Inspection on 31/10/05 for Cardinalls Road

This inspection was carried out on 31st October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cardinalls Road 20/10/08

Cardinalls Road 26/10/06

Cardinalls Road 09/06/05

Cardinalls Road 03/02/05

Cardinalls Road 27/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Cardinalls Road 43 Cardinalls Road Stowmarket Suffolk IP14 5AA Lead Inspector Deborah Seddon Announced Inspection 31st October 2005 10:00 Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 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 Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 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. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cardinalls Road Address 43 Cardinalls Road Stowmarket Suffolk IP14 5AA 01449 677527 01449 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) Royal Mencap (Housing & Support Services) Miss Christine Anne Smylie Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th June 2005 Brief Description of the Service: The primary role in this service is to prompt, encourage and support the service users to maximise their skills, abilities and interests. To provide service users with opportunities to persue active lives in the community and to access a range of services and facilities available to them. Cardinals Road is a three bedded home for people with learning difficulties and is centrally placed in relation to facilities and transport in the town of Stowmarket. There are three female service users living at the home who form an established group having lived together for a significant period of time. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place on Monday 31st October 2005 between 10am and 5pm. The inspector spent the morning with one resident who was having a home day and two members of staff and the manager. The resident showed the inspector their room and other communal areas of the home. A selection of records were examined including those relating to residents and staff. In the afternoon the inspector was invited to walk into town to meet with the other two residents returning from day care. Time was spent talking with all three residents and two staff on the late shift in a relaxed atmosphere sitting around the dining room table. Three comment cards from relatives were received prior to the inspection and all were very positive about the home with the exception of one comment that there was not always enough staff on duty. Residents were issued with comment cards, however staff helping residents to complete these were not able to do so with the questionnaire format. The inspector took some adapted questionnaires with symbols on the day of the inspection and left them for residents to make comments. Two of the comment cards have been returned since the inspection with positive response about the care they receive in the home. What the service does well: What has improved since the last inspection? The home had three requirements at the last inspection and a recommendation to improve the décor in two areas within the home. The home has met two of the requirements ensuring that new staff have received training and are competent to administer medication prior to lone working. They have decorated two of the residents bedrooms and have repaired the plasterwork in the landing bathroom and decorated. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 6 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. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 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 Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 Residents cannot expect to have an up to date contract or statement of terms and conditions with the home. EVIDENCE: There have been no new residents moving into the home since the previous inspection, therefore standards 1 – 4 were not assessed on this occasion, however the service user guide was seen and had been revised and updated in April 2005 and was available in different formats upon request. One resident’s care plan seen showed that there was an updated letter regarding their individual placement contract (IPC) and the amount they had to contribute to their fees, however the licence agreement had not been reviewed since August 2002. A basic guide to the tenancy and licence agreement between the resident and the home was in was in picture and written format. There was a note on the file indicating that this document to be reviewed and amended after April each year after the rent increase had been agreed. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Residents can expect to have their needs reviewed on a regular basis and to be supported to make decisions of how they spend their time and participate in the running of their home. Residents can expect to be supported to take control of their own lives and to take responsible risks. EVIDENCE: Two care plans were looked at during the inspection. Each of the care plans consisted of details covering the emotional and social needs and personal preferences and activities of the residents. Evidence was seen that the care plans are regularly reviewed. Evidence was seen that one care plan had been discussed at the resident’s annual review with a relative and social worker and objectives had been reviewed and agreed for the coming year. One of the care plan’s had a detailed communication summary, which staff had read and signed to agree to work with the plan and to provide continuity. The plan detailed a positive approach to communication with the resident explaining what they said could mean different things and that staff needed to be aware of this, so that they would be able to give the appropriate response. The plan also included indicators that would trigger a change in the resident’s behaviour and how to avoid them or reduce their agitation. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 10 The residents have a home day, spread over the week so that each resident has one to one support with a member of staff. The home day is to carry out personal and domestic tasks within the home and the community to persue their interests. On the day of the inspection one resident having an at home day showed the inspector their room and told them that they had changed their bed linen themselves that morning. They spent time painting their own and staffs nails whilst having a coffee and chat around the dining room table before going into Stowmarket. They told the inspector they were going out to take a prescription to the general practitioners (GP) surgery and to “Toys R Us” to by some plastascine. They were also going to do some shopping at Tesco where they were going to having their lunch. Residents are supported to make decisions about the lives; one of the residents is involved in an advocacy group, Suffolk People First based in Stowmarket. The resident attends these meetings without staff support, which promoting their own independence. The resident told the inspector that they were an active member of the advocacy group and are involved in discussions that affect them as an individual, such as obtaining direct payments and that they were also a member of the partnership board that discusses issues about the counties. The resident is also an active member of Mencap service users forum. The resident told the inspector they attended a meeting at the Keys in Ipswich every six weeks, where they discussed issues relating to the running of Mencap homes. Residents are offered the opportunity to vote but have chosen not to participate in the political process. Residents are supported to manage their finances. Mencap is corporate appointee for all three residents. The resident’s disability living allowance is paid by Giro. Monies not needed for immediate use are paid directly in to a building society account. The manager is the only signatory for the account and is the only person that can withdraw money from the account on the resident’s behalf. Each of the residents has their own lockable container to hold a small amount of money which staff monitor. Two members of staff countersign any withdrawals made by the resident and a record of all purchases are kept and receipts. The inspector was informed that staff and residents have regular house meetings where the residents are able to contribute to the day to day running of the home. At the most recent meetings, discussions were held about holidays, Christmas activities, trips out, decoration to the home and a meal out for the new year with residents staff and their partners. Risk assessments specific to the individual were seen on their care plans. These related to all aspects of activities and events in the domestic environment and for community based activities. There were also assessments detailing the risk of financial, physical and sexual abuse. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 17 Residents can expect to be supported to participate in appropriate leisure activities in the community and be able to maintain relationships with friends. EVIDENCE: All three residents attend a day care service called Stowmarket resource centre (SRC) where they are able to take part in activities with other people. On the day of the inspection one of the residents had attended Mid Suffolk leisure centre with the SRC where they had had a Jacuzzi. The residents told the inspector that they were going to a Halloween party at the SRC Gateway club that evening, and showed a selection of witches hats and a devils hat with horns and a wig that they were wearing to the party. One of the staff had helped residents to decorate the home to celebrate Halloween, and had brought in a selection of plastic spiders to add to the decorations. One of the residents thought these were great fun and was joining in with the staff putting the spider rings on their fingers. Residents returning from the SRC were observed relaxing after the day at the resource centre choosing how they spent their time before going to the party. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 12 Residents and staff sitting around the dining table invited the inspector to join them for a coffee. General discussion took place about the resident’s day at the resource centre and about the party. One resident who likes to draw, produced paper and felt tip pens and requested the inspector to join in drawing pictures of their favourite topics. The resident was very tired following their Jacuzzi in the afternoon and spent some time relaxing in their own recliner armchair watching the television. On their home day, each resident takes part in the household chores, which involves keeping their rooms tidy, hovering, washing up and putting away their own laundry. Residents are also encouraged to help purchase and prepare food. Residents are supported to take part in activities of their choice. Once they have completed their share of the domestic chores residents choose an activity, such as food shopping, having a Jacuzzi, going to the cinema in Stowmarket or go to Ipswich by train. One resident informed the inspector that they had had a short break in Hemsby earlier in the year and had chosen to go out for days during the summer holidays. They had been accompanied by a carer to go to Felixstowe, Sherringahm, Yarmouth and Wroxham by train. Evidence seen on another resident’s care plan showed that they regularly attend an activity group in nearby Old Newton. One resident had been supported to complete an Open University degree course and had a certificate in their room dated 1995 for their work on patterns for living and working together and normalisation. One resident has a long-standing friendship with a person who used to attend SRC. Due to the deterioration in their disabilities this friend is no longer able to attend the resource centre on a regular basis. However, this friend does attend occasionally when they know that the resident will be at the centre. The friend has a one to one carer who used to work at SRC. The carer assists the resident and their friend to