Inspection on 31/01/08 for Argyll House

This inspection was carried out on 31st January 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Argyll House 578 Cricklade Road Swindon SN2 7AS Lead Inspector Alison Duffy Unannounced Inspection 31st January 2008 10:10 Argyll House DS0000070486.V358932.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 Argyll House DS0000070486.V358932.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. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Argyll House Address 578 Cricklade Road Swindon SN2 7AS 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) 0118 9581950 C.H.O.I.C.E Ltd Tracey Alexander Care Home 5 Category(ies) of Learning disability (4), Physical disability (1) registration, with number of places Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability (Code LD) - maximum of 4 places 2. Physical disability (Code PD) - maximum of 1 place The maximum number of service users who can be accommodated is 5. This is a new service and therefore the first inspection Date of last inspection Brief Description of the Service: Argyll House is a 5 bedded home for adults with a learning disability, between the ages of 18 and 30 years. One person may have a physical disability. The service is one of 18 homes owned by CHOICE Ltd. The registered manager is Ms Tracey Alexander. The home was registered with us, as a new service in August 2007. Argyll House is located in Swindon, close to the town centre and a range of local amenities. All bedrooms are single and have an en-suite facility consisting of a shower, hand washbasin and toilet. There is a spacious lounge/dining room, which leads to a conservatory. There is parking to the front of the home. There is a secluded garden to the rear of the house, with a patio area and summer house/sensory room. Staffing levels are maintained at three or more staff on duty during the waking day. At night, there are two waking night staff. An on call management system is available at all times. Fees for living at Argyll House range between £1600 and £2200 a week. Argyll House DS0000070486.V358932.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 2 star. This means the people who use this service experience good quality outcomes. This key inspection took place on the 31st January 2008 between the hours of 10.10am and 5.30pm. Mrs Alexander, the registered manager was not on duty yet came into the home to assist with the inspection. Mr Rob Anscomb, operations manager also visited and was available throughout the day. We met with three people who use the service and four staff members. We looked at the medication systems and at care-planning information, training records and recruitment documentation. As part of the inspection process, we sent surveys, to be distributed by the home to people’s relatives, their GPs and other health care professionals. The feedback received, is reported upon within this report. We sent Mrs Alexander an Annual Quality Assurance Assessment (AQAA) to complete. This was completed in detail. Some information from the AQAA is detailed within this report. The AQAA and the surveys were sent to Mrs Alexander after we visited the home. There was therefore a delay of approximately four weeks until their return. All key standards were assessed on this inspection and observation, discussions and viewing of documentation gave evidence whether each standard had been met. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the experiences of people using the service. What the service does well: The home was totally refurbished before the home opened. The environment has been developed to a high standard. All areas are spacious, clean and well maintained with good quality furnishings. A clear admission procedure is in place. People have a detailed transition plan, which ensures their needs will be met within the home. All admissions have been staggered enabling staff get to know the person effectively, before the next admission. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 6 Care planning is of a good standard and reflects individual need and the support required. Clear behavioural management strategies are in place. These have been developed with the input of a psychologist. The manager has a sound value base, which is transferred to the staff team and service provision. Clear systems such as staff supervision and monitoring of practice are in place, to ensure a good standard of care. Priority is given to social activity and community involvement. This will be further enhanced when the intended activity coordinator is successfully recruited. Staff are motivated and engage well with people who use the service. Medication systems are clear and well managed therefore reducing the risk of potential error. Meal provision is based on peoples’ preferences, healthy eating and fresh produce. A dietician has confirmed the nutritional value of the menus in place. Staff are clear of their responsibilities to report any suspicion or allegation of abuse. A robust recruitment process is in place, which gives people who use the service, additional protection. 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. Argyll House DS0000070486.V358932.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 Argyll House DS0000070486.V358932.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. The home has a detailed, well-organised admission procedure, which ensures the person’s needs, will be met within the home. EVIDENCE: Within the AQAA a detailed admission process was evidenced. The placing authority would complete an initial assessment. The manager would meet with the person and complete the home’s own assessment form. If it were felt the home could meet the person’s needs, a transitional plan would be drawn up. Various visits, including an overnight stay would be encouraged. Staff training, if required, in relation to the person’s health care condition would be arranged. A written contract of terms and conditions would be drawn up, when the home was deemed suitable and safe for the person. Three people have been admitted to the home since it opened. Mrs Alexander told us that all admissions had been staggered. This enabled staff to get to know the person before the next person arrived. There are currently two empty rooms. Mrs Alexander told us that careful consideration is being given to these placements, to ensure the compatibility of all people who use the service. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 9 We looked at the assessment documentation of all new people to the service. The information demonstrated the admission process, as described in the AQAA. The documentation was detailed and clearly demonstrated individual needs and the support required. Argyll House DS0000070486.V358932.