out into the local area and taking part in activities, which they enjoyed. Evening and weekend activities were also arranged so that the service users did not get bored and those spoken to felt their social lives were good. The managers knew how important it was to make sure staff were properly trained so they could do their jobs safely and give the service users the right support. Apsley House DS0000058327.V291508.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. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The admission process was good with relevant information being given to service users before they moved in and a full assessment taking place to ensure the home could meet their identified needs. EVIDENCE: The service users spoken to said they had each been given a copy of the service user guide that they kept in their bedrooms. The most recently admitted person said her admission process had been good. She had visited the home to look around and meet the other service users and staff, had then stayed for meals and had two overnight stays. She said she had settled in well and that she really liked the staff who worked there. The file for this person was checked and it contained a full care management assessment. The Social Services Department had funded the placement for this service user and the care manager had completed a detailed assessment, which gave the reader a very clear picture of the persons needs. The deputy manager said that once the service user was admitted, a full in-house assessment took place and this was also in the file. The care plan was then drawn up, using the information from this documentation. The assessments for the other 3 service users had been seen on previous inspections. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 9 From checking the staff training files, it was evident the staff team were qualified and experienced to meet the assessed needs of the service users currently living at Apsley House. Specialist training was sought as and when needed. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Care plans were detailed, accurately reflected each service users changing needs, choices, goals and support requirements, thus ensuring service users were supported to increase their independence, self-esteem and ability to make informed choices within a safe environment. EVIDENCE: The home had an effective care planning system in place, which included monitoring and reviewing arrangements. The initial assessments formed the basis of the plans. Two plans were looked at, including the one for the person who had recently come to live at the home. The plans identified service users strengths and needs and, achievable short and long term goals had been planned with each person. Two of the service users spoken to said they were fully involved in goal setting. They said their goals were looked at by the staff to see whether they had achieved them. Records seen on the files confirmed this was the case but one person’s goals had not been reviewed since January 2006. Staff were mindful that the goals should be achievable and where it was identified service users were struggling to meet their goals, they were broken Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 11 down into more easily achievable tasks or reviewed accordingly. Each service user had a copy of their individual goals in their bedrooms so that they could easily see when they had met them. They also each had a weekly chart showing what they did on certain days i.e. socially and educationally. The good practice of addressing religious/cultural and relationship/sexuality needs in care plans was noted. When the monthly progress update sheets were completed, they were forwarded to the service users relatives/representatives so they were aware of progress being made, together with a feedback questionnaire, in order they could make any comments. The inspector was told that these questionnaires were not usually returned. The deputy manager said they were in the process of completing person centred plans with each person, which would be more easily understandable by them. These were seen and good progress was being made to complete them with the service users. They were being done gradually as some of the service users did not have the motivation or commitment to spend long periods of time completing their plans. Any restrictions on choice or freedom were recorded and detailed risk assessments and behavioural/management strategies were in place. One of the service users had signed their plan and risk assessment but the other person had not. The deputy manager said she would address this. All documentation had been reviewed and updated on a regular basis. Challenging behaviour was monitored and recorded in order that staff could establish whether there were any triggers or particular patterns leading up to behavioural issues. These forms were seen and had been fully completely. Where problems were identified with regard to absences from the home, detailed instructions were on the office wall, explaining clearly to the staff what procedures they must follow. Although the staff team was small, a key worker system was in operation and continued to work well. It was evident from speaking to service users that positive, trusting relationships had been formed with the staff. One returned relative questionnaire commented that a new key worker had not been given to the person she visited. When checking out this information, it was found that all the service users had key workers. When staff were off sick or on maternity leave, new workers were allocated. Two of the service users spoken with knew whom their key worker was. From discussion with the deputy manager, it was clear that staff were continuing to try and motivate each of the service users and were aware of the individual needs of each person. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 12 Files checked showed that where appropriate, referrals had been made to advocacy services for their involvement. All 3 service users spoken to felt they were able to make important decisions about their lives, sometimes with support from the staff. One service user felt the staff had given her a lot of support and advice but that she had been treated as an adult and not a child. Apsley House DS0000058327.V291508.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Personal development, together with education and occupation opportunities were being promoted by the staff team, independence skills were being encouraged and, service users were able to make informed decisions about their daily lifestyles. EVIDENCE: All 4 service users had worthwhile education, occupational or leisure activities to follow each week. One service user said she was looking forward to her new job, which staff had supported her with. Another service user was attending college and had recently passed her first aid certificate, which she showed to the inspector. One service user had a structured day time programme which involved one to one time with staff, going out to places of interest, having meals out and going shopping. The other service user had a part-time job twice a week and enjoyed helping out in the office both at Apsley House and one of the other homes. