CARE HOME ADULTS 18-65
Arundel Close (1) Chippenham Wiltshire SN14 0PR Lead Inspector
Elaine Barber Key Unannounced Inspection 13 and 28th February 2007 10:30
th Arundel Close (1) DS0000028238.V323154.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 Arundel Close (1) DS0000028238.V323154.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. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Arundel Close (1) Address Chippenham Wiltshire SN14 0PR 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) 01249 651112 01249 765520 www.unitedresponse.org.uk United Response Vacancy Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17th November 2005 Brief Description of the Service: 1 Arundel Close is one of a number of homes that are run by the national charity, United Response. The home is a detached property in a residential area of Chippenham. 1 Arundel Close fits in well with the neighbouring properties. The accommodation is domestic in style and includes a lounge, a dining room, a recreation room and four single bedrooms. Service users receive support from a manager and a permanent staff team. Relief staff members also regularly work in the home. A keyworker system is in operation. At present there is no registered manager. The previous registered manager left and the new manager, Karen Moore, has not yet been registered. The fees range between £1019.55 and £ 1044.77. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit to the home on 13th February 2007 and a planned visit by the Pharmacist Inspector on 28th February 2007. During the visits information was gathered using: • • • • • Observation Discussion with three people who lived in the home Discussion with three staff Discussion with the manager Reading records including care records. Other information and feedback about the home has been received and taken into account as part of this inspection: • • • The acting service manager provided information prior to the inspection about the running of the home. One person who lived in the home completed a comment card. Three staff members completed comment cards. The judgements contained in this report have been made from all this evidence gathered during the inspection, including the two inspection visits. What the service does well:
People’s individual needs were assessed so that their needs could be met. Each person who lived in the home had their needs assessed by staff at 1, Arundel Close. These assessments were reviewed. Each person had a care plan, which provided detailed information about how their needs were to be met, in areas such as communication and personal care. This helped to ensure that the staff team provided consistent support in the way that each person preferred. The care plans were regularly reviewed and objectives were set to reflect changes in the people’s lives. Staff had taken a creative approach to involving one person in their review by using a power point presentation with photographs. People were provided with a range of activities and opportunities, offering access to their local community. Each person had a day time activity of their choice. They used the community facilities such as the shops, cafes, church and leisure centre. People had access to the community on a daily basis. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 6 People were able to maintain and develop appropriate relationships with family and friends. They had regular visits to friends and relatives who were also welcome in the home at any time. Routines were flexible and fitted in with people’s activities. People participated in the household chores. People’s rights were respected and their responsibilities were recognised in their daily lives. There was a varied menu, which reflected a balanced diet. People had opportunities to go food shopping and to be involved in meal preparation. People were offered a healthy diet and enjoyed their meals. There was information about people’s individual needs and preferences in their assessments and care plans. People’s preferred routines were recorded in their personal notes so that people received support in ways they preferred and required. People’s healthcare needs were included in their personal plans. Each person was registered with a GP and they saw a range of health professionals including a physiotherapist, community nurse, occupational therapist, psychiatrist, dentist, optician and chiropodist. People’s physical and emotional health needs were met. Staff supported people to take their medication. There were appropriate arrangements for the storage, administration and recording of medication and people were protected by the home’s policies and practices. There was a complaints procedure. People’s views and those of their relatives were obtained in reviews. People’s views were listened to and acted upon although people were dependant on others for raising any formal concerns. Staff members received guidance about prevention of abuse and staff were aware of the adult protection procedures. This helped to protect people from abuse and harm. Each person had their own bank account and there were financial records. The financial procedures and practices safeguarded people’s financial interests. The home was very spacious. There was a large lounge and dining area with a linked snooker room and office area. There was also a separate activities room and a large kitchen. People lived in a comfortable, clean and safe environment, suitable to their needs. The shared spaces complemented people’s rooms. Each person had a large single bedroom, which was individually decorated and furnished. People had made their rooms very individual with their own possessions. People’s bedrooms suited their needs and lifestyles. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 7 There were sufficient toilet and bathroom facilities to ensure privacy and meet people’s needs. The laundry facilities met the needs of the people who lived in Arundel Close. The home was clean and hygienic. There were usually two members of staff on duty when people were at home. There was a range of training to ensure that staff could meet people’s diverse needs. Two staff had a National Vocational Qualification or equivalent. People were supported by an effective staff team, who were appropriately trained and competent to meet their needs. Appropriate recruitment checks were completed before staff started work so that people were protected by the home’s recruitment practices. A new manager had been appointed who had a relevant care qualification and was undertaking a management qualification. The previous acting manager was still working in the home and was suitably qualified, competent and experienced, so that people benefited from a well run home. A quality assurance survey had been conducted and views of people who lived in the home and relevant professionals had been collected. A report had been produced and areas for improvement had been identified. People’s views underpinned all self-monitoring, review and development by the home. There was a range of health and safety measures and staff had received appropriate training. People’s health and safety were protected by the health and safety systems in place. What has improved since the last inspection?
