Inspection on 13/02/08 for Brightwater

This inspection was carried out on 13th February 2008.

CSCI found this care home to be providing an Excellent 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

Brightwater 12/02/07

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Brightwater 3 Otter Close Bishopstoke Eastleigh Hampshire SO50 8NF Lead Inspector Christine Walsh Unannounced Inspection 13th February 2008 10:30a Brightwater DS0000068060.V356950.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 Brightwater DS0000068060.V356950.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. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brightwater Address 3 Otter Close Bishopstoke Eastleigh Hampshire SO50 8NF 023 8064 4920 023 8005 1205 andrewfoster@inchorus.co.uk 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) In Chorus Ltd Debora Lyon Care Home 5 Category(ies) of Learning disability (0) registration, with number of places Brightwater DS0000068060.V356950.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 the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is 5. Date of last inspection 12th February 2007 Brief Description of the Service: Brightwater specialises in and supports 5 young adults who are on the Autistic Spectrum. Brightwater is owned and managed by In Chorus Ltd who also own 2 other care homes for young adult which are also situated in the local area. The home is located in a quiet residential area close to local amenities. These consist of local shops, surgeries, public house and a bus service that provides access to Eastleigh town centre where there is a rail service that is connected to the national network. The building is a 2 story semi-detached family house, which was extended in 2007 in order to increase the number of residents from three to five. The home is split into two fully equipped homes, linked by the office. The two areas of the home have been developed to accommodate differing dependency levels and devised to take into account compatibilities and interests of the residents. There are four separate small-enclosed gardens, one of which contains a swimming pool. All potential residents are referred to the service by statutory agencies i.e. a Primary Care Trust or the Adults Services Department of a local authority. The fees range from £4.850 to £ 7.780 per month, this does not include the cost of toiletries, leisure activities and transport. Brightwater DS0000068060.V356950.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 3 star. This means the people who use this service experience excellent quality outcomes. This site visit formed part of the key inspection process and was carried over one day by Mrs C Walsh, regulatory inspector. The manager completed an Annual Quality Assurance Assessment (AQAA) document, which was returned to the Commission for Social Care Inspection prior to the visit to the home. The information obtained to inform this report was based on viewing the records of the people who use and work at the service, speaking with the residents, and staff and observing care and support practices. A tour of the home took place and documents relating to health and safety matters were viewed. What the service does well: Brightwater does well to ensure it provides prospective residents and their representatives with information about the home, it assesses if it can meet their needs and supports them to become familiar with their new surroundings and others living in the home by supporting regular visits prior to moving in. The home does well to support the residents using a person centred approach, respecting their wishes, decisions and aspirations. It encourages the residents to develop and maintain their independence, integrate into their local community and maintain contact with family and friends. The staff do well to ensure the physical and psychological needs of the residents are being met, providing the residents with support to access health care professionals such as GP’s, dentists, speech and language therapist and psychologists and support them with their medication. The home listens to the resident’s needs, wishes and concerns and acts promptly to deal with any concerns or complaints the residents or their representatives may have. Staff are trained to protect the residents and to inform someone immediately if they are concerned that they are at risk of harm. Brightwater offers a homely, safe and welcoming environment. It is spacious, tastefully decorated and furnished and offers individual bedrooms that are personalised and decorated to the residents liking. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 6 The manager and her staff are skilled and competent to meet the needs of the residents, they go through a thorough interview and induction process followed by mandatory training such as moving and handling and fire safety and specific training such as Autism, abuse awareness, communication and managing challenging behaviour. 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. Brightwater DS0000068060.V356950.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 Brightwater DS0000068060.V356950.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 will ensure they can meet the needs of people who wish to use the service by carrying out an assessment prior to them moving in. EVIDENCE: The Annual Quality Assurance Assessment tool (AQAA) informed us that the service undertakes a full assessment of any potential resident, assessing whether they can provide a high standard of care and support for the person and to see if the person will be compatible with the residents already living in the home. This was tested by viewing and tracking the assessments details of a resident, speaking with the manager, the managing director and a resident who was not part of the tracking process. The manager spoke of the process that is used to assess and support the transition of a new resident to the home. This included undertaking a thorough assessment of their needs and meeting the prospective resident in their current home with their carers. Prospective residents are also Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 9 encouraged to visit the home with support of their carers, building up to over night stays. Health care professionals such as occupational therapists and psychologists are also involved and undertake assessments if required. The manager went onto say that potential residents are observed to see how they get on with others already living in the home. If this is successful and the move is confirmed, the potential resident is invited back to choose colours and furnishing for the bedroom that will be theirs. A resident confirmed that he had gone through this process with the support of people who know him, including family members and his social worker. Brightwater DS0000068060.V356950.