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 14 All four service users were supported to be involved in activities in the community, for example going swimming, attending the gym, going to Karate, to the markets, pubs and cafes, McDonalds, supermarkets and theatres. One service user had been supported to use the library to do some research which she was interested in. Wherever possible, the service users used local transport, but only when staff were satisfied they were safe to do so. Risk assessments were on files showing how identified risks were to be addressed. New garden furniture had been provided and the owners of the home were arranging for the plot of land at the rear of the home, to be tidied and cleared so the service users could plant vegetables. It was hoped that if they had grown their own produce, they would be encouraged to eat more vegetables. Two of the service users spoken to said they had been away on holiday, supported by one member of staff. They had each been to a different place, one to Blackpool and the other to Wales. Whilst one service user would have preferred to go elsewhere, there were reasons documented on her file why this would not be possible. Service users were supported to keep in contact with their families/relatives and an example of this was noted during the inspection, when a service user was being encouraged to telephone her mother. Records on files also showed how service users kept in touch with their families/friends. One resident said her boyfriend visited the home and could stay and have tea there. A birthday party was being planned and a lot of her friends and relatives were being invited. Some of the service users had made friends at the owners’ other two homes and visited regularly. Outings to the local Gateway Club were looked forward to as the residents said they met a lot of their friends there. The 2 relative questionnaires, which had been returned, commented they were made welcome in the home, could visit in private and that they were kept informed of matters affecting their relative. The daily routines and house rules promoted independence and gave service users choices about their chosen lifestyles. All took part in household tasks and during the inspection, one service user, who had been out shopping to the supermarket, put all the shopping away without supervision. Another service user folded up and sorted out her laundry without prompting. The dietary needs of service users were adequately catered for with menus showing a balanced and varied selection of food being offered, which met individual tastes and choices. One service user said they met with the staff once a week to choose what to eat the following week. Three of the service Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 15 users took turns to cook each week with support from the staff. One night a week they said they usually had a takeaway meal. The service users’ weight was monitored and the staff tried to ensure they ate healthily. However, problems were experienced when service users had meals out during the day as they could only promote healthy eating options in-house. A good selection of fresh fruit, vegetables and salad ingredients had been bought on the day of the inspection as well as meat and fish. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area was good. This judgment has been made using available evidence including a visit to this service. The health and personal care needs of the service users were well met with evidence of good multi-disciplinary working taking place. EVIDENCE: All 4 service users were given the appropriate level of support and assistance to ensure their personal care needs were being met. This was evidenced during the inspection and aims/goals that they were working towards were recorded on their support plans. Progress reports showed where motivation or improvements had either been made or where problems were being experienced. Each service user had a file, which included details of medication, correspondence and appointments with health care professionals and other relevant information. Records showed that service users were supported to attend regular dental check ups and other health care visits. From discussions with service users and the deputy manager, it was clear their health care needs were closely monitored with referrals being made to appropriate professionals as necessary such as psychologist, psychiatrist, Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 17 dentist, Doctor and optician. When any problems were identified either emotional or physical, the manager was knowledgeable about whom to seek help and advice from. The home had excellent links with a community behaviour management worker. Where problems in this area were identified, he would be requested to come into the home to give advice and training to the staff. The training was usually geared to an individual service user and staff had recently had physical intervention training. Staff had also received training in epilepsy. When weight problems were identified, referrals were made to the G.P. and/or dietician, which had resulted in service users being referred on to healthy eating courses and arrangements made for gym membership. One service user had been supported to Weight Watcher classes with a staff member who had joined herself so as to encourage the service user. Unfortunately the service user had chosen to stop attending the meetings. Swimming was however, done on a weekly basis by anyone who wished to join in. Medication procedures were being followed and subject to a satisfactory risk assessment, service users could self medicate. The file of one service user contained a self-medication risk assessment and the medication sheets had been signed by her. The medication files contained “Consent to Medication” forms, which had been signed. There were no service users taking controlled drugs. All staff responsible for the administration of medication had received accredited medication training but those who had been on the training on 13 May 2006 had not yet received their certificates. All unused medication was returned to the pharmacist who signed upon receipt. Health care professionals regularly reviewed medication. