Inspection on 12/07/06 for Carlton Road Care Home

This inspection was carried out on 12th July 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 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

Carlton Road Care Home 23/02/07

Carlton Road Care Home 24/11/05

Carlton Road Care Home 15/08/05

Carlton Road Care Home 11/03/05

Carlton Road Care Home 13/09/04

Carlton Road Care Home 19/02/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Carlton Road Care Home 181-183 Carlton Road Worksop Nottinghamshire S81 7AD Lead Inspector Jayne Hilton Key Unannounced Inspection 12th July 2006 1:30 Carlton Road Care Home DS0000008815.V302648.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 Carlton Road Care Home DS0000008815.V302648.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. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlton Road Care Home Address 181-183 Carlton Road Worksop Nottinghamshire S81 7AD 01909 473 831 01246 810207 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) NORSACA Andrew Graham Beech Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: 181/183 Carlton Road supports 9 adults with learning disabilities and who have an autistic spectrum disorder. The service is owned by NORSACA (Nottingham Regional Society for Adults and Children with Autism). Accommodation is in 2 adjoining houses. There is linked access between the houses but through access is encouraged to be for emergencies only. 181 Carlton Road accommodates five service users with around the clock support needs. 183 Carlton Road accommodates four service users who are identified as being more independent. As part of the home’s ethos, some service users at 181 Carlton Road have progressed and have chosen to move on to 183, the semiindependent house. All of the bedrooms are single. The home has recently registered from 8 to 9 service users, with a 4th bedroom, which has e-suite facilities, in the semi-independent house. The home is sited within walking distance of town centre amenities. The fees charged are reported to be £1000.00 a week. This information was provided by the registered manager in the pre - inspection materials, supplied on 8th June 2006. Service users are expected to contribute to their holidays, fund hairdressing, chiropody, magazines, newspapers and activities. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection was undertaken by Jayne Hilton on 12th July 2006 and lasted four and a half hours. The methodology used included observation of staff practices. Speaking with five staff and the Assistant Director of Residential Services (for Nottingham Regional Society for Adults and Children with Autism, (NORSACA)), and three service users. A tour of the environment was facilitated. A sample of service users personal files was examined and associated records. The inspector wishes to thank the staff and service users for their help and cooperation with the inspection, particularly as the manager was not available due to sickness. What the service does well: Staff, enable service users to have opportunities to maintain and develop social, emotional, communication and independent living skills. With the recent development in communication aids at the home the service users with greater support needs now have increased opportunity to develop communication and social skills. The ethos of Carlton Road Care Home is to promote independence and to encourage service users to work towards their own identified and achievable goals. Service users have regular opportunities to access community facilities, including going down the pub, going swimming, accessing the library and shops, going to college. Leisure activities are included in the care planning process and interests are recorded. Service users are offered a healthy diet and enjoy their meals and mealtimes. Service users benefit from a well managed home. Record keeping on the whole was good and service users rights and interests are safeguarded by effective policies and procedures. Service users also benefit from a competent and accountable service. Prospective service users have the information they need to make an informed choice about where they live. Service users needs are assessed, which include their wishes and preferences to ensure that staff can support them, in a way, which meets their individual and specialist needs. Service users are generally supported by an effective care plan structure, which enables them to participate and make decisions about their daily lifestyle and promotes independence and responsible risk taking where they are able to do so. Complaints procedures are accessible to service users. Service users are protected from abuse, neglect and self -harm. The homes have been well maintained and do not look out of place in the community in which they are placed. The homes are maintained and decorated to provide a homely and Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 6 safe environment and bedrooms were in reasonable decorative order and reflected the tastes of the occupier. The communal spaces are well equipped with TVs, music centres and computers for service users to use, and there is a sensory room, which will shortly be available for those needing such activities. No service user currently requires physical adaptations to the building. Necessary policies and procedures were in place to maintain standards. The home appeared clean and free from offensive odours. Service users are supported by a well supported and supervised team committed staff team. Service users benefit from a well run home with good record keeping. Service users are confident their views underpin all self-monitoring review and development of the home. The health, safety and welfare of service users are promoted and protected. What has improved since the last inspection? What they could do better: There was no requirements set at this inspection however recommendations are made in relation to the following. Care is needed to ensure care plans detail all aspects of care and support needs and given. There are some areas to further improve in relation to medication management and maintenance work records and risk assessments for surface temperatures. Copies of the electrical certificate and the fire risk assessment should be available in the home for inspection. One first floor bedroom window was noted not to be restricted. This should be rectified promptly. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 7 A facsimile should be sited at the home. 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. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 8 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 Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 9 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): 2,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed, which include their wishes and preferences to ensure that staff can support them, in a way, which meets their individual and specialist needs. Service users are provided with a contract. EVIDENCE: Two service users support plans were selected for sampling purposes throughout the inspection. Two others viewed for selective information. All prospective new service users are fully assessed prior to admission and additionally applications are submitted to an admissions panel for approval. A transition plan for each new service user is produced. Prospective service users have a full assessment of their needs and the approval of the application by the admissions panel prior to any transition to the home. Each transition is planned to meet an individuals unique needs. The home does not take emergency admissions. NORSACA have recently been in the process of assessing the needs of all their service users in order to ensure that individuals’ are housed in the most appropriate environment where their needs are best met. As a result of this process one service user has left Carlton Road and 2 service users have moved to 183 Carlton Road. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 10 One service users personal file did not contain a full assessment document, strengths and needs and a detailed profile were included, however there were no dates or signatures of when or who by completed by. Through discussion with the staff it is evident that the home can meet the assessed needs of individuals admitted to the home. The cultural needs (including dietary preferences) of a service user of AfricanCaribbean origin are recognised and met. There is regular access and consultation with specialist professionals such as a consultant psychiatrist. There was evidence of development in meeting the communication needs of service users, with speech and language input and the subsequent production of communication tools such as pictures and symbols. The terms and conditions/contract between the home and service user were seen within the plan. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are generally supported by an effective care plan structure, which enables them to participate and make decisions about their daily lifestyle and promotes independence and responsible risk taking where they are able to do so. Limitations and restrictions on freedom were not always recorded. EVIDENCE: Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 12 Service users spoken with said that they are involved in the review of their care plans through discussion with their key workers. Key workers review care plans monthly and the manager reviews these plans every 4 months. In addition to monthly reviews, staff can bring care plans to the staff meetings for peer advice and discussion in how best to meet service users’ needs. The care plans seen were generally detailed and comprehensive. Two aspects of service users care had not been written into the care plan and risk assessment structure, these were in relation to a limitation imposed for independent access in the community and visits to relatives and in relation to non prescribed medication for hay fever. ‘Star Profile’s are used, which is a model that measures the levels of different skills / needs and where further input and development is required. Individual’s risk assessments were also evident within the files. Service users are encouraged to participate in care planning and reviews. NORSACA is currently introducing person centred planning and a new formalised care plan structure which should address the type of gaps identified at this inspection in the future and which will provide a full life picture of the individual service user and the support needed and given. All service users were present at some point of the time of the inspection and there was evidence through documentation and observations during the inspection that staff provide service users with the information, assistance and communication support they need to make decisions about their own lives. Signs, symbols and pictures are being used to enable service users with communication needs, to help choose meals and menus and what activities they would like to participate in. Advocacy services are available to service users if they wish to use them. Through discussions with staff it became apparent that a sanction/limitation had been imposed on a service user, which in effect is a limitation /restrictions that had been implemented, this was not documented in the individual support plan and even though it appeared to be justified to be in the persons best interests there was no signature of agreement by the service user or representative. The staff members present at the inspection were once again advised that all limitations on facilities, choices or human rights to prevent self harm or self neglect or abuse or harm to others should be fully documented in the individuals care plan and agreed by the relevant representative and professionals involved in the service users care. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 13 Service users spoken with confirmed they are consulted and informed about proposed events in the home. There are regular residents meetings where issues about the running of the home are discussed. An information board using pictures and photographs has recently been introduced to 181 Carlton Road and a communication mat is being developed. NORSACA are currently looking at meaningful ways in which service users are to be involved in the recruitment process. Service users’ views are not only obtained as part of NORSACA’s quality assurance review but there is also opportunity for service users to be on the working party that visits different services to obtain the views of its residents, staff and relatives. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 14 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): 12, 13,1 4,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff, enable service users to have opportunities to maintain and develop social, emotional, communication and independent living skills. With the recent development in communication aids at the home the service users with greater support needs now have increased opportunity to develop communication and social skills. The ethos of Carlton Road Care Home is to promote independence and to encourage service users to work towards their own identified and achievable goals. Service users have regular opportunities to access community facilities, including going down the pub, going swimming, accessing the library and shops, going to college. Leisure activities are included in the care planning process and interests are recorded. Service users are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 15 It was clearly evident throughout the inspection that staff enable service users to have opportunities to maintain and develop social, emotional, communication and independent living skills. The ethos of Carlton Road Care Home is to promote independence and to encourage service users to work towards their own identified and achievable goals. Service users take it in turns to assist staff with the weekly food shop. Service users are supported to follow leisure pursuits and college courses of their choice and work placements are also pursued. With the development in communication aids at the home the service users with greater support needs now have increased opportunity to develop communication and social skills. Care plans include what support individual’s require in order to access the community and its facilities. Some service users need a member of staff to accompany them into town whereas other service users (all in the semiindependent) have progressed and been risk assessed as being able to go out into town independently. By talking with service users and staff it was apparent that service users have regular opportunities to access community facilities, including going down the pub, going swimming, accessing the library and shops, going to college. Providing this support is regarded as a fundamental part of staff duties. Service users are offered a wide range of activities. All service users have the opportunity to have holidays and these are taken in small groups throughout the year. Communication tools were seen for service users to make choices about holidays and which staff they would like to accompany them. Various trips were arranged. Local trips are taken also and people have the opportunity for meals out and pub visits. Leisure activities are included in the care planning process and interests are recorded. Service users spoken with said that members of staff always knock on the door and wait for an answer before entering their room. Most service users have a key to their bedroom and to the front door of the home but one service user was noted not to have a lockable facility. There was no information within the care plan process of whether service users have been offered the opportunity to hold keys, neither was there any risk assessments where this was not provided. From observation during the inspection it was evident that staff naturally interact with service users. Service users did however state to the inspector that they were not always satisfied in how staff spoke to them and felt staff should ask rather than tell them to do things and this issue needs to be discussed within the staff team for improvement. Staff were observed engaging with service users who have significant communication difficulties. Service users spoken with said that they could choose when they want to be alone or in company and when not to join an activity. Service users have responsibilities for household tasks and these are recorded and agreed in individual care plans. Service users confirmed that the cooking Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 16 is shared and each service user has a day when they clean their own rooms and when they vacuum and polish the house. Evidence was provided that service users are supported to maintain relationships. Service users visit relatives and visitors are made welcome at the home. Menus were examined and appeared to be varied and nutritious. These are planned and offer two choice options, which are fully recorded. Options also include a vegetarian choice. A tool has been devised for this purpose and combined food safety check records. A menu in pictorial format is also displayed. The meal options on the day of the inspection were Warm chicken and bacon salad and omelette and salad. Jugs of juice were supplied and observed to be filled, when needed. A good supply of up to date food items was seen in the fridge and store cupboards. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 17 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way they prefer and require and generally service users healthcare needs appear to be met. Medicine management within the home was generally satisfactory but there is some improvements needed in relation to policies and procedures, particularly for homely remedies and monitoring the storage temperatures of medication. Further development is also recommended of medication profiles. EVIDENCE: All service users have a designated key worker. Service users who were spoken with know who their key worker is and what they are for. The service users spoken with are happy with the support they are given and feel they have control in their lives. Care plans indicate likes and dislikes and the different forms of support that are required for each individual. For example, where ‘hands on’ support is not applicable, prompting is. Care plans record when other specialist support has been obtained. Healthcare needs of service users appeared to be well met. One service user has diabetes, which is controlled by medication. Routine, blood monitoring Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 18 checks are carried out by the nurse at the medical centre. Another service user suffers from epilepsy. Healthcare needs of service users are well monitored and documentation is kept of routine chiropody dental and ophthalmic checks. Weight records now have a comment/action section. There was now more information regarding medication in the service users files, and a medication profile section is being further developed to include details of medication reviews, adverse effects and contraindications and changes of medication. Consent forms for medication should also be part of this section. A risk assessment has been carried out for a service user taking medication on visits to relatives. A supply of anti- histamine medication was found in the medicines cabinet without any evidence of consultation with the GP in relation to its use, neither was there any reference in the service users care plan about this. The policies for medication management need review and updating to meet the Royal Pharmaceutical society’s Guidance for medicine administration in care homes. A visible drug error policy was seen. It was reported that a drug error occurred recently and notification was made to CSCI, however there was no record of this been received on the service information. Storage temperatures of medicines were not being monitored for their safety and this should be implemented daily. Medication is otherwise stored securely. The medicine keys are kept securely but are not kept separate to other keys in the home, despite this being clearly stated they should in the homes own policy. Carlton Road Care Home DS0000008815.V302648.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints procedures are accessible to service users. Service users are protected from abuse, neglect and self- harm. EVIDENCE: There is a complaints procedure and this is displayed in both 181 and 183 Carlton Road. Complaints procedures are in symbol and pictorial versions also. There has been no complaint recorded since the previous inspection. A formal system has been introduced for documenting and filing complaints. The complaints procedure has appropriate time scales for response and action. Relevant policies and procedures are in place for adult protection. The NCVAP [Nottinghamshire Committee For Vulnerable Adults Procedural guidance manual] is held in the home and the manager reported at the previous inspection that he had attended training and updated the file. Training in adult protection for other staff is planned over the next twelve months. Policies for dealing with challenging behaviour and individual reactive strategies are included within the care plans. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes have been well maintained and do not look out of place in the community in which they are placed. The homes are maintained and decorated to provide a homely and safe environment and bedrooms were in reasonable decorative order and reflected the tastes of the occupier. The communal spaces are well equipped with TVs, music centres and computers for service users to use, and there is a sensory room, which will be shortly available for those needing such activities. No service user currently requires physical adaptations to the building. There is some plaster cracks/structural damage in the home, which requires attention. EVIDENCE: Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 21 Carlton Road Care Home is made up of 2 adjoining houses, 181 and 183 Carlton Road. Given that each house provides a different level of support and is treated as separate houses, this helps to ensure that the environments at both 181 and 183 are relaxing and homely, with adequate communal space. The kitchens in each house are spacious and equipped to enable service users to be supported in using facilities and developing cooking and daily living skills. There is good access from the home to local amenities. There has been some work done outside the front of the house to improve access, in accordance with the Disability Discrimination Act. A new relaxation room is almost completed. The premises appeared on the whole safe, comfortable, and bright. There is some plaster cracks/structural damage throughout, which requires attention. It was reported that the problem had been previously looked into and a drain repaired, however there appeared to be some evidence of movement of the structure. Staff reported that the problem is currently being investigated and that re-decoration will be planned as necessary after completion of remedial work. The bedrooms were all very personalised to reflect individual service users’ tastes. Bedroom seen had pictures and posters displayed on walls and further shelving where requested. The rooms have sufficient furniture and fittings sufficient and suitable to meet the needs of the service users. All bedrooms are lockable. There are lockable facilities available in most bedrooms. There is also the choice to have a mini-fridge. Except for one bedroom with en-suite, there are shared facilities for the other service users. There is the choice of a shower or a bath in both houses. The facilities are adequate in meeting the needs of the service users and offering sufficient personal privacy. Bath mats were observed in