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. The home does well to ensure the people who use the service have their needs met using an individual approach (person centred). They are supported to have a say about how they wish to receive their care and make decisions about their everyday lives. The risk to their health and welfare is minimised by using a risk management approach. EVIDENCE: The AQAA informed us that residents have individual care plans, risk assessments of which the residents are involved in developing and reviewing. They are encouraged to make decisions about their daily lives and they are encouraged to express their thoughts, concerns and desires with their Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 11 keyworkers. The home recognises where improvements are needed and plans to improve the communication processes and tools for the residents with limited verbal communication over the next twelve months. This was tested by observing practice., viewing the personal plan of a resident, speaking with residents, staff and residents. Each resident has a personal plan of their own which provides information on who the person is (“who am I”), my lifestyle, my health and mental health, how I communicate, how I make choices and, my family and friends and behaviours. This detail has been written as if the resident has written it himself. The personal plan goes on to provide specific detail on how the resident wishes to be supported, highlights their strengths and the level of support the person needs such as verbal and physical prompting. In addition the home keeps a daily record of how the residents, which includes their daily routines, personal care, their health and describes how they have appeared during the day/night such as if they are happy, settled or anxious. There is evidence that plans are reviewed frequently and annual reviews take place with the involvement of the resident if they wish. The residents are encouraged to develop their [personal plans with their keyworker and sign if they agree with the information held on them. The manager said the residents are welcome to view their personal files when they wish, however this usually takes place with the support of the key-worker or manager to help the resident to understand the information held about them. The manager went onto say that staff are kept informed of all changes to care plans and the needs of the residents by holding handovers, team meetings and staff supervisions, in addition staff are asked to read revised personal care plans and risk assessments and sign and date when they have read them. This was seen in a number of plans. A resident said that he had been involved in the development of his personal plans and regularly met with his keyworker to review them. Staff are also made aware of the residents health and wellbeing through weekly keyworker reports which records the residents activity and achievements including contact with family members, time spent with the residents on a 1 –1 basis, community and social activities and daily living skills. It was observed during the course of the visit that residents are encouraged to make decisions about how they wish to spend their day, what activities they wish to engage in and making everyday choices such as what they would like to eat, drink and wear. This was also evidenced in the way the care plans are written, reminding staff to offer choices and listen to what the residents are saying through the way in which they communicate. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 12 The personal plan of a resident was reviewed and tracked for the purpose of the inspection visit. It was noted that a record is kept of the choices the resident has made during the week, the location, what the choice was, who offered it and how the resident responded in making the choice. This included choices of what to wear, kitchen activity, shopping and attending day services. The manager is aware that the development of alternative communication tools for residents with communication difficulties will improve the residents independence and decision making, and plans are in place to do this. A resident said that he had been involved in making choices and decisions about the decoration and furnishing of his bedroom and planning a holiday. Each care plan is linked to a risk assessment and provides details of the risk and action required by staff to minimise the risks. The information was written in plain English and easy to follow. The manager said the residents are supported to develop new skills such as accessing the community, which includes the risks of crossing roads, using transport, and accessing help on an emergency. The manager described how they have been working with a resident to develop these skills using a risk management process and the improvement in the person self awareness and confidence they have witnessed since the resident has become more independent. Brightwater DS0000068060.V356950.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 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home does well to ensure the people who use the service are supported to maintain an active lifestyle that suits their needs and individual interests. The home does well to ensure the people who use the service maintain contact with family and friends and socially engage with their peers and the local community. The home does well to ensure the people who use the service have their rights respected, are provided with opportunities to make decisions and develop individual living skills. EVIDENCE: The AQAA informed us that the home is a service specifically for people with autism and that residents are involved in discussing and planning their daily Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 14 lives and social activities. The AQAA stated that the home considers the organisation and structure of the residents daily lives and social activities to ensure they are well planned and organised to take into account the individuals level of need and individual preferences. This was tested by viewing personal plans, daily activities, menu plans, observing practice, and speaking with residents, staff and the manager. Each resident has in their personal file an activity plan that identifies the activities they enjoy and a record of activities they have been involved in each day. The records included a number of activites such as gardening, playing golf, attending college for literacy, numeracy and music sessions. Residents are reminded of what activities they are involved in by displayed notices on a notices boards especially allocated for them, for those with limited communication pictures are used as visual prompts. On the day of the inspection visit, the manager was making financial arrangements for some of the residents to go on holiday. The holiday had been chosen