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. An effective complaints system was in place which service users were familiar with and staff training and good recruitment practices ensured that residents were protected from abuse. EVIDENCE: The service user guide which each service user had a copy of, contained a copy of the home’s complaints procedure. One service user said she would feel able to confide in any of the staff if she had any problems about anything. Another service user said the staff listened if you were unhappy and tried to do something about it. The Commission for Social Care Inspection have not had cause to investigate any complaints in the home over the past twelve months and the home have not had any complaints made to them. The Rochdale MBC Protection of Vulnerable Adult training had been done by the two owner/managers, one support worker and the manager of Mornington House. Following this training, the Mornington House manager had done inhouse training for the staff team. Due to the staff turnover, some of the staff had left and the new staff needed to have this training also. The Learning Disability Award Framework (LDAF) training also covered abuse but only 3 of the current support staff had done this training. Apsley House DS0000058327.V291508.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area was good. This judgment has been made using available evidence including a visit to this service. The home provided a safe, comfortable, clean and safe environment for the service users. EVIDENCE: The house was a large terraced providing a good-sized en-suite bedroom for each service user. Two lounges were provided, one of which was nonsmoking. The house was clean, comfortable, bright and airy and the layout enabled service users to have space without having to use their bedrooms. As there was no lift to the first and second floors, it would be unsuitable for anyone with a physical disability but this was made clear in the Statement of Purpose. The premises were in keeping with the community and close to the local shops, cafes and pubs in Heywood centre. Good public transport services were close to the home. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 20 The owner/managers had an annual maintenance plan and budget in place. One of the service users said they were going to have a new kitchen fitted and that she had been with a member of staff to choose it. Plans of the kitchen were seen. Service users were also pleased that the owners had had a digital box fitted, which meant they could access music channels on Sky television. As stated above, arrangements were being made for the plot of land behind the home to be cleared so that the service users could plant vegetables, which would hopefully promote healthier eating. The residents spoken with were all satisfied with their bedrooms and said they had keys so they could lock their doors when they were out. The pre-inspection questionnaire showed that maintenance checks were up to date except for the testing of small electrical appliances. This work was done on 7 July 2006 and a receipt for the work was in place. A random sample of other maintenance checks was made e.g. the gas certificate was renewed on 25 May 2006 and fire fighting equipment serviced 22 March 2006, resulting in the emergency lighting being replaced. The laundry was situated just off the kitchen. Any soiled laundry was put into bags before being taken out of the front door and in through the back door, so that no cross infection was possible. Disposable gloves and aprons were in stock. Liquid soap and paper towels were supplied in the toilet and service users had their own toiletries and towels. Prior to registration, the requirements of the local fire service and environmental health department were met but no further inspection visits from these bodies had since been made. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The staff team had the collective skills, training and expertise to undertake their roles efficiently and effectively which ensured the needs of the service users were being well met. EVIDENCE: From interviewing staff and training records seen, it was identified that whilst the team was small, there was a good match of qualified staff, offering consistency of care within the home. At the time of the inspection however, 2 staff were off long term sick and another person was on maternity leave. In addition one support worker had recently handed in his resignation but was working his notice. This left only the deputy manager and 2 support workers to provide cover within the home, together with the joint managers. As changes in the staff team were unsettling to the service users, the existing staff were trying to cover the additional shifts, with the managers covering the occasional ones. Staff from the other 2 homes, sometimes provided additional cover and this had happened on the day of the inspection. The deputy manager said that two new staff had been recruited and were waiting to start as soon as references and Criminal Record Bureau checks had been successfully carried out. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 22 Even though staffing problems were being experienced, the rota reflected that additional staff were working when service users wanted to do different activities and their needs were being met. From checking the staff rota, it was difficult to see how much time the joint managers were spending at the home. It is required that managers time is recorded and this must be addressed. The deputy manager felt the team worked well together and team meetings and supervision sessions were being held regularly. Minutes of the meetings were seen. The staff team were able to communicate effectively with the service users and good relationships had been formed between them. This was seen throughout the inspection. The residents spoken to said they liked all the staff. The newest service user said she liked the younger staff because they knew what she liked to do. Recruitment and selection policies and procedures were being followed and the two staff files checked for the most recently recruited staff showed that 2 satisfactory references had been obtained. Whilst one contained a Criminal Record Bureau (CRB) check, the other contained a CRB check that had been transported from the staff member’s previous employer. New CRB checks must be obtained by the home before a new employee commences work. The good practice of issuing staff with a General Social Care Council, “Code of Practice” was given to new staff as part of their induction. The staff files contained staff signatures to show they had received a copy. The owner/managers were committed to ensuring that staff were properly trained and a Training and Development plan dated 2005-2006 was in place. Of the home’s 7 permanent staff, the deputy manager had successfully completed her NVQ level 3 award and was part way through her level 4 which she hoped to complete in November 2006, 1 worker had done NVQ level 3, 1 person was half way through their level 3, 1 worker had achieved NVQ levels 2/3 in child care and 2 were awaiting to start their level 2 training. One of the newer staff had partly completed their Learning Disability Award Framework training (LDAF) and 2 had completed the LDAF training. The remaining staff would be doing this training as soon as the funding arrangements were sorted out by Rochdale MBC. This training should be done within the first 6 months of employment. The managers must ensure that if the LDAF training is further delayed, then all staff who have not completed their mandatory training e.g. moving/handling, food hygiene, infection control and first aid, must be enrolled on other courses. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 23 In addition to the above training, other in-house training had taken place e.g. challenging behaviour, mental health, abuse. The files of the two most recently recruited staff were seen and contained evidence of them completing their in-house induction/abuse training, physical intervention and fire. Apsley House DS0000058327.V291508.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Service users benefited from a well run home, with the owner/managers promoting and safeguarding the health, safety and welfare of the service users. EVIDENCE: Both the owner/managers had successfully undertaken their Registered Managers Award training as well as the LDAF Level 4 training in challenging behaviour. In July 2005, they had also completed their LDAF Assessors course. In the absence of the owner/managers, the deputy manager, who was present during the inspection, was competent in her role. As the manager/owners hours were not recorded on the staff rota, it was difficult to establish how much time they spent at Apsley House as they were also joint managers of one of the other homes they owned. From checking the rota in the office, it was seen that on occasions, they did provide cover on the shifts. The chain of 3 homes, which they own, do benefit from the collective skills and expertise of themselves and the manager of Mornington House. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 25 The service users said they all liked the owner/managers and that they gave them money to buy things for themselves and the house. The home’s business plan for April 06 – March 07 was seen. It contained reference to quality assurance and a quality assurance file was in place. The home had also attained The Investor in People Award. Monthly visits by one of the providers were taking place and copies of the reports were sent to the Commission for Social Care Inspection. Monthly service user meetings were being held and the minutes of the February, April and May meetings were seen. Another meeting had been planned for later in the week of the inspection. The service users have their own agenda and chair the meeting. A member of the staff team attends to take the minutes. Service users were asked to complete feedback questionnaires monthly, but many of them had been returned incomplete, as they had got fed up of filling them in. Discussion took place around this and in view of regular meetings being held, it was felt that questionnaires could be circulated on a less frequent basis. When the service user guide is next reviewed, the outcome of the service users questionnaires should be included. Relatives of the service users are circulated monthly with questionnaires so they can make their comments known, but very few were returned. The home should consider sending questionnaires out to care managers, G.Ps and other professional visitors to the home. The pre-inspection questionnaire showed that some of the home’s policies and procedures had been reviewed and updated. Regular team meetings and senior management meetings took place, the minutes of which were seen and regular supervision was undertaken. Staff appraisals were also done each year. The good practice of doing house reports monthly was also noted. Any corrective action needed was recorded and a signature indicated when the work had been completed. Service users were encouraged to budget and manage their finances as far as possible, with some support from the staff. An example of this was seen during the inspection, when a service user wanted to do a leisure pursuit but did not have the money to do so. The deputy manager handled the situation well and encouraged the service user to think why she had not got any money left to spend. Receipts were held for all money spent on behalf of the service users. The manager/owners have always co-operated with the CSCI in progressing any requirements made in reports, within the agreed timescales. Information from the pre-inspection questionnaire showed that all the necessary maintenance checks had been undertaken. The deputy manager had that day, sent water samples off to be tested for legionella. Environmental risk assessments were in place and the monthly house check ensured that any Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 26 faulty item could be replaced or mended. Accidents/incidents were being recorded in detail. As identified in the staffing and training section above, the newer staff had not completed all the necessary mandatory health and safety training and if the LDAF training is further delayed then the managers need to ensure that other training is arranged. Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X X 3 X Apsley House DS0000058327.V291508.R01.S.doc Version 5.2 Page 28 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. 2. Standard YA33 YA34 Regulation 18 19 Requirement The managers’ hours must be shown on the staff rota. The home must obtain their own Criminal Record Bureau checks and not rely upon those transported from other homes. Timescale for action 31/08/06 31/08/06 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 YA6 YA23 YA35 YA39 Good Practice Recommendations In order to show the plan has been drawn up by the service user and/or family, signatures to the plan should be obtained. New staff members should receive training in the protection of vulnerable adults. The managers should ensure that all new staff undertake LDAF training within the first 6 months of their employment. Quality assurance questionnaires should be circulated to a wider range of people and results of service user surveys should be included in the service user guide when it is updated. DS0000058327.V291508.R01.S.doc Version 5.2 Page 29 Apsley House Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Apsley House DS0000058327.V291508.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. 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