Inspection on 16/11/06 for Blackwells

This inspection was carried out on 16th November 2006.

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

Blackwells 17/03/05

Blackwells 27/10/04

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 Blackwells Blackwells Residential Care Home Blackwells (Hereford) Ltd 210 Whitecross Road Whitecross Hereford HR4 0DY Lead Inspector Christina Lavelle Unannounced Inspection 16th November 2006 12:15 Blackwells DS0000061934.V319852.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 Blackwells DS0000061934.V319852.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. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blackwells Address 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) Blackwells Residential Care Home Blackwells (Hereford) Ltd 210 Whitecross Road Whitecross Hereford HR4 0DY 01432 350853 F/P 01432 350853 Blackwells (Hereford) Limited Mr Carl Douglas Gillson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may have a physical disability or a mental health disorder in addition to their learning disability. N/A Date of last inspection Brief Description of the Service: Blackwells was first registered as a care home in 1986 and the current provider took it over in September 2004 and set up this company to operate the home. The company comprises of two directors, one of whom (Mr Kevin Betts) is the responsible individual for the home. They are also registered jointly in respect of four other care homes, two in Herefordshire. The company’s head office is at Park View House, 59 Thornhill Road, Streetly, West Midlands B74 3EN. At the time of registration the provider proposed to change the purpose of the service to provide care solely for younger adults who have learning disabilities. Plans had also been made to extensively upgrade and refurbish the premises. Subsequently all the existing service users moved elsewhere and the home did not provide a service for over a year whilst the improvements were carried out. The Commission agreed a variation to the service on 9th of August this year and the home is now registered to provide accommodation with personal care for seven people, men and women, aged from between eighteen and sixty five years. Service users must require care primarily due to learning disabilities but may also have a physical disability or mental health disorder. They are likely therefore to have complex needs and to use behaviour that can be challenging. Blackwells is located about half a mile from the centre of Hereford city, in one of the older residential areas. There are local shops and other facilities close by and it is within a reasonable walking distance of the city centre on a main bus route. The house is a large detached property, which has three floors and a cellar. There is a small enclosed garden at the back of the house and car parking space. A sitting room and separate dining room are available for all the service users to use. Six bedrooms are on the first and second floor of the house, although one is on the ground floor and so more suitable for a person with mobility difficulties. They are en-suite; all but one also having a shower. Information about the home is provided in a statement of purpose and service users’ guide, available from the home. The current fee for the service is from £1,575 up to £1,720 per week, which is dependant on the needs of individual service users, as agreed with their funding authority. The charge covers day services and activities, and items not covered by the fee include personal clothes and toiletries, newspapers, hairdressing, dry-cleaning, private health treatment e.g. dentist, optician, chiropodist and additional transport i.e. taxis. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a key inspection of the service provided by Blackwells. This means the inspector checked all the standards that can have most effect on service users. Only two people are living at the home at this time and so this surprise visit took just five hours and was made on a Thursday afternoon. The manager and one care worker discussed how the home is being run. They were also asked about their job, training and experience and about service users and their care. It is difficult to find out from service users directly what they feel about living at Blackwells because of their disabilities. However some time was spent with them both to see how well they seem to have settled in. Some relevant records kept by the home and the parts of the house service users use most were looked at. All information received by the Commission about the home since the service changed is also considered. This includes events that had affected service users and copies of the reports made following the provider’s monthly visits to check that the home is being run properly. The manager had completed a questionnaire before the inspection with details of the current service. One service user, one of their relatives and two health care professionals had also sent in survey forms with their views of the home. Everyone was very helpful and all the above information is used in this report. What the service does well: The manager and staff meet possible service users to make sure the home is suitable and could give them the care they need. New service users can check out the home before they move in to see if they would like to live there. The home looks after service users well. All the help that each person needs, and what they want, are written in a care plan. Staff also check possible risks and plans show staff how to keep them safe and what to do if they are upset. Service users seem to be happy and to get on well with staff. They each have a special staff member (a keyworker) who gives them more individual support. They get to know each other better and help them to plan their own care. Service users are able to choose what they do every day. Staff encourage and support them to have interesting lives by taking part in activities they enjoy, both at home, and out in the community. Staff help them keep in touch with their families and one relative said they are made welcome and kept informed. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 6 Staff make sure each service user has all the help they need to manage their personal care. They also support them to stay well and to have regular health checks. Service users medicines are managed safely in the home by staff. The home is in a good place near the centre of Hereford. This makes it easier for service users to visit shops etc. in town and to take part in other activities. Blackwells offers service users a very comfortable, safe and well-kept home. Service users have made their bedrooms nice and personal and rails have been put around the house to help them get about and so be more independent. Staff receive all the training they need to help them care for service users better and keep them safe. They have good support from the manager. The manager has the right knowledge and skills and the home is well run. The manager and staff work together to make sure service users have good care. They way the home is run is checked and plans made to keep making it better. 