by residents themselves the manager advised. This was later confirmed by a resident who said he was looking forward to his holiday. Photographs of various outings and activites were displayed and a newsletter written by a resident spoke of the recent activities the residents had been involved and enjoyed. A resident said: “ I’ve always got something to do, the staff are good at supporting me to join in activities but recognise that I like my own company also”. Residents meetings are held every Sunday, with an agenda which includes, what’s happening in the coming week, news, what we enjoy at Brightwater, what else we would like to do and any other business, this demonstrates that the home is supporting and listening to what the residents want and like to do. Activities that are requested are discussed and are planned for as demonstrated in the homes diary and observations on the day. The residents are supported to maintain contact with family and friends, evidence of this was records held in the residents personal file that informs the reader about relationships that are important to the resident and the contact the resident has with those people. Daily notes record if contact has been made with family and friends, which includes visiting the family home for the weekend and friends visiting the home. Residents have access to a mobile phone handset that has a separate line from the office phone line, which allows residents to call their family and friends when they wish. A resident said that he has regular contact with his family who he will visit or they will visit him at his home. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 15 At the time of the visit arrangements were being made to support residents to visit a special friend and as it was close to Valentines day to give a personal card. The resident concerned was keen to do this. Through observation it was demonstrated by the staff and the manager that the residents are treated with respect and their dignity, privacy and individual choices are upheld. The residents personal files inform those who have the right to access them, what name the resident wishes to known by, what the residents’ behaviours and non-verbal clues are telling staff about the person and how they are feeling. A member of staff was aware of her roles and responsibilities in respect of providing an individual approach and valuing the person for who they are. Demonstrating that she has an awareness of the importance of treating and respecting peoples individuals rights and beliefs. The residents have access their own bedrooms when they wish and they have access to communal areas of the home. For those residents who require supervision for their safety, staff provide support to access areas such as the kitchen and garden. The home’s mealtimes are led by the residents and their wishes, this includes the residents taking responsibility to plan, shop for and prepare meals. A menu plan is devised by the residents and each week a resident tales responsibility for shopping for groceries and each day a resident with support prepares and cooks the evening meal. A resident was observed preparing an evening meal of chicken pie, which was being prepared from raw ingredients. Staff commented on how good the resident was at cooking. Residents were observed during the day making snacks and drinks. The manager said that the staff support the residents to make healthy options, offering advice when planning the menu to ensure the residents are considering foods such as fruit and veg. The menu was balanced and provided healthy options. A resident said: “ we are supported to plan, shop and cook our meals, we take turns, if I don’t like what’s on the menu for the day I can always have something else”. The manager said that the home monitors the weight of the residents but currently does not have any concerns or need to seek advice from a dietician or nutritionist. The manager is aware that she can access these professionals through a doctor if needed. Brightwater DS0000068060.V356950.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 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home does well to ensure the people who use the service receive the appropriate support with their personal care, health care and medication in the way in which they require and prefer. EVIDENCE: The AQAA informed us that the residents are supported sensitively as individuals, intimate care is provided in private and where possible, residents are encouraged to develop their independence skills. Daily lives and activities are person centred, the home ensures the health care needs of the residents are maintained and keyworkers take responsibility for supporting residents to attend appointments. Senior members of staff are responsible for administering medication and this signed by two members of staff. This was tested by observing daily practice, viewing personal plans, speaking with staff and residents and viewing medication records. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 17 The personal plans provide detail on how the resident wishes to spend their day including what time they like to get up, go to bed, have a bath and they provide detail as to how to support the residents with their personal grooming. A member of staff said she was aware of residents individual support needs as the staff are encouraged to read the plans, be involved as a keyworker to support residents with their everyday needs and be involved in reviewing the plans with the resident. There was evidence of regular reviews taking place and residents being involved. Plans demonstrate that there are clear structures in place which have been devised with the support of the residents and which supports them to undertake everyday activities with limited stress and anxiety. The manager stated that the home has good links with primary care and specialist health care teams. Personal plans demonstrated that the health care needs of the residents are regularly monitored and reviewed. The plans also provide information on the residents’ specific health care needs, what action is required and how staff must attend to these health care needs. On the day of the visit arrangements had been made for a resident to have an eye examination and arrangements were being made for a resident to have dental treatment. A resident confirmed that he had been seen by an occupational therapist for an assessment to access the bath and another was in the process of being assessed for an alarm that will alert staff to the resident having a seizure. Personal plans give staff specific guidance on how to support the resident when having a seizure. The home has systems in place for the administration of medication. The home uses a local pharmacy that dispenses medication in separate named boxes for the residents. Medications are received, stored, recorded