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. 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. People benefit from a good standard of care planning. People are encouraged to make decisions in relation to their ability. Peoples’ welfare is promoted through a well-managed risk assessment process. EVIDENCE: Each person who uses the service has a detailed, up to date care plan. The plan highlights individual needs, preferences and individual goals. The support needed to meet these areas, is clearly identified. Detailed behavioural management guidelines, which have been developed in consultation with the psychologist, are in place. Mrs Alexander told us of one situation, which has enabled the person to establish a more improved sleep pattern. The care plans are reviewed on a monthly basis or as needs change. Regular formal reviews are also held. We saw that the care plans were stored on a cabinet in the lounge. We advised that all such information should be stored securely. Mrs Alexander discussed this with staff and gave assurances that the documentation would be moved, to a more secure place. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 11 Mrs Alexander and the staff team were clearly aware of peoples’ needs. We observed good interactions and people responded well to staff on duty. Within a survey, two relatives told us that the home always gives the support or care that is expected or agreed. In answer to the question, what the home does well, they said ‘absolutely everything – the standard of care is outstanding’ and ‘looking after and caring for XX.’ Staff told us within their surveys, communication, day care, guidance and personal care of service users were aspects the home did well. A health care professional said ‘[the home] works well with the challenges presented by the service users. High level of care provided at all times.’ Due to complex health care needs, people are unable to communicate how they wish their care to be delivered. Mrs Alexander told us, that due to this, information from relatives and previous placements is key. One member of staff told us, they felt it essential to get to know the person, in order to build trust and give support effectively. Another staff member told us that decisionmaking is promoted in line with the person’s ability. They told us about ways in which people are encouraged to make their own choices. We saw one person use push-button lights to voice, yes or no. Another person lead staff to the kitchen door, identifying they wanted a drink. Staff signed to the person, to confirm their need. Mrs Alexander told us that some decisions are made on behalf of the person. In these instances, known preferences or past experiences are taken into account. Decisions may also be discussed with other people such as relatives or a psychologist. Due to the level of people’s complex needs, risk taking is generally associated with daily living skills. For example, control measures are in place to address safety within the community. Each person has a detailed risk management plan, which forms part of the care plan. These are regularly reviewed and contain pictorial formats, for easier understanding. One person has one-to one staff support during the day due to having epilepsy. The staff member providing this support felt it was essential to ensure the person’s wellbeing. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. Social and leisure activities are based on individual need and preference. People are supported to maintain important relationships and have visitors at any time. Meal provision is of a good standard enabling variety, healthy eating and individual preference. EVIDENCE: Mrs Alexander told us about the importance the home and the organisation places upon social activity. A full time activity organiser is in the process of being recruited. It is expected that they will take the lead with organising events, yet staff will continue to provide on going support. Mrs Alexander told us that leisure activities within the community are promoted. However, each event is tailored to meet individual need. For example, crowds and noise levels are taken into consideration with people who may find this difficult. Staff told us, that as all people are new to the service, peoples’ individual preferences are being established. They said one person enjoyed swimming, shopping, Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 13 bowling and trips out. Another enjoyed ‘pampering’ such as a massage. Each person has an activity plan, as part of his or her care plan. During the inspection, one person went for a walk with a member of staff. Two people remained at home yet received a high level of staff support. Staff were attentive and engaged with people rather than talking between themselves. People were supported with soft play, a foot spa and general relaxation. Staff told us that people who use the service are supported to maintain important relationships. Visitors are welcomed at any time. People are able to receive visitors in their own room or in any of the communal areas. The support required with managing mail is detailed within care plans. Within surveys, both relatives said that they were kept informed of important matters. The preferred routines of people using the service are detailed within care plans. People are encouraged to make choices such as what they wish to wear. We saw staff encourage one person to receive personal care in the privacy of their room. This was done sensitively and at the person’s own pace. Staff told us that people are able to be involved in cooking and housekeeping tasks, if they wish. The level of involvement however, may depend on the person’s ability. There are picture boards in the lounge to aid communication. Photographs of staff are also in place, so that people know who is on duty. Staff showed us the current menu. They told us it was devised with a dietician, on the basis of healthy eating and peoples’ individual preferences. Staff told us the majority of meals are cooked ‘from scratch’ with fresh produce. We saw a range of fresh fruit and vegetables in the kitchen. We saw the serving of both lunch and tea. Both meals were well presented and looked appetising. All staff and people using the service eat together in the dining room. We saw that discussion over the meal was natural. All people who use the service were included. Mrs Alexander told us that staff currently prepare and cook all meals. However, a cook is being recruited, which will enable staff to spend more time with people who use the service. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. People receive a high level of support with their personal care routines and have good access to health care provision. Medication errors are minimised through clear, well-managed medication systems. EVIDENCE: People who use the service, receive full assistance from staff in all aspects of daily living. This support is detailed within care planning information. There are detailed guidelines in place regarding morning and evening routines. Aspects such as ensuring privacy and dignity during the provision of personal care are stated. Detailed guidelines, which have been developed with a psychologist, are in place regarding the management of behaviours. People rely on staff to recognise and act upon any sign of ill health. Each person has a health care plan. This includes areas such as weight monitoring, oral hygiene and optical care. All people are registered with a local GP and attend appointments as required. Staff are currently working with a community nurse to monitor one person’s seizures. Detailed guidelines to manage the person’s epilepsy were evident. Clear records detailing the time, duration and Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 15 type of seizure, were in place. All people who use the service have access to regular psychology and psychiatry input. Mrs Alexander told us that a speech and language therapist is currently involved with developing communication systems. There are detailed medication policies and procedures in place. The procedure to follow in the event of a medication error is displayed on the medication cupboard. People who use the service, are reliant on staff for their medication administration. One person receives their medication covertly in food. There was written authorisation from the GP regarding this practice. All staff who administer medication have received training. Mrs Alexander told us that on going competency checks will be undertaken. The medication was stored securely. Records demonstrated that all medication was satisfactorily receipted on arrival to the home. Two staff sign to demonstrate the administration of each medication. We recommended that any handwritten medication instruction be signed and dated by two members of staff. As good practice, all medication had been dated when opened. Wipes were available to ensure bottles were kept clean. Weekly stock checks were in place. Information was available for staff reference regarding each medication and its possible side effects. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 16 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. The home has a clear, well-managed complaint procedure, which relatives and staff are confident in using. People are assured greater protection from abuse through well-managed adult protection systems. EVIDENCE: There is a copy of the complaint procedure within each person’s file. This is in a pictorial format for easy understanding. However, Mrs Alexander and staff told us that people generally rely on staff or others to recognise any form of discontentment. One member of staff told us that in some instances, identifying the cause of discontentment would be a process of elimination. For example, staff would need to ensure that the person was comfortable and not hungry, thirsty or cold. They felt that ensuring good physical wellbeing was often a starting point, when identifying discontentment. Within surveys, two relatives told us that they knew how to make a complaint. All six staff who returned their survey, were also confident of what to do if a relative had concerns about the home. They said ‘show them the complaints procedure,’ ‘refer them to the manager and let your manager know too’ and ‘the concern would be reported to the manager straight away.’ Mrs Alexander told us that all staff are given a copy of local adult protection reporting procedures during their induction. This is evidenced within documentation. The procedure is further discussed within formal staff supervision. Staff told us that they would immediately report any allegation or Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 17 suspicion of abuse to their line manager. This may involve the on call management system. Staff told us that management would then make the decision to alert the Safeguarding Vulnerable Adults Unit. Training records demonstrated that adult protection forms part of the home’s mandatory training programme. Ms Alexander told us that she was aiming to enable a ‘whistle blowing’ environment. This would enable honesty and ensure any hint of poor practice, would be identified and subsequently addressed. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 18 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 environment is clean, furnished to a good standard and conducive to peoples’ needs. EVIDENCE: There are three bedrooms on the ground floor and two on the first floor. Each bedroom has a full en-suite facility. This consists of either a walk in shower or shower cubicle, a toilet and hand washbasin. There are no baths within the home. One bedroom has been designed for a person with a physical disability. The room has a wider opening to the shower room in order to accommodate a mobile hoist. When we visited to register the home, we said a door or a curtain was needed to separate the bedroom from the en-suite. A curtain has been applied to enable greater privacy. All first floor bedroom windows have been fitted with restrictors to ensure peoples’ safety. Hot water outlets have temperature regulators to minimise the Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 19 risk of scalding. All rooms have low surface temperature radiators. A call bell system has recently been installed. There is a large sitting and dining room, which leads to a conservatory. There is a large well-equipped kitchen. The kitchen has a low-level work surface. This enables people with a physical disability, to comfortably sit at the work surface, in their wheelchair. All areas of the home were clean and furnished to a good standard. There were no unpleasant odours. We saw staff immediately clear up any spillages and use the ‘wet floor’ signs to minimise the risk of slipping. Mrs Alexander told us that the laundry facilities were satisfactory in meeting the needs of the people using the service. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 20 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, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive a good level of one-to-one staff support from a motivated staff team. People are protected through a clear, well-managed recruitment procedure. EVIDENCE: There is a minimum of three staff on duty during the waking day. At night there are two waking night staff. Mrs Alexander told us that a cook is being recruited. Until the position is filled, care staff are responsible for all housekeeping and catering tasks. As stated earlier in this report, a day care organiser is planned. Mrs Alexander told us, that the position is currently being advertised. There was one agency member of staff on duty with two other permanent members of staff. Mrs Alexander told us that there had been a number of recent staff changes. This had led to the need for some agency use. Some staff confirmed this within their surveys. One staff member, in answer to the question, are there enough staff, said ‘sometimes, because our home don’t have permanent night staff now. So its hard to give 100 individual needs, as Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 21 most of the time its agency staff and having new people all the time who don’t know our service users doesn’t help much. We do what we can. Sometimes, its one permanent staff with 2 agency who never been here, counting three.’ Further comments included ‘currently having to use agency but have now recruited new staff, awaiting them to start’ and ‘at the present time we have three staff to three service users so all needs are met.’ One health care professional told us that staff usually have the right skills. They said ‘all permanent staff [have the right skills] however bank and temporary staff can lack the experience of working with challenging behaviour and epilepsy. All permanent staff are trained to a high standard by the company.’ Mrs Alexander told us that she is expecting the use of agency to be short term, as attention is being given to further recruitment. Mrs Alexander spoke highly of the staff team. She told us, all were committed to peoples’ well being and developing the service in a positive manner. Within their surveys, two relatives told us that they felt staff always had the right skills and experience to look after people properly. We observed interactions between staff and people who use the service. Staff engaged well with people. Interactions were attentive and respectful. Staff appeared motivated within their role and spoke of peoples’ needs in detail. We looked at the documentation demonstrating the recruitment process of two new members of staff. The information was clear, ordered and all required information was in place. There were two written references. A Criminal Records Disclosure had been received before the member of staff had commenced employment. We spoke to staff on duty regarding the training they had undertaken. They told us that subjects, such as first aid, manual handling and adult protection, had been completed before people moved into the home. They told us that the organisation gave priority to training. They had also completed epilepsy, antidiscriminatory practice and values training. One member of staff told us ‘if you need any information about anything, you only have to ask and it’s provided.’ Within surveys, all staff told us that they had received relevant training. Training records were clear and up to date. Mrs Alexander told us that out of the seven staff, four have National Vocational Qualification Awards (NVQ) level 3. One member of staff is planning to do NVQ level 4. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 22 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. People benefit from a manager who is motivated with a sound value base. The service is person centred and is developing with a clear focus. Peoples’ wellbeing is promoted through clear health and safety systems. EVIDENCE: Mrs Alexander has support worker and management experience within the Avon and Wiltshire Mental Health Partnership NHS Trust. Before gaining the position of registered manager, Mrs Alexander worked for the Ambulance Service. Mrs Alexander has experience of working with adults with a learning disability yet not within a residential care home setting. Mrs Alexander acknowledged that some aspects might present a learning need. However, she told us she felt well supported by her line management and was looking forward to the potential challenges ahead. Mrs Alexander has started her Registered Managers Award. She plans to do the NVQ level 4 in care. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 23 Mrs Alexander has a clear focus regarding the service she wishes to provide. She strongly believes in the promotion of people’s rights and enabling a good quality of life. Mrs Alexander has developed clear systems such as staff supervision, staff meetings and monitoring visits. The use of disciplinary action has been effectively used to ensure expected standards are in place. As the home has only recently opened, focus has not been given to a formal quality auditing system. However, the organisation has a system in place, which will be adopted in due course. Mrs Alexander told us that feedback about the service so far, has been gained informally through general discussion. There has been a service user’s meeting. Within this, people were asked if they liked the staff and the activities offered. Photographs of staff and pictures of activities were used to assist communication. The organisation has a range of health and safety policies. Health and safety audits have been established. There are weekly maintenance checks in place. Individual and environmental risk assessments have been developed. The fire log book demonstrated satisfactory testing of the fire alarm systems. All staff are up to date with their mandatory training such as first aid, food hygiene and manual handling. Health and safety matters have been taken into account within the environment. For example, there are low surface radiators and hot water regulators in place. All rooms on the first floor are fitted with window restrictors. Any hazardous substances are locked away. Staff have access to disposable protective clothing such as gloves and aprons. We saw one member of staff clean the floor in the downstairs toilet. Wet floor signs were used and people, were kept away from the area, until the floor was dry. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 24 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 X 34 3 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 3 3 3 X 3 X 3 X X 3 X Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Not applicable – this is a new service 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. 1 2 Refer to Standard YA6 YA20 Good Practice Recommendations The registered person should ensure that care-planning information is stored securely. The registered person should ensure that another member of staff countersigns any hand written medication instruction. Argyll House DS0000070486.V358932.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Argyll House DS0000070486.V358932.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. You have been warned!