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. Blackwells DS0000061934.V319852.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 Blackwells DS0000061934.V319852.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): 1, 2, 3 & 4 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. There is written information about the home to help prospective service users and/or their representatives decide if they would live to live there. It will be better when the guide is available in a more suitable format for service users. Thorough assessment and admission procedures are in place to ensure that the home could suitably meet the needs of new service users. EVIDENCE: The home provides a statement of purpose and service users’ guide document. The manager said he intends to produce this guide in a more service userfriendly format, with simple language, pictures and photographs. This should be done as a priority, especially as the home still has vacancies. The home also provides a terms & conditions of residency to be agreed by both parties; a copy was seen in a service users file, signed by their relative on their behalf. There have been two new service users since the home re-opened. Their care records were looked at and the process leading up to their admission discussed with the manager and staff. Staff had been given all the available information about their care needs and history before they moved in. The home’s manager and staff had been to meet and spend time with one person at their former Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 9 residence when they had discussed their needs and routines with them (to the extent possible) and the staff team working with them. An assessment of their needs and risk assessments were also undertaken by the manager and an initial care plan set up based on all this information, to be developed as the home gets to know them. The plan was discussed in a discharge meeting held with the service users’ family, psychiatrist and relevant staff. It was not in one person’s best interests to visit the home before their trial stay, which would normally be arranged as part of the introduction. However their family and a placement officer from where they were living visited so they could check the suitability of the home and tell them about it. The other person was assessed by the manager but came to the home at short notice, following an operation. In this instance staff from their former home worked at Blackwells for a number of shifts to inform staff and help them settle in. Service users are admitted on a trial basis of at least three months. At the end of this period a review meeting is convened which all relevant people attend. In one instance an advocate is also involved to ensure their best interests are being considered. A decision will not be made about the continuation of any placements until these review are held and the service user wishes to stay. Blackwells DS0000061934.V319852.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Service users receive good support from staff who help them make a care plan to meet their needs and wishes. They are able to make choices in their daily lives and routines. Staff encourage their independence and consider possible risks and how best to minimise and manage risks for their safety and welfare. EVIDENCE: Service users’ care records were examined and their care needs discussed with the manager and staff. Each service user has a plan detailing all their needs and how staff should support them to meet the identified needs. Plans also cover factors such as environment, communication, mobility, health, culture, religion and social needs. It is good that the diverse needs of service users in respect of disability and ethnicity are taken into consideration. For example one person’s mobility difficulties were assessed and grab rails and other aids provided to promote their independence and make life easier for them. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 11 An appropriately “person centred” approach to care planning is taken and service users’ preferred daily routines, likes and dislikes are ascertained and included in their plans. Staff will be working with service users to continually develop their plans, based on their wishes and goals. Service users have a keyworker allocated to them from the staff team. They spend more individual time to get to know them and their needs and wishes better. Keyworkers also take responsibility for such as helping them choose their clothes and activities and arranging their regular health care checks. They also have a role in care planning and are expected to review plans monthly with service users involved. Staff make detailed daily reports about such as service users’ health, activities, behaviour etc, which provide helpful information about their progress and for care reviews. The staff member interviewed is fully aware of service users’ needs and difficulties and how staff should always manage them consistently. Reviews are also being held with service users’ funding authorities and their families to discuss their placement at the home. Such reviews will be held annually as well as ongoing reviews carried out by the home. Comprehensive risk assessments have been undertaken for service users in respect of aggressive and self-harming behaviour and care management plans put in place. These plans include techniques to try to reduce agitation and to diffuse situations as they arise. When necessary (and only ever in exceptional circumstances) this can involve physical restraint. Staff all receive training and there are detailed descriptions and pictures showing the physical interventions they must use. In any event detailed incident records are completed, with an accident record made and body chart if there are any injuries. The manager would then review all the incidents and staff would be debriefed if needed. Other risk assessments to keep service users safe include moving & handling, bathing, travelling in vehicles, access to the kitchen and when they are out in the community. Again specific plans are in place to guide staff. Blackwells DS0000061934.V319852.