and disposed of using systems as stipulated in the Royal Pharmaceutical Guidelines. Following the last visit to the service it recommended that the suitability of the cupboard and its fixing be reviewed, the home has installed a new medication cupboard that at the time of the visit met with the needs of the home. Currently the residents living in the home do not administer their own medication although the home can demonstrate that it promotes the residents independence in this area. Residents are supported to collect their prescriptions and medications from they’re GP and local pharmacy. It was observed that residents are supported to administer their own medication where they have been accessed as competent to do so. This is clearly documented in the resident’s personal plans. The manager went on to describe how the home has recently supported a resident to challenge their medication with their prescribing GP, this was later confirmed by the resident who said he has been well supported by the manager to sort things out. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 18 Each resident has a list of medications prescribed, which includes regular and “as required” medication. “As required” medications are supported by care plans that detail when the medication needs to be administered such in the case of a resident requiring additional support whilst having a seizure. The manager, deputy manager and team leaders are responsible for the administration of medication. The manager confirmed that they have received training which was delivered by an outside agency and who covered such areas as storage, procedures for administration, side effects and controlled medications. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 19 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 does well to listen to and act upon the concerns raised by the people who use the service. The home does well to ensure the people who use the service are safeguarded from potential risk of harm. EVIDENCE: The AQAA informed us that residents and staff are made aware of the complaints procedure, and any complaints are taken seriously and dealt with promptly. All staff receive abuse training and are reminded of the importance of reporting any suspected or possible abuse. The service recognises that there are areas of improvement required which they have plan to carry out in the next 12 months. These plans includes Makaton training for staff to improve communication with residents who have limited verbal communication and plans to expand the complaints section in the contract. This was tested by viewing the homes current complaints policy, the complaints log book, speaking with residents and staff and the manager. The complaints procedure details how the people who use the service can make a complaint and what action must be taken to resolve a complaint. The home encourages open dialogue with residents and relatives, holding regular meetings with the residents and spending time with relatives sharing information. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 20 A resident confirmed that he knows how to make a complaint or raise concerns with his keyworker or the manager. A member of staff was clear about the procedure in responding to complaints. The manager described the ethos of the home as being open and supportive, encouraging the residents to share they’re concerns as they arise. This was seen at the time of the visit where the counselling skills of the manager were seen to be supportive and positive for a resident. The home supports some people who have cognitive and sensory difficulties and it was noted that the complaints procedure in its current format may not meet their needs. The need to consider and develop a more accessible format was discussed and agreed with the manager. The staff are provided with safeguarding of vulnerable adults training, which provides them with the knowledge to identify various types of abuse and how to report these. A member of staff spoken with at the time of visit confirmed that she had received training and was aware of her roles and responsibilities in maintaining the residents’ health and wellbeing and reporting incidents of concern. Some residents present with behaviours that challenge, but there are intervention plans in place and the home monitors the wellbeing of residents on a regular basis with the residents input. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 21 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): 24,25,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does well to ensure the people who use the service live in a welcoming, comfortable and clean environment that meets their physical and social needs. EVIDENCE: The AQAA informed us that to suit the needs of people living in the homes, it is the policy of the In Chorus organisation, to limit homes to no more than five residents. People living at the home are affected by autistic spectrum disorders, but may also be affected by other conditions such as epilepsy, or mobility difficulties. Occupational therapists have been involved to support those living at the home with aids for their environment. This was tested by touring the service, seeking the permission of a resident to view their bedroom, speaking with residents to obtain feedback on the facilities Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 22 provided and speaking with the manager to establish how maintenance and ongoing improvements are planned and undertaken. The home is split into two parts to accommodate the different needs and dependency levels of the residents, and these are staffed in accordance with the needs and activities of the residents. Both areas have communal space, kitchen and bathroom facilities and individual bedrooms. The kitchens are domestic in size and fully equipped to allow the residents to participate in the daily preparation and cooking of meals. The home is spacious and is decorated and furnished in keeping with the needs of the residents. Warm subtle colours on the walls, and quality furniture and soft furnishings. The home has a swimming pool that is fully serviced, risked assessed and used only under full supervision of staff. There are three other separate garden areas and a patio area for BBQ’s. The residents who were spoken with said they liked their home and had been involved in the choosing of decorations and soft furnishings. Resident’s bedrooms were comfortable, clean, furnished with quality furniture and furnishings. The bedrooms are personalised to reflect the resident’s personality and individuality. Where a resident has a physical need and requires support to undertake certain activities such as bathing, the home refers the resident for assessment and the appropriate equipment is obtained or installed. The home is clean and follows recognised practices in maintaining a clean hygienic environment and staff have received training in infection control. There are cleaning rotas for staff to follow and staff are provided with protective disposable gloves and aprons to use when required. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does well to ensure that the people who use the service are supported by competent, skilled and appropriately recruited staff in such numbers that meet their individual needs. EVIDENCE: The AQAA informed us that the home has recently employed a deputy manager and has systems in place to ensure the home is appropriately covered by staff. Staffing levels are dependent on residents’ needs and daily activities. The service has a nominated person responsible for recruitment and all staff undertake specific training in order to meet the needs of people with autism and staff are supported to undertake National Vocational Qualification (NVQ) following a structured induction and probationary period. This was tested by viewing staffing levels and observing practice on the day, viewing staff recruitment and training records, speaking with staff and the manager. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 24 The home was busy at the time of the inspection visit as residents were undertaking various activities with staff support. This included supporting residents go to college, supporting residents to visit their local superstore and opticians, and organising monies for planned holidays. The staff appeared organised and confident. A resident said: “There is always a member of staff on duty who you can go to if you need advice or just want to chat with”. Another said: “The staff are there for me when I need help”. Staff are encouraged by the company which runs the home, to undertake a national vocational qualification (NVQ) and will support them to undertake NVQ levels 2 and 3. All of the homes staff have achieved or are working towards an NVQ. At the time of the visit an external NVQ assessor was visiting the home and working with a member of staff. The assessor said: “The service is very good at supporting its staff to achieve their NVQ, giving them time to complete work and meet with me”. She went to say that she found the staff enthusiastic and demonstrate a good understanding of their roles and responsibilities. Recruitment files were viewed and found to hold all appropriate documents required when employing staff to work with vulnerable people. Evidence of an application form, two references, criminal record bureau (CRB) disclosure and protection of vulnerable adult (POVA) check were in place for each member of staff. A member of staff confirmed that she had completed an application, attended an interview and provided identification and names of referee’s. Staff undergo an induction into the home where they are supported by named staff to become familiar with the needs of the residents, the ethos of the home and the way in which the home operates. The staff receive training required by law (mandatory training), such as moving and handling, first aid, fire safety and food hygiene. In addition staff receive training specific to the needs of the residents such as communication, managing challenging behaviour medication and epilepsy. The service is keen to introduce Makaton training for staff, a recognised form of communication used with people with learning disabilities and autism. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 25 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, 39,41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A competent manager manages the home with a skilled staff team who ensure the home is safe and run in the best interest of the people who live there. EVIDENCE: The AQAA informs us that the registered manager has been in post since the home opened in September 2006 and who has both a National Vocational Qualification (NVQ4) and the Registered Managers Award (RMA). The home has regular resident and staff meetings and both residents and staff are fully involved in contributing their views on how the home is managed. The home receives regular visits from the director and Regulation 26 visits will be undertaken by an expert unrelated to the service. All staff receive health and safety training and the home is fully insured. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 26 This was tested by speaking with the manager, the director, viewing Regulation 26 reports, staff training records, touring and viewing fire service records and speaking with residents and staff. The manager demonstrated through the course of the day that she has a good understanding of the needs of people living at the home and of her roles and responsibilities in ensuring their needs are appropriately met. The manager was observed interacting positively with residents and staff, giving clear guidance and direction in a relaxed manner. The manager has the registered managers award (RMA), NVQ 4 and regularly updates her skills and knowledge by attending mandatory and related training. The home is in the process of undertaking its first quality audit which includes seeking the views of the residents and relatives. In addition, monthly resident and staff meetings take place and the home is visited by the director who undertakes an unannounced, monthly visit to the home as required under Regulation 26 of The Care Homes Regulations. This provides the manager and staff team with guidance as to how they can continue to improve on the quality of care and support. Residents are supported with their finances, and their care plans detail the level of support required. The home has good systems for managing and monitoring residents spending, and supports resident’s to develop their personal skills in managing their own money. There are safe systems in place for fire safety. Staff receive regular training and regular checks are made on fire safety equipment. However the manager should check with the fire safety service if they have to undertake monthly visual checks on fire extinguishers. Substances which may be hazardous to health were securely locked away and there are notices discreetly displayed around the home reminding people of good hygiene practices. All serviceable utilities including small electrical appliances are regularly checked to ensure they are in good working order. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 4 X 3 X 3 X 3 2 X Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard YA42 Good Practice Recommendations It is recommended that the manager should seek advice from the local fire safety authority to ensure that she is following correct procedures when testing and checking fire safety equipment. Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Brightwater DS0000068060.V356950.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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!