meet for tea after day care at a local café. The manager informed the inspector that this resident chooses independently of staff whether or not they choose to go. The resident also is supported to invite their friend and carer to Cardinals Road. The resident at home on the day of the inspection went out for lunch. One resident had taken sandwiches to the SRC and chose to have a jacket potato for their tea. The other resident told the inspector they had had a cooked meal at the SRC. They had meat pie and vegetables followed by rice pudding and jam. They decided to have a sandwich for tea. The resident who has a visual impairment was guided by a member of staff to make their own sandwich. The range of food seen in the cupboards and fridge catered for all three residents choices and diet. The inspector was informed and saw evidence in their care plans that two residents had been advised by the general practitioner (GP) to monitor their weight. The residents follow the at home weight watchers programme to maintain a healthy weight. A selection of weight watchers meals was available as well as fresh vegetables, salad and fruit. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21 Residents can expect to have their physical and emotional health needs monitored and have professional input when required. Residents can expect to protected by the homes procedure for dealing with medication and can expect to have their wishes respected in the event of the death. EVIDENCE: Evidence was seen on one care plan that the health needs of residents are identified in a health action plan. Details of health professionals used were listed for a private dentist, optical healthcare who visits the home every two years and six weekly visits by a chiropodist. An ongoing record of dates for health visits was kept. Specific conditions were identified around the residents diet; the general practitioner (GP) had advised that they loose weight. Details were recorded that the resident was encouraged to follow the “weight watchers at home programme” and that they needed guidance with food choices. The plan also stated that the resident was known to have Epilepsy and the symptoms were that they experienced were short absences. The plan states that staff are to monitor the residents condition and to report any changes. The plan was reviewed in September 2005 with no changes. The health plan also stated that the resident was not able to recognise their health needs and that staff needed to be aware that changes in their behaviour might signify a health issue. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 14 The inspector was informed that the behaviour of one resident had changed and was being monitored. The resident had begun to display behaviours that challenged others whilst away for a weekend. The GP has made a referral to the intensive support team who already has links with the home working with a resident and staff to focus on positive behaviour management. A requirement from the previous inspection in June 2005 was around the sequence of training for staff working alone and administering medication without the appropriate training. An incident had occurred where a member staff had administered medication incorrectly, however they had not received medication training at the time. This was discussed with the manager who confirmed that they had now completed training and were competent to administer medication. A record was seen on the staff’s file that they had completed a learning module contribute to the management of medication in July 2005. There is currently only one resident taking medication at the home. An entry in another resident’s care plan states that the GP had stopped their medication for a trail period of three months. On one resident’s care plan seen there was a letter from the GP dated December 2003 regarding the administration of homely remedies medication, stating that they had no objection to staff administering over counter medicines if needed which included cough linctuses or soluble aspirin, but states that staff must follow manufacturers instructions. One resident had a note on their file about arrangements in the event of their death; this had been discussed and signed by the relatives of the resident. The express wishes were that the resident not to be administered last rights or prepared for the funeral. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Residents can expect to be protected by the home’s recruitment procedures however, they cannot expect to be protected from abuse until Mencap review their training schedule for new staff expected to lone work with vulnerable residents, without the appropriate adult protection training. EVIDENCE: Two staff files were looked at and evidence was seen that a protection of vulnerable adults (POVA) First and a criminal records bureau (CRB) check had been undertaken prior to staff taking up their posts. A requirement from the previous inspection in June 2005 raised concerns that new members of staff were rostered to do lone working after their initial sixweek induction training. Adult protection training is part of the foundation packs provided by Mencap, which takes place within the first six months. A discussion took place with the manager about the schedule of training; they had discussed this as an issue with the training officer for Mencap, and told the inspector there appears to be anomalies throughout Mencap with the provision of adult protection training and when this should be completed by new staff. Therefore as discussed with the manager the requirement remains that consideration must be given by Mencap to review the sequence of their induction training programme to include the protection of vulnerable adults, before staff commence lone working to ensure the protection of the residents. One staff member spoken with said they would not have any concerns about following the whistle blowing procedure if the witnessed bad practice occurring in the home. They spoke of two of the residents that were particularly vulnerable as they would not be able to communicate verbally that they were experiencing abuse. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 29, 30 Residents can expect to live in a home that meets their needs in a safe and homely atmosphere, which is clean and hygienic, however the hallway, stairs and landing are in need of redecoration. EVIDENCE: Cardinals Road provides the resident with a comfortable home that has been decorated to reflect their personalities and needs. It is in easy reach of local amenities and local public transport. The home is bright, cheerful airy and clean. The dining room looks out of large patio doors onto a garden that has been landscaped providing residents with a nice view. Some redecoration has taken place since the last inspection, one staff member has previous experience in painting and decorating and has used their talents to redecorate the toilet on the landing and the office and sleep in room used by staff. They have also decorated one of the resident’s bedrooms. The inspector noticed that the hallway, landing and stairs were looking tired and dated and needed redecorating. The fuse boxes were covered by a flap of plywood, which looked unsightly and would benefit from being covered by a built in cupboard. The manager informed the inspector there is money available to pay for a decorator to undertake the job. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 17 The carpet in the dining area has a large stain and needs replacing. The manager informed the inspector that this stain had occurred from a spillage of bleach and that an insurance claim was paying for the carpet to be replaced. Two of the residents were proud to show the inspector their rooms. One resident’s room had recently been decorated in the colours of their choice and had brought new curtains to match. The other resident who used to share a room until last year, showed the inspector their room. This was beautifully decorated with the resident’s own furniture, curtains and bedding. All rooms seen had personal items that were all age appropriate and reflected the resident’s personalities. Each of the residents bedrooms are fitted with door locks and residents are offered the choice of holding their own key. One resident with significant sight impairment who has a bedroom upstairs, used to have a chest of draws outside their door on the landing, which they used as a guide to locate the top of the stairs. However, the chest was a health and safety concern, which had been raised at a previous inspection as it partially blocked their exit. The chest of draws has been removed but the resident has not been happy about this decision. The home have discussed the issue with the resident and have reached a comprise and will be fitting a leader rail to the banister to assist the resident to find their way form their bedroom to the landing and stairs. The home has a separate utility area for dealing with laundry situated at the rear of the house with access to the garden, to hang out the washing. There are hand-washing facilities available for staff to use situated in the laundry area and staff have access to the appropriate personal protective equipment such as gloves and aprons. Any clinical waste form the home is double bagged and disposed of in yellow bags and collected through agreement with the local council. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Service users can expect to be cared for by a staff team who have the skills and knowledge, however they cannot expect to be protected from abuse until all staff have received training in protection of vulnerable adults. Service users can expect to be cared for by a staff team who are supervised, supported and available in sufficient numbers to meet service users needs. EVIDENCE: When the inspector arrived at the home they were invited to join two staff and a resident for coffee. The resident was having a home day and was planning their day with the staff. The inspector observed that staff were comfortable and had a professional yet relaxed approach with the resident. They demonstrated good listening and communication skills. They encouraged the resident to do tasks for themselves, instead of doing them for them to maximise their independence. Throughout the day the inspector observed that staff demonstrated an interest, motivation and commitment to the residents and the smooth day-today running of the home. There are a core group of staff that have been involved with the home for a long time, including relief staff and volunteers. Staff were observed to have the skills, experience and knowledge of residents to meet their individual needs, including the skills to deal with communication and anticipated behaviours of the individual residents. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 19 The staff rota was seen and showed that 1 member of staff was working 7am – 2pm. One member of staff was working 10am – 4.30pm to support the resident on a one to one basis who was having their home day. The manager was working 11am to 11pm to help out with the residents attending the party and to meet with the inspector, plus doing the sleep in. A relief member of staff well known to the residents was working 4.30pm to 9.30pm to support the two residents returning from the day centre. The manager and staff spoken with considered that the home has sufficient number of staff on duty to meet needs of residents. The manager explained that they worked a very flexible rota to meet the individual needs of the residents and would have double cover on between midday to 6pm at weekends, unless one or more of the residents was away for the weekend. Three volunteers visit the home on a regular basis and will support residents to go for walks, feed the ducks or go out for lunch. One volunteer helps to undertake home visit reports where they discuss living in the home with the residents, which is feedback to Mencap as part of the quality monitoring process. Two staff files were inspected; these