Inspection on 31/05/07 for Arden House

This inspection was carried out on 31st May 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Arden House 14/10/09

Arden House 24/11/05

Arden House 20/06/05

Arden House 18/11/04

Arden House 08/06/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Arden House 11 Roden Avenue Kidderminster Worcestershire DY10 2RF Lead Inspector Sue Davies KEY Unannounced Inspection 23rd May 2007 10:00 Arden House DS0000018492.V334622.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 Arden House DS0000018492.V334622.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. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arden House Address 11 Roden Avenue Kidderminster Worcestershire DY10 2RF 01562 744056 01562 864811 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) Mr Stephen Forester-Morgan Mrs Susan Forester-Morgan Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This service is primarily for people with a learning disability. It may also cater for 2 named people with an additional physical disability and 2 named people with an additional mental disorder 24th November 2005 Date of last inspection Brief Description of the Service: Arden House is a three storey semi-detached house situated in a quiet residential area, within easy walking distance of Kidderminster town centre. The stated aim of the home is to provide a family home environment, with a warm atmosphere, where each member of the group is encouraged to participate in the day to day running of the home. Arden House is registered to provide residential care for up to eight adults with a learning disability. The home is also registered for two people who may also have a physical disability and for two people who may also have mental health problems. The home is unable to offer accommodation for service users who are wheel chair dependent, and staff are not able to care for residents who have severely challenging behaviour. Whilst aiming to offer a home for life, Arden House is not registered to provide nursing care, should a residents health deteriorate. Mr Stephen Forester-Morgan is the registered proprietor of Arden House and his wife Susan is the registered care manager with day to day responsibility for running the home. Current fees for this service awaited clarification at the time of writing this report. The fees are inclusive and there are no extra charges. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, unannounced key inspection the purpose of which was to look at the quality of outcomes for service users in relation to the National Minimum Standards and the home’s stated aims and objectives. Preparation consisted of looking at the service history and contact with the Commission, and reading previous inspection reports, a pre-inspection questionaire returned by the service, and responses to surveys sent to service users and their families. The inspection took approximately 7 ½ hours over two days. Time was spent talking with all the 8 men who live here, 1 staff and the management of the home, looking at the accommodation and observing practice. Case tracking was carried out using a sample of care records. In addition, a sample of the records kept in respect of staffing, safety, maintenance and safe working practices were checked. Surveys were sent to all service users, their relatives and GPs. Responses were returned from 8 service users and 4 relatives. These indicated respondents were generally very satisfied with the service, and comments have been included in the report where appropriate. All the service users met on the day said that they like living here and are very happy at Arden House. The inspector was made very welcome, and appreciated the co-operation and time of the service users and staff. What the service does well: This is a large, comfortable secure and safe home for eight people with a learning disability. Service users say Arden House is a happy home. Service users and staff all make visitors very welcome, and there is a calm and relaxed atmosphere where mutual respect and consideration are constantly in evidence. Each person receives individual treatment and support that is right for them. Service users enjoy a good quality of life because the managers and staff work hard to do their job well. People who live here have a good place to live because the managers are good at organising things. Good communication makes sure everyone has the information they need to make the right decisions. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 6 Service users keep in close touch with families and friends and enjoy many varied activities they choose themselves, at home and in the community. They are supported to be as independent as possible and have the help they need to take good care of their health. 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. Arden House DS0000018492.V334622.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 Arden House DS0000018492.V334622.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thorough assessment is undertaken prior to admission to ensure that the needs of the service user can be effectively met. EVIDENCE: Service users can be confident this service is able to meet their needs because careful assessments are carried out before a prospective service user is offered a place. Evidence of these is found in the community care and in-house assessments within personal folders. Discussion with the provider and manager showed prospective service users are offered a personal and considered approach to admission with detailed information to help them decide if this is the right service for them. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 9 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users’ plans of care are kept up to date and clearly identify their needs, how they understand and deal with risky situations and how these will be supported, so that they are able to make their own decisions about their lives as far as possible. EVIDENCE: Service users each have a plan of care that is detailed and clearly expresses their own needs hopes and goals, showing how they want to meet these. Their plans include statements showing how they understand and respond to risky situations, and the support they will receive to enable them to lead a fulfilling life in a way which promotes their personal development. Plans are reviewed and updated 6-monthly although the provider and manager regret that social workers rarely attend reviews. It is clear from observation, talking to service users and from surveys that the manager and staff take a warm interest in each of them as individuals. This means they have sensitive support, and encouragement to take decisions with regard to their daily lives as far as they are able. This is specific to their Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 10 personal needs, for example service users with a diagnosis of dementia are supported with patient care to retain their individuality and remain as independent as possible. Another service user whose behaviour presents some challenges to his supporters is encouraged in a planned and structured way to take responsibility for his behaviour and the consequences of his actions, and has been taking positive steps to manage his own behaviour. People with needs such as epilepsy, ‘brittle bones’ and diabetes have careful descriptions showing how they wish to be supported. Service users’ risk handling information is recorded in separate places according to the nature of risk, for example behavioural and lifestyle matters are in their service user plans, matters linked to their health are in their health action plans while those concerned with fire safety are recorded with fire safety measures. This reminds staff where service users need particular support in specific areas. Service user plans and risk assessments are kept under regular review and updated as needed. To help this process it would be good practice to keep a summary record of all information about risk with review dates, so service users can be sure details are co-ordinated and staff always take a consistent approach. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Service users generally have good contact with their families, and enjoy a variety of individual and group activities both within and outside the home, which are appropriate to their age and interests and offer the chance to try new experiences EVIDENCE: Each service user is being supported to develop a fulfilling lifestyle based on who they are and how they want to lead their life. Where service users have progressive needs such as dementia or other needs associated with ageing, they are being supported to sustain a full lifestyle compatible with their needs. For example one service user is able to go on enjoying attending his day centre because he now has one to one staff support to do so. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 12 Service users told in different ways how they enjoy making their home together and getting to know their local community. A range of opportunities is available to them, and they are supported to explore new areas for extending skills and building confidence, and widening their circle of friends and acquaintances. Contact with neighbours is generally friendly and supportive, and service users take a keen interest in a variety of community events arranged by the local church. They benefit from good staff support when out in the local community, with care taken to understand each person as a unique individual so that they are welcomed and able to take part in many community activities. There was enthusiastic support for a local ‘pudding club’ event. Service users described the many activities they take part in. These include various day centres one of which is a specialist dementia service, the recycling centre, colleges, the local church, leisure centre and cinema, pottery classes and Lifestyles. They enjoy visiting the local town, shopping, eating out and going to pubs, while at home they enjoy music, arts and crafts, games, snooker, television and DVDs. One service user showed the books he had borrowed from the local library, and there was enthusiastic support for the favourite football team. Service users bedrooms have photos of them holding certificates of achievement in various fields. There is a carefully planned garden that service users enjoy both relaxing and working in, including growing their own produce. The providers have purchased an outdoor pool recently tested out for the first time, and photographs show how service users are supported (with a lifeguard on the staff team) to have a good time and gain personal confidence. Along with this the providers are commended for having also purchased a sun awning as they realised some service users were reluctant to use sun cream to protect their skin. Service users clearly enjoy their food whether eating at home, going out for meals, or barbecues in the garden. Menus show an appetising and nourishing range of meals provided, and service users feel they have plenty of choice but ‘its all good’. Friendships and family involvement are welcomed, supported and encouraged. Relatives’ survey responses show this is highly appreciated with comments such as ‘always keep me informed’ ‘makes the care home their home and gives the attention and love that would be expected of a family’ ‘we were told (by the previous home) his life was going to deteriorate … due to the staff and owners (he) has a great quality of life’. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each service user receives personal support and encouragement suited to their individual needs and wishes and that promotes their independence, in respect of their personal and healthcare needs. Arrangements for the safe administration of medication are in place at the home. EVIDENCE: Each service user is supported to take responsibility for their own personal and health care, and where help is needed this is given in a way which has been discussed and agreed with them wherever possible involving their relatives where appropriate. Service users each have clear, detailed and informative personal care records and a health action plan. These are regularly reviewed. This means they know their records contain up to date information so that staff can understand them well, and help them in the way they need and prefer. Special needs such as epilepsy, diabetes, dementia, acquired brain injury and a brittle bone disorder Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 14 are well understood and documented, and staff are provided with appropriate training so service users can be confident they are supported by skilled staff . Service users health action plans are detailed and up to date. These show all action in relation to health care, monitoring, well-man checks and attention to healthy living such as careful monitoring and attention to weight management. This means their health action plans can help them to take a fuller part in managing their own health care when attending appointments, by carrying important information with them and helping them discuss their health needs. The provider, manager and staff have established good working relationships with local and specialist health care teams. This means service users can be sure of getting the right support so that they keep well and active as far as they are able to, and enjoy life. The provider and manager explained that they have also established a good regular dialogue with day services and some placing authorities to make sure service users benefit from consistency and prompt responses to any problems which might arise, although they are concerned for service users that Worcestershire does not provide the level of support offered by other placing authorities. A check on medication systems showed that service users can be sure their medication is correctly stored, managed and administered to safeguard them. The provider, manager and two staff responsible for medication are all trained, and the local pharmacy provides regular oversight and monitoring of the systems. Recording is in order. A suggestion that it would be good practice to seek the GPs comments on the suitability of the homely remedies in use has been followed up, with a list sent to the GP and the supplying pharmacy. It is advisable the GP be asked to confirm, for each service user, if all the items on the list are suitable for the named individual as health needs and compatibility with current medication do vary. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service There is a complaints procedure but this may benefit from revision with service users to make sure they understand it fully. Procedures for protecting service users interests are generally in place, and staff receive appropriate training, but these need bringing up to date and to include reference to local procedures. EVIDENCE: Relationships between all staff and service users are characterised by warmth, mutual respect and courtesy. The provider and manager aim to promote a spirit of mutual cooperation and support, and although as with any large group of people sharing a household some conflict may be anticipated, this mutual concern is clear. Service users have a system for making sure they can let staff know of any concerns they have about the service, and that these are put right. There is a clear written procedure for the investigation of formal complaints, and the manager and provider say any everyday issues are dealt with immediately. All service users asked knew who to talk to if they are unhappy, and were confident or fairly confident they understood how to make a complaint if they needed to. It would be good practice to consider ways to support them all to be clear about this, perhaps reviewing the current documents with them to see if this Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 16 needs revision to make it easier to understand. It would also be good practice to establish a system for recording the everyday concerns and comments showing how these are responded to. This would also provide evidence for the quality assurance process. Records show there have been no complaints to the home since the last inspection, and the Commission has received none. Survey responses quoted elsewhere in this report show service users’ families are very satisfied with this service. Service users can be confident staff employed to support them have had Criminal Record Bureau checks, and references have been sought. However care is needed to make sure two satisfactory written references are always received before new staff are appointed, and evidence needs to be recorded showing that previous employment history is fully explained. The service has policies and procedures in place to safeguard service users, and the provider and manager maintain high standards of staff conduct. Staff have received training as part of their National Vocational Qualification programmes so that they understand and recognise what constitutes abuse. The home has some information on local procedures for reporting abuse, established in accordance with the Department of Health guidance ‘No Secrets’. However, the home does not have an up to date copy of the full local guidance and procedures for safeguarding people from abuse. The home’s policies and procedures need to specify how they link to local procedures, and up to date training needs to be provided for all staff familiarising them with local procedures so they know what to do if there is any suspicion or allegation of abuse. It would be good practice for the manager to make contact promptly with the Adults at Risk Coordinator at Worcestershire Adult and Community Services to discuss these matters. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall standard of accommodation and facilities is extremely high, and there is generally a sound approach to safeguarding service users well being with a high standard of maintenance and safety procedures. However one important safety procedure had not been attended to since the fire officer’s visit over a year ago. EVIDENCE: The people who live here benefit from a house well suited to their needs. Arden House is a large and substantial building, providing accommodation on three floors and an attractive well-equipped garden with aviary. It has been extended and adapted to provide a family environment for the people who live here. Their home is clean, fresh and comfortable, they are consulted and their views listened to about any changes to be made. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 18 Service users’ enjoy accommodation that is well designed, very well equipped, well maintained and generally very safe. It is homelike, sufficiently spacious, the décor and furnishings are in good condition and attractive making this a welcoming place for them to live. The service users are easily able to get to local services and facilities because the house is in a good location, and the layout provides them with good communal space indoors and out for their needs. Service users all have bedrooms furnished to a high standard and many are equipped with tea making facilities. Most service users possess their own TV and music equipment, and they have personalized their bedrooms. Four service users have single bedrooms, one of these being on the ground floor with an ensuite facility and suitable for someone with limited mobility. Two bedrooms are spacious doubles each shared by two people. The current service users have chosen to share or the arrangement is one of long standing which suits them well. However the provider and manager recognize it is unlikely they will be used as shared accommodation once the present occupants leave, and are preparing for the need to make changes to bedroom arrangements. Service users share a bathroom and a shower, both with toilet facilities, and also have 2 separate toilets, in suitable places for them to use by day and night around the home. They enjoy the facility of a top of the range bath which is temperature controlled and also has a hydraulic lift, to assist service users who may have a physical disability. Service users generally benefit from a sound approach to their health and safety, but one fire safety measure needs prompt attention. The last visit from the Fire Safety Officer was in March 2006, work has been done in response to his recommendations but one item remains outstanding since that visit. Intumescent strips have not been fitted to doors as recommended. In the light of the excellent approach overall to general safety and maintenance it is disappointing that service users may have been exposed to risk because this safety measure has not been attended to promptly, and the Fire Safety Officer’s guidance is to be sought. In all other respects action is being taken as needed to safeguard service users from the risk of fire. Where service users’ specific needs pose any risks fire safety arrangements take these into account. Records show that appropriate checks are being carried out as needed. There are no outstanding requirements following a visit from the Environmental Health Officer (food hygiene) in August 2006. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 19 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): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service 50 of staff have a suitable National Vocational Qualification. The recruitment policy and practices need some attention to ensure that service users are supported and protected fully. The training provided to staff ensures that they are competent in their work and able to meet the assessed needs of service users living at the home. Staffing levels need to be kept under review with regard to the increasing needs of some service users with special needs and /or progressive disorders. EVIDENCE: Service users benefit from the support of a stable and tightly knit staff team whom they know and who know them very well. The provider and his wife who is the manager, manage and run the home themselves assisted by three staff. In addition, Mr. Colin Forester-Morgan, previously the Proprietor, maintains a supervisory and supportive role. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 20 Staffing levels would appeasr unexpectedly low, but the quality of service has been achieved because the provider and manager live on the premises and provide sleep-in cover. Their input provides for a minimum of two staff over the 24-hour period and three staff at key times, however this may not provide the flexibility or one to one support some service users are coming to need with ageing and the progress of their condition. Staffing levels are therefore likely to require attention in the near future, particularly at night when service users might be expected to need waking staff. The management were keen to offer assurances that they are aware of this and the need to keep staffing levels under review. The training needs of staff are regularly reviewed and monthly in-house training sessions are provided on work related subjects. A training record is maintained in respect of each member of staff. This was discussed at inspection, but full details of all staff training were not seen. These are therefore requested together with a copy of the current year’s training programme as the basis for discussing the approach to future training needs. In particular confirmation is sought that all staff have suitable training in communication, meeting the needs of older people and people with epilepsy, diabetes, dementia, brittle bone conditions, challenging behaviour and safeguarding people. Service users can have some confidence staff are trained to understand and meet their needs, although it would be good practice to ensure all staff are trained to a higher level of expertise in keeping with the aims of the service. Staff follow a Learning Disability Award Framework foundation programme and National Vocational Qualification programmes. Two (50 ) of staff are trained to NVQ level 2 as required, although this may fall well below the expected level as one staff is due to leave shortly. In view of the small size of the staff group, the senior responsibilities they take on to provide relief cover for Mr and Mrs Forester-Morgan and the very specialised needs the service is seeking to meet, it would be good practice to aim for all staff to be trained to at least NVQlevel 3. While service users can be confident staff employed to support them have had Criminal Record Bureau checks, and references have been sought, records need to show recruitment procedures are sufficiently robust. Two satisfactory written references must be obtained before new staff are appointed, and evidence needs to be recorded showing that previous employment history is fully explained. Staff receive regular, individual supervision that is recorded. There are good systems for supporting and communicating with staff, and they have opportunities to take part in service development. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 21 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, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed, and management responsibilities are carried out sensitively and effectively, enhancing the well being of everyone living and working in the home. EVIDENCE: Service users benefit from a service that is well run, with their own interests the foremost priority. They have a good relationship with the manager and provider who share responsibility for the running of the home and both work here full time. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 22 Management arrangements ensure there is a suitably qualified and experienced person with full time responsibility for this home. Mrs ForesterMorgan is qualified to NVQ Level 4 and is also an NVQ Assessor. She keeps up to date with current thinking on policy and practice via the internet, attends relevant training courses and ensures she keeps herself and staff informed of matters relating to the care, support and safety of people with a learning disability. Staff receive regular individual supervision and support, and training in safe working practices is up to date. With the exception of work needed to fit intumescent strips to doors (referred to in the Environment section), safety in the home is well managed. This means service users and their supporters can have confidence good practice is promoted within the home and there is ample evidence in this report to support this. Service users and key people confirmed they are actively encouraged and supported to contribute their views and to have a role in planning and developing the service. However there is not yet a formalised system for doing this, and for producing an annual development plan based on the findings as is required. An external agency has responsibility for carrying out an annual service audit and quality review, this was taking place at the end of this inspection. The outcome report supplied to the commission shows the auditors addressed all management and administrative areas significant to the well being of service users, and that they were satisfied with the quality of operations on this occasion. The audit process does not however address the need to seek the views of service users and stakeholders about the quality of the service they receive, relying for this aspect on the outcome of the Commission’s inspection surveys. These are designed to provide feedback to the inspection process and so are not sufficiently comprehensive for the purpose of a quality assurance system, which needs to explore service delivery in much more detail. Thus, the audit is a valuable business tool and it is reassuring the provider and manager are conscientious about making sure they run their business soundly, but more work needs to be done. The need to develop a full quality assurance system was discussed during the inspection with the provider and manager. This must be designed to find out from service users and key stakeholders whether they are satisfied with the quality of outcomes for service users, and what improvements they would like to see. An annual report on the outcome should be provided to service users, with a copy to the Commission, showing how the provider intends to respond and develop the service in line with the findings. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 23 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 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000018492.V334622.R01.S.doc 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 4 15 4 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arden House 4 X 3 X X 3 X Version 5.2 Page 24 Score 4 4 3 X no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 YA23 Standard Regulation 13(6) Requirement Policies and procedures and staff training on safeguarding people must be updated, and include local procedures for responding to suspicion of abuse, to make sure all staff understand their responsibilities clearly and know the action to take in the event of concerns about abuse being raised. Timescale for action 05/09/07 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 Refer to Standard YA22 Good Practice Recommendations The complaint procedure for service users should be discussed with them to ensure they understand it, and with a view to considering ways of making it easier for them to use should they wish to do so. It would be good practice to consider recording verbal concerns and how they are responded to Staffing levels should be kept under review to make sure there are always enough staff on duty to meet the service users identified needs. DS0000018492.V334622.R01.S.doc Version 5.2 Page 25 2 YA33 Arden House 3 YA35 4 YA39 The staff training policy should be reviewed, to ensure staff have the specialist training for their responsibilities and necessary to meet all the service users identified needs, including NVQ programmes to an appropriate level The Quality Assurance system should include a suitable method designed to obtain the views of service users and their supporters about the quality of service received, followed by a report provided to service users explaining how the service will respond to the findings and its plans for developing the service. The Commission should also be provided with a copy of this report. Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office The Coach House. John Comyn Drive, Perdiswell Park Droitwich Road WORCESTER WR3 7NW 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 Arden House DS0000018492.V334622.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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