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 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Service users are supported to pursue a variety of activities they have chosen both at home and in the community. They are helped to keep links with their family and friends and their self-determination and individuality is respected. Staff promote service users healthy eating and encourage them to be involved in choosing, shopping for and preparing their own meals. EVIDENCE: Service users social needs and interests are detailed in their care assessments and plans. They both have a weekly programme of activities, which are to be reviewed monthly by their keyworkers, with them. The programmes reflect the aims of the home as well as the needs and preferences of service users. Activities therefore include developing independent living skills e.g. cooking, sewing and household tasks. Whilst at home staff support them with drawing, music, arts & crafts, hair & beauty sessions and writing letters to their families. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 13 The manager said in-house group activity sessions, such as crafts and music & movement, are being considered for when there are more people living in the home and they will probably use external facilitators. Staff have been seeking local developmental, social, and leisure opportunities and the home is putting together a file of all services and facilities that may be of interest or benefit to service users. Including day services, college projects and social clubs for people with learning disabilities. In respect of community integration this can be difficult for some service users due to their condition and/or behaviours and they may not want to go out. However the home will enable and support them as much as possible. One current service user likes to go out daily for walks and to the cinema. Vehicles are currently being used if needed from the providers other local care homes, although the intent is to purchase one for the home in due course. Service users can choose their daily routines to a great extent. Consideration is also given (and risk assessments carried out) in respect of them managing their own finances, medication and bedroom keys, although current service users are not able to give informed consent about this. One person has an independent advocate and issues relating to equality & diversity are covered in staff induction e.g. anti-discriminatory practice and disability awareness. Staff support service users to maintain links with their relatives and one person with care staff from their previous home. One relative has agreed to visit two weekly and in between the service user is helped by their keyworker to write and to phone them. The home provides a care planning format to help service users develop a social network of relationships, although current service users have difficulties in developing friendships and relate primarily just to staff. The home has recently started to arrange monthly service user meetings and it is intended they will become more involved in the day-to-day running of the home, such as choosing menus. Regarding food provision, staff know current service users likes/dislikes and meals/mealtimes are flexible. Staff and service users eat together and main meals are viewed as a social occasion, although breakfast is taken when they choose to get up. There is a 3 week set menu, used as the basis for the main meals, indicating overall service users receive a reasonably balanced and wholesome diet and they are also encouraged to have fresh fruit. One person’s diet in respect of their ethnic origin has appropriately been considered and they are offered suitable dishes, but prefer British food. Service users all have a nutritional assessment undertaken on their admission. One person requires a special diet and there is information and clear guidance for staff about their condition and how it should be managed. An individual record is kept of all the food they receive which is closely monitored. Another person needs their food cut up to prevent risk of choking and food stuffs they had best avoid are also recorded. Blackwells DS0000061934.V319852.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Service users are supported by staff to meet their personal and health care needs. It would help to confirm that all their health needs are monitored; preventative steps taken and their good health promoted if service users have an individual Health Action Plan. Staff are managing service users’ medicines safely in the home. EVIDENCE: Service users plans outline the support each need with their personal care and for good hygiene. Plans cover any resources needed and aims and objectives for promoting their independence, which staff confirmed is always encouraged. Service users were observed to be well presented and appropriately dressed. Care records provide full details of service users’ medical history and current health care needs. As both service users are not local it is good that an initial appointment was arranged for them by the home with their new surgery. During this visit the GP went through their current medication and any relevant information about their health and condition sent from their former placement. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 15 Service users also receive input from relevant health care specialists, such as a Psychiatrist and regular health checks e.g. Dentist, Optician etc. are arranged. A district nurse visits one person twice weekly to check and dress their wound following a recent operation. Two health care professionals indicated in their comment cards that the home has communicated clearly with them. Also that there is always a senior staff member to confer with; they are able to see their patients in private and that staff understand service users’ needs. Records are kept of all the advice, support and treatment received. Both service users also have particular health conditions that require special diets. Staff are carefully monitoring this and physical checks are made and recorded as part of the process. There is also guidance about symptoms staff need to monitor and action to be taken to minimise and/or control them. Advice had been sought from district nurses about pressure care to make sure staff are fully aware of preventative measures in respect of one person with limited mobility. Following this a pressure relief cushion is to be purchased for them. It is good that individual’s needs in respect of their physical difficulties were considered before they moved in and handrails fitted in their bedroom. It is considered good practice by the Department of Health for people with learning disabilities to each have a Health Action Plan. These plans can help to ensure and confirm their health is being monitored, any problems identified and their good health promoted. This would include that