demonstrated that the home had the necessary checks in place for the safe recruitment of staff. Both files looked at had records of the staffs criminal records bureau check (CRB) and relevant documents and for the most recent employee a protection of vulnerable adults (POVA) First check. The home benefits from being part of a large organisation, which has developed it’s own induction and foundation learning programme for all new staff in line with the sector skills council for social care (TOPPS) training. The induction and foundation workbook of one most recent member of staff was looked at. Evidence was seen that the member of staff had worked through each section of the workbook. They had written detailed accounts of their knowledge and understanding of the topic and how they linked into good practice when working with residents and the policies and procedures of Mencap and the home. As part of the induction training the member of staff had attended courses for moving and handling, first aid, fire safety and control of substances hazardous to health (COSHH). Evidence was also seen that the staff member had attended a managing challenging behaviour course on in May 2005 and a lone working personal safety course run by the Suzy Lamplugh Trust. The staff member spoken with told the inspector that they had attended the first part of their adult protection course and had completed medication training, however this remains an issue that staff are not receiving adequate training to give them the skills to work with vulnerable people prior to lone working. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 20 The file of another member of staff showed that they had attended relevant training to their job, they had completed managing challenging behaviour, moving and handling, fire safety, first aid, medication, Care of Substances Hazardous to Health and health and safety training. They had also attended an induction and foundation assessor’s day with a view to becoming an assessor within Mencap. They had recently attended a six-day total communication course at Kerrison. Following this training they were going to be the designated lead co-ordinator for communication. Their role will be to teach makaton and induct and mentor new and existing staff to help residents who have no oral communication. They are in the process of implementing care plans with pictorial format so residents can know the information contained about them and be involved in updating and reviewing their care plan. Staff spoken with felt that they were supported from the manager and received regular supervision. Staff files confirmed this and both staff files seen had an annual performance and development appraisal setting out objectives for the coming year. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 Service users can expect to live in a home that is effectively managed and is run in their best interests by an experienced and supported staff team. EVIDENCE: The registered manager has worked at the home since it opened in 1986. They are well qualified for the post of registered manager. They hold a certificate of qualification in social worker (CQSW) and certificate in management studies (CMS). They have completed the national vocational qualification (NVQ) assessor award and in 2004 to demonstrate the commitment to learning they successfully completed the registered managers award. To keep updated with the knowledge and skills required for the managers role they attend relevant training events, they are currently booked to attend health and safety training for managers by Mencap. The manager and staff observed on the day demonstrated that they have a very clear understanding of the needs of the residents and the impact that staff have on their lives and respect that 43 Cardinals Road is the resident’s home. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 22 Service users are involved in regular meetings and have their views taken into account with the management of the home. A Lay visitor (volunteer) visits the home on a regular basis and meets with service users to obtain their views. The lay visitor produce reports, which are in a picture format and show items, discussed which are around living standards and service users overall feelings about the home. One resident’s file seen showed that they had completed a quality assurance questionnaire that was in picture format and writing, with face symbols with expressions that indicated very good to very poor, this was dated February 2004. The manager explained that these quality assurance questionnaires have been completed this year and were forwarded to the head office for the responsible individual to review. Advocates and a volunteer supported the residents to complete the surveys. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X 2 Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 X X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cardinalls Road Score X 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X X X DS0000024541.V261019.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA23 Regulation 13 (6) Requirement Timescale for action 18/12/05 2 YA5 5 (b) The sequence of induction training must be varied to ensure that staff receives protection of vulnerable adults and other appropriate training prior to undertaking lone working. The terms and conditions laid 18/04/06 out in the licence agreement must be reviewed in line with the homes procedure to amend the agreement yearly in April to include the increase in rent. 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 YA24 Good Practice Recommendations The hall, stairway and landing are in need of redecoration and arrangements to better conceal the electrical fuse boxes considered. Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 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 Cardinalls Road DS0000024541.V261019.R01.S.doc Version 5.0 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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