A requirement was made at the previous inspection that a form of annual development and improvement plan needed to be produced, based on a review of the quality of care. This must include the contribution of service users and their representatives. This had been addressed, questionnaires had been sent to people who lived in the home, their relatives and relevant professionals. A report of the findings had been produced and an improvement action plan had been developed for May 2006 to May 2007. Three recommendations which were made a t the last inspection had been addressed. One recommendation was that the monthly activities sheets are consistently and fully completed in order to give an accurate record of the activities undertaken. Detailed information was recorded. This ensured it was possible to monitor what activities people had participated in and they had a range of regular activities. Information for one person about epilepsy and medication had been updated since the last inspection. All staff except the newest member had received training about specialised techniques of giving the epilepsy medication. This would ensure that the epilepsy was managed effectively.
Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 8 A statement about quality assurance and how it is implemented in the home had been included in the quality monitoring report. A statement had also been included about how the evidence was gathered from questionnaires, reviews, health and safety checklists and training records. 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. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 9 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 Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 10 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. People’s individual needs were assessed so that their needs could be met. EVIDENCE: The four people had lived together in the home for several years and their needs were assessed when they moved in. No new people have moved into the home. The staff had completed intimate and personal support assessments for each person and these were reviewed. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s abilities, needs and goals were reflected in their individual plans.. Although objectives were identified, a lack of detail about how these are to be achieved may affect people’s quality of life. People were supported with making decisions about their lives and what they wanted to do. They benefit from the approach that is taken to assessing risk, which promotes their independence. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 12 EVIDENCE: The care records of three people were read. Each record had a section called ‘About me’ which provided information about personal history. One member of staff said that they had found this to be very useful when they first started work. There was detailed information about people’s daily routines and support plans for the morning and evening. These were reviewed and updated where necessary about every three months. People had information about support needed with communication. Each person also had a six monthly review with their relatives and any professionals involved. One person had the slides from a power point presentation in folder. The presentation was used at their review to help them understand what was happening and to be involved. The person continued to refer to the slides to remind them of the review and decisions that were made. This was a creative way of involving the person and an example of excellent practice. Objectives were set after each review and progress with these was monitored two monthly. These objectives were recorded in the review minutes. However, these objectives could be reviewed and monitored more easily if they were written up into a plan, which identified the objective, the action needed to meet the objective and spaces to monitor progress. There was information in the records about how people communicate. Any limitations on choice and freedom were recorded in the support plans. Information about how people made choices and decisions was also recorded. During the inspection the people who lived in the home and the staff gave examples of how people made choices and decisions such as choosing the décor of their bedrooms and their meals. People were supported to manage their own money. Staff took people to the bank and helped them to withdraw their money. There were records of risk assessments that covered a range of activities and facilities. These showed that attention was being given to supporting people with activities and pastimes that may involve a degree of risk. Although some were of a general nature, for example, bathing and window openings, others were specific to an individual and covered things that they liked to do, such as going to the shops and having a Centre Parcs holiday. Many of the risk assessments had been updated in August and September 2006. These risk assessments were kept together in a separate risk assessment file. It would be good practice to keep personal information about individual people in their personal files to enable easy access to their records. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were provided with a range of activities and opportunities, offering access to their local community. People were able to maintain and develop appropriate relationships with family and friends. People’s rights were respected and their responsibilities were recognised in their daily lives. People were offered a healthy diet and enjoyed their meals. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 14 EVIDENCE: The records of three people were seen. Each had a ‘Weekly Activity Plan’. The weekly programmes involved some activities outside the home. Three people attended a local resource centre. Changes in day centre provision meant that people had fewer planned activities. The staff team were providing support with more home based pastimes and community activities, such as swimming. Each person also had a ‘Monthly Activities’ monitoring sheet. These were used by staff as a way of helping to ensure that people regularly participated in a range of community activities throughout the month. A recommendation was made at the last inspection that the monthly activities sheets are consistently and fully completed in order to give an accurate record of the activities undertaken. This had been addressed and detailed information was recorded. These monitoring sheets and the daily records showed that people had a range of activities and used community facilities. Activities included shopping, going to the cinema and theatre, going to the bank, having a haircut, swimming and massage. People also went to the local leisure centre, went swimming and bowling, went for walks and had meals out. Two people had been to Centre Parcs for a holiday. People also had activities at home. These included colouring, stencilling, watching TV and videos, games and crafts. People were involved in the routines of the home. They cleaned their own rooms with support, did the washing up and cleared the table after meals. At the beginning of the inspection one person was doing the washing up. The people and the staff spoke about the visits that were made to family members. One person stayed with parents every other weekend. The others also visited their parents and had visits from parents and other relatives. The personal records included an, ‘About Me’ section, which recorded people’s important personal contacts and relationships. These were also discussed at review meetings and recorded under a ‘Family and Friends’ section. One person said that they had friends at a local rugby club where they were made to feel welcome. They were well supported with this by the home’s acting manager. Opportunities for other people and their capacity to develop friendships outside the home appeared to be more limited. One person talked about friendships with people in other houses managed by United Response. They had been on holiday with one person from another house and had an ongoing friendship with them. It was evident during the inspection that people were able to participate, within their abilities, in the everyday routines such as making drinks, making
Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 15 cakes, washing up and responding to callers with support from staff. There was also encouragement for people take small responsibilities, such as putting clothes away in their rooms before moving on to something else that they wanted to do. The menu showed that a varied and balanced diet was offered. During the inspection a choice of lunch was offered of sandwiches or cheese on toast and salad. People were observed to be enjoying their lunch. People were involved in shopping for food and meal preparation. A dietician had provided advice about one person’s diet. Healthy eating was promoted. Arundel Close (1) DS0000028238.V323154.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People received personal support in the way that they preferred and required. People’s physical and emotional health needs were met. People were protected by the home’s policy and procedures for safe medication handling. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 17 EVIDENCE: Information was recorded in each person’s file about how they liked to be supported at particular times of day. Each person also had an ‘Intimate and Personal Support’ assessment form and a ‘Medical Profile’. This information had been updated within the last six months and provided staff with individual guidelines for how to support people. Any assistance with personal care was identified in the support plans and personal support took place in the privacy of people’s own rooms or the bathroom. People’s preferred times for getting up and going to bed were identified in the daily routines while meal times were fitted in with activities and were flexible. People chose their own clothes and hairstyles. The people who lived in the home were registered with GPs at a local surgery. Specialist support was being provided through the Community Team for People with Learning Disabilities including community nursing, occupational therapy, physiotherapy, psychology and psychiatry. People’s individual needs in respect of medical conditions and disabilities were assessed and recorded. Each person had an annual check up. Visits to opticians, dentists, podiatrists and other health care professionals were also recorded. People had recently had flu vaccinations. The Pharmacist Inspector looked at arrangements for the handling of medicines. Medication was stored and recorded appropriately. No residents were able to manage their own medicines. Staff had all been trained in safe medicine management and most have had training in additional tasks to enable them to support residents. Information about medicines and a procedure are available to staff. Care staff were using blood testing equipment which was designed for self-use, this must be reviewed in line with recent guidance. All medicines were stock checked regularly and expiry dates noted, except for one item kept separately for emergency use. Staff were able to discuss residents’ medication and their particular requirements with the inspector, this information was recorded in the residents’ files. Information for one person about epilepsy and medication had been updated since the last inspection. All staff except the newest member had received training about specialised techniques of giving the epilepsy medication. Arundel Close (1) DS0000028238.V323154.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s views were listened to and acted upon although people were dependant on others for raising any formal concerns. Staff members received guidance about abuse, which helped to protect people from abuse and harm. The financial procedures and practices safeguarded people’s financial interests. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 19 EVIDENCE: United Response had produced an organisational complaints procedure. This has been adapted and simplified locally and given to people who lived in the home in the form of a laminated card. There had been no complaints since the last inspection. There was a record of compliments. People would need support to use the complaints procedure. People’s views and the views of relatives and other professionals were sought at review meetings. It was recommended at the last inspection that the written information and guidance about complaints includes a reference to the different ways and opportunities that people may have to raise concerns and how these will be followed up. There had been no changes to the complaints procedure. One person completed a comment card. They said that they would tell the staff or their parents if they had a complaint. The home’s policy and procedures file contained information on the prevention and reporting of abuse. This had been produced as a new policy in 2004. The home received updated policies and procedures on a regular basis through United Response, together with an accompanying sheet for staff to sign to confirm that they have read the information. There was an easy to read protection of vulnerable adults policy and information about ‘No Secrets’ and the local multi-agency adult protection procedures. A member of staff said that all staff have this information. Staff training records showed that three out of five staff had received training about prevention from harm. Three staff who completed comment cards were aware of the adult protection procedures. Staff supported people to manage their money. Records were kept of people’s finances and two staff signed the record when money was withdrawn. Each person also had a bank account and bank statements were seen. Some of the support workers were signatories to the accounts. This had been agreed with each person and the bank. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 20 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to this service. People lived in a comfortable, clean and safe environment, suitable to their needs. People’s bedrooms suited their needs and lifestyles. There were sufficient toilet and bathroom facilities to ensure privacy and meet people’s needs. The shared spaces complemented people’s rooms. The home was clean and hygienic. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 21 EVIDENCE: The property was a detached house in keeping with other houses in the street. The home was very spacious. There was a large lounge and dining area with a linked snooker room and office area. There was also a separate activities room and a large kitchen. People could receive visitors in private in the activities room or their own rooms. Each person had a large single bedroom, which was individually decorated and furnished. Staff had supported people to choose the colours of their rooms. People had made their rooms very individual with their own possessions. Downstairs there was a toilet and shower room. Upstairs there was a bathroom with a walk-in bath to meet the needs of two of the people who lived in the home. One person had an ensuite bathroom. There was a laundry area with an industrial type washing machine and a tumble drier to meet the needs of the people who lived in the home. During the inspection staff were doing the cleaning as part of their support worker role. One person was being supported by a staff member to mop the kitchen floor. The home was clean and tidy throughout. The person who completed a comment card said that the home was always fresh and clean and they helped to do some of the cleaning. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 22 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were supported by sufficient numbers of staff, who were appropriately trained and competent to meet their needs. People were protected by the home’s recruitment practices. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 23 EVIDENCE: Some of the staff had worked with the people who lived in the home for several years. The rota showed that there were usually two people working in the home when the four people were at home. There were more when people needed support with activities or appointments. One member of staff slept in at night. Comment cards were received from three staff. They said that they had regular team meetings and these were recorded. All staff who completed comment cards said that a recruitment process was followed when they were recruited but they did not have CRB checks because all started work before these checks were required. They had them at a later date. The recruitment records of one new member of staff were read. They completed an application form with a declaration that they had no offences. Two written references were obtained and criminal records bureau (CRB) and Protection of Vulnerable Adults (POVA) checks before they started work. There was a declaration that they were physically and mentally fit. All staff who completed comment cards said that they had an induction period and they had enough support to start working with people. One said that the training provided was very good. Individual training records were included in the staff members’ employment files. They showed that over time each staff member had received a wide range of training. There was a training plan for 2006-7, which included training about moving and handling, medication, challenging behaviour, ‘the way we work’, a course about the ethos of the organisation, first aid, prevention of harm, health and safety and equality and diversity. Some training had also been undertaken in areas relating to the needs of service users, such as diabetes. A recommendation was made at the last inspection that training about epilepsy was arranged. All staff except the newest member had received training about epilepsy and specialist methods of administering particular medication. One new member of staff had undertaken the Learning Disability Award Framework (LDAF) induction. One member of staff had a Diploma in Social Work, one had a National Vocational Qualification (NVQ) level 2 in care and another had the NVQ assessors award and were part way through their NVQ. The manager reported that two other members of staff have the NVQ assessors award. More staff need to complete NVQ to meet the standard of 50 of staff holding a qualification. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a new manager who was about to apply to become the registered manager. The acting manager was suitably qualified, competent and experienced, so that people benefited from a well run home and continuity was maintained. People’s views underpinned all self-monitoring, review and development by the home. People’s health and safety were protected by the systems in place although the arrangements for blood testing need to be reviewed. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 25 EVIDENCE: A new manager had been appointed since the last inspection. She had a Certificate of Qualification in Social Work and was undertaking National Vocational Qualification (NVQ) Level 4 in management. She had not applied to be the registered manager but on the day of the inspection she sent off her Criminal Records Bureau check application. Once this is received back she will apply to become the registered manager. The support worker who had been the acting manager at the previous inspection was still working in the home and was present throughout the inspection. A quality assurance process had been started since the last inspection. A requirement was made at the last inspection that an annual development plan must be produced based on a review of the quality of care. This had been addressed. Questionnaires had been sent to the people who lived in the house, their relatives and relevant professionals. There had also been an evaluation of the service by an individual consultant. A report of the findings from the survey and the evaluation had been produced for May 2006 to May 2007. The format of the report included ‘What we do well’, ‘What we could do better’ and an action plan to improve the service. A recommendation was also made that a statement on quality assurance should be produced to show how quality assurance is implemented in the home and the timescale for the frequency and completion of the different components. This had also been addressed. The report included a statement about the components of quality assurance and about the evidence that had been used to complete the report including reviews, reports from management visits, health and safety checklists, training records and questionnaires. The last quality assurance survey identified that the home could provide more opportunities for people to go out into the community, to make friends and form relationships, to take holidays of their choice and to have more meaningful activities. There was an action plan showing how these would be achieved. There had also been a national evaluation of United Response and a report had been produced. A number of individual risk assessments and more general risk assessments about safe working procedures had been recorded. These included a fire risk assessment and individual risk assessments about the safety of radiators and unrestricted windows. A risk management manual had been produced by United Response. Arrangements were in place for the training of staff in moving and handling, fire safety, first aid, food hygiene and infection control. A monthly safety inspection of the home was carried out by staff. Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 26 Hot water temperature regulators had been fitted to all hot water taps except the kitchen. These were regularly serviced. There was a health and safety policy and a health and safety handbook was available to the staff team. This detailed the action to be taken in order to comply with the relevant regulations. There were Control of Substances Hazardous to Health (COSHH) assessments and a range of safety checks. These included portable appliance testing, servicing of the boiler, taking of hot water temperatures, vehicle checks, cleaning of the shower head and fire safety checks. There was also fire instruction for staff and the people who lived in the home to ensure that they were kept safe in the event of a fire. When inspecting the medication the pharmacist inspector identified that the staff were using blood testing equipment which was designed for self-use, this must be reviewed in line with recent guidance. Arundel Close (1) DS0000028238.V323154.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 2 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 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 x 32 2 33 3 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 2 x 3 X X 3 x Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 28 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. Standard YA42 Regulation 13 (3) Requirement The registered person must ensure that the safety of staff and residents is not compromised by the use of inappropriate blood testing devices. Recent information from the MHRA (Medicines and Healthcare Regulatory Agency) must be actioned. Timescale for action 28/02/07 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. 2. 3. Refer to Standard YA9 YA6 YA22 Good Practice Recommendations It would be good practice to keep personal information about individual people, such as risk assessments, in their personal files to enable easy access to their records. Objectives following a review should be written up into a plan, which identifies the objectives and the action needed to meet each objective. The written information and guidance about complaints should include a reference to the different ways and opportunities that people may have to raise concerns and information about how these will be followed up.
DS0000028238.V323154.R01.S.doc Version 5.2 Page 29 Arundel Close (1) Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Arundel Close (1) DS0000028238.V323154.R01.S.doc Version 5.2 Page 31 - 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!