all their special health care needs are understood and recognised and they are helped to stay healthy through preventative as well as routine and specialist health care input. Regarding medication there are policies & procedures in place that also reflect relevant guidelines for managing medicines safely in care homes. Service users’ ability to consent to medication and self-administration are appropriately considered. There are specific protocols in place with clear guidelines for staff when medicines can be given as required when service users become agitated or distressed, and this involves consulting the manager or deputy manager. There are suitable storage facilities for medicines in the home and records or medications kept and administered are being maintained properly. The home keeps all the patient information leaflets and has a recent reference book to help staff be aware why medicines are prescribed and any possible side effects. There is a list of staff authorised to administer medicines. Staff can only do so when they have undertaken accredited training for safe handling of medicines and they are observed by another authorised staff member for a while before they can take this responsibility. Blackwells DS0000061934.V319852.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. There is a framework in place for service users to express their views and concerns and appropriate steps are taken by the home for their protection. EVIDENCE: The home provides a complaints procedure that is also in a format people with learning disabilities are more likely to understand i.e. with simple language and pictures. Copies of this are displayed in service users’ bedrooms. One service users indicated he would know who to talk to if he had any concerns and feels staff would listen and take action. There is also a record format for the home to complete should any concerns be raised, which appropriately would detail the investigation, outcome and any action taken, with timescales. There are policies & procedures in relation to abuse and adult protection, (including whistle blowing) and the home also has a copy of the Herefordshire procedures for Protection of Vulnerable Adults (POVA). Staff receive relevant instruction during their induction and are expected to consider any incidence or suspicion of abuse or neglect at the end of every shift and compete a form to raise any issues if necessary. The manager plans to arrange a training session with the local POVA co-ordinator when the staff team is complete which is good There have not been any complaints or vulnerable adults issues raised with the home or the Commission. Blackwells DS0000061934.V319852.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, 25, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to this service. Blackwells offers service users a very comfortable, well-maintained and secure home, which suitably meets their needs. Staff also ensure the accommodation is kept clean and safe for service users’ health and welfare. EVIDENCE: Blackwells is in a convenient location, within walking distance of Hereford city centre and is on a main bus route. It is also good that the house is set back from the busy main road and has a secure, although rather small garden at the rear. The overall impression obtained of the home is bright, fresh, homely and very comfortable. It was found to be warm, clean and tidy during this visit. The premises has been extensively upgraded and the facilities, furnishings and equipment are now all of very good quality. When the variation to change the service was agreed the work was approved by Building Control (and so the Fire Authority) and deemed satisfactory by Environmental Health. A maintenance record is completed by staff when minor repairs are needed and arrangements are in place to address them and regularly service the heating system etc. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 18 The home provides a sitting room and separate dining room that are very well furnished and the kitchen also has a small breakfast area. The office is on the first floor and is rather small, although there is a large room in the cellar that can be used for meetings. The laundry/utility room is also in the cellar and a staff sleep in room, toilet and shower. There are keypad locks fitted to doors to some areas, such as the cellar and kitchen, to safeguard service users. Service users have good sized single bedrooms, which have en-suite facilities, (all but one also including shower facilities). One bedroom is on the ground floor and so suitable for the service user who has mobility difficulties. The other bedrooms are less easily accessible, being up a rather steep staircase, although there are handrails. All the bedroom doors are fitted with suitable locks and an assessment is made so that service users able to would hold their own key. The two service users have started to personalise their rooms with their keyworker, and will be able to choose the colour scheme. All areas seen were clean and tidy and staff have a cleaning rota to ensure the daily routine tasks are completed. Support staff undertake all cooking, cleaning and laundry tasks and encourage service users to be involved as much as they can and want to. The home provides all the relevant policies & procedures for good infection control, this is covered in staff induction and they also receive instruction. Protective gloves and clothing are provided and there is guidance relating to one service users condition that may need special attention. Blackwells DS0000061934.V319852.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, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to this service. Service users are supported by sufficient staff who have the experience and/or are qualified and receive training and support to help them know, understand and meet all their needs. Overall the home follows a thorough recruitment process including taking up necessary checks to ensure staff are suitable, for service users protection. This would be improved if more information is obtained as part of their applications. EVIDENCE: Staff rotas show there are always two staff on duty throughout the working day and one person on waking duty, with another sleeping in at night. This is considered to be an appropriate level to meet the current two service users’ needs. Staffing levels will be increased as service users are admitted to the home and is arranged flexibly to fit in with service users activities. The staff team has gradually increased but as it is small staff are all working closely together. The manager said regular staff meetings will be arranged in due course. Meanwhile detailed daily reports and a communication book and daily diary are completed, which are reviewed during every staff handover. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 20 In respect of recruitment the staff member spoken with confirmed that their appointment had appropriately involved them completing an application form, and attending an interview. The home had then taken up a CRB/POVA check and three written references. An induction had followed, over six weeks and they are now working a probationary period and receiving regular supervision with feedback as to their progress. Two staff records were checked and included copies of relevant personal documents. Each person also had two appropriate written references and a CRB/POVA check. It was noted however that the home’s application form does not request a full employment history, and for any gaps to be explored and explained, as is now required. Staff had either completed or are in the process of doing an induction at the home. The provider has produced a comprehensive induction programme that includes health & safety, principles of care, supporting service users and other relevant areas relevant to a care service and to service users’ special needs. All staff are also expected to complete the LDAF induction training, which is accredited especially for staff working with people with learning disabilities. More than half the staff team had already achieved an NVQ qualification in care and others will progress on to do so, following the LDAF training. Each staff member has an individual training record, which includes records of individual supervision held two monthly and they will also have an annual appraisal. A staff team training overview highlights any unmet training and development needs, with a plan to address them. Other relevant training sessions are also arranged such as autism awareness, epilepsy and positive interventions for the management of challenging behaviours. Blackwells DS0000061934.V319852.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to this service. The home is well run by an experienced and qualified manager. There is an open and positive management approach that helps to ensure service users’ individual rights are respected and they receive a good service. Appropriate steps are also taken to keep the home safe and protect service users and staff. Systems are in place to monitor and review all relevant aspects of the service. This results in a plan for its continual improvement, which should also involve service users and other interested parties in the way that the home develops. EVIDENCE: The manager (Carl Gillson) was registered in respect of Blackwells in January 2005. Mr Gillson has previous residential care and management experience, working with people who have learning disabilities and has achieved an NVQ 4 qualification in care and management, as well as much other relevant training. Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 22 He is committed to continue to further developing his skills and knowledge and is currently enrolled on a three-year distance learning degree course relating to the psychology of people with learning disabilities. The home has suitable management arrangements, with an assistant manager and two team leaders allocated particular responsibilities for administrative tasks and staff supervision etc. It was clear there is an open and positive management approach. The provider operates a comprehensive formal quality assurance & monitoring system. This includes a monthly quality audit, covering all relevant aspects of the service resulting in action plan to address identified shortfalls. Weekly inhouse monitoring forms are to be introduced that will be used to review any accidents, incidents, staffing, concerns and other key events. A representative of the provider visits the home monthly as required to crosscheck audits and monitor how the home is run by observing and talking to service users & staff. This leads to an annual development plan for the service outlining the areas to be developed and of the action required with timescales and details of those responsible. The provider has recognised the need to consult with service users and significant other people as part of this monitoring process. This is being addressed through service users’ meetings and obtaining the views of service users’ families, and should be extended to include other stakeholders. Regarding the promotion of health & safety the home arranges for staff to undertake all mandatory training topics i.e. first aid, fire, moving & handling, infection control and food hygiene. Staff had all recently attended a fire drill. The pre-inspection questionnaire confirmed regular maintenance and servicing of gas and electrical installations. Records kept in the home showed that staff are undertaking fire safety checks as required and risk assessments had been carried out and/or are in place, including COSHH. For instance radiators are all guarded or have low surface temperatures, windows have restrictors and some doors (such as the cellar) have keypad locks. Also checks related to the environment e.g. water temperatures are made regularly undertaken for the protection of service users. There is also an emergency call system for staff. There were no hazards observed in the environment during these inspection visits, and overall the home it is apparent the home pays due attention to ensuring the safety and welfare of service users and staff. Blackwells DS0000061934.V319852.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 2 2 3 3 3 4 3 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 4 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 2 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 Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered persons meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered provider must comply with the given timescales. No. 1 Standard YA34 Regulation 19 Requirement Staff employed to work at the home must submit a full employment history (with any gaps explored and a satisfactory explanation given) before their appointment is confirmed. Timescale for action 15/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the registered provider to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations The service users’ guide and other information about the home should be provided in a more suitable format for people with learning disabilities as soon as possible. Health Action Plans should be set up for service users. 2 YA19 Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection 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 Blackwells DS0000061934.V319852.R01.S.doc Version 5.2 Page 26 - 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. 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