use and were identified as potential trip hazards, which need to be addressed. There are no specific aids and adaptations in the home as all current service users are fully mobile and have no assessed needs in relation to these. Radiator covers have been fitted to some radiators and some are of the low surface type. Risk assessments were seen but these did not identify, which radiators posed a priority risk and what action if any had been taken. One first floor bedroom window was noted not to be restricted. This should be rectified promptly. There are no maintenance request records kept within the home, a list is made but there is no copy held in the home when the handyman is given his job list. The system needs to be reviewed by which a copy of all maintenance requests is held and the date of when and whom the job was completed. The home was found to be clean and a good standard of hygiene observed in practice. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 22 There is no fax machine available at Carlton Rd. The manager has access to a fax but this is at another project one and a half mile away from the site. It is strongly recommended that a facsimile machine be provided at the home. The registered provider is reminded to refer to Regulation 16 in respect of this. Carlton Road Care Home DS0000008815.V302648.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service users are supported by a well supported and supervised team committed staff team, Recruitment practices, were, not fully assessed at this inspection but arrangements had been recently discussed. Service users individual and joint need are met by appropriately trained staff. EVIDENCE: A copy of the staff rota was sent to CSCI and evidenced generally three support staff throughout the weekdays and two on at a weekend with one staff member on sleep in and on call arrangements. Staffing levels are arranged around the number of service users who are at the home at the time. There were no issues raised at the visit in relation to staffing levels. NORSACA has its own thorough recruitment policy and procedures. NORSACA are currently looking at ways that service users can meaningfully be involved in the recruitment of new staff. Staffing and personnel issues are dealt with centrally and subsequently staff files have been held at a central office. A discussion was made with the assistant director the day before the inspection about the arrangements underway to ensure that recruitment files of staff are held within the home. The staff personal files for Carlton Rd were due for completion and arrival at Carlton Rd the day after the inspection. Confirmation of this process will be requested from the manager. Staff confirmed they had training in first aid, speech and language course, food hygiene, manual handling, BILD and fire safety training. A training programme for the following Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 24 twelve-month period was not seen but the manager had supplied a copy of NORSACA’s ‘The Knowledge Tree’ Publication and stated that Mandatory and Advanced training is on a rolling programme, run by NORSACA’s training Dept. The manager has also commenced Continual Professional development folders for staff to use for supervision. Supervision records were not available at this inspection. Staff confirmed they had supervision meetings every three weeks usually. Future training included Equality and Diversity level 2. All staff receive mandatory training for infection control, health and safety, first aid, fire safety, food hygiene and manual handling and additional training is arranged for Challenging behaviour, managing diabetes, epilepsy, food and nutrition, adult protection and working with people with autistic spectrum disorders. Staff are undertaking NVQ training and training for staff that work with people with a learning disability. The manager stated in the Pre Inspection Information that 60 of staff hold NVQ level 2 or above. Carlton Road Care Home DS0000008815.V302648.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Service users benefit from a well run home with good record keeping. Service users are confident their views underpin all self-monitoring review and development of the home. The health, safety and welfare of service users are promoted and protected; however copies of the electrical and the fire risk assessment should be available in the home for inspection. EVIDENCE: The overall management of the home appeared well organised and staff members and the assistant director reported that the manager had been missed in his recent spell of sickness. The manager is currently undertaking the Registered Managers Award. There was evidence of a range of quality assurance tools used by the home, including the quality network system mentioned earlier in the report. Regulation 26 visits are carried out and one was in process on the day of the inspection. The home also uses the Quality Tree folder. Consultation with service users is also Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 26 part of the day-to-day running of the home and as part of the service user meetings. Records examined on the day were satisfactory, these included fire records, accident, incident, water outlet temperatures, Portable appliance test records, systems in place for prevention of legionella, care plans and associated records. A visitor’s book is in place. There is a health and safety policy in place and generic risk assessments were viewed. The fire risk assessment was not available but the person responsible for fire safety said that this was currently underway. The certificate for the 5 yearly electrical testing was not available for inspection but the Gas safety certificate was seen. The information supplied by the manager indicated that the electrical safety certificate was issued on 8th may 2006 and remedial work was also carried out as part of this process. Staff and service users spoken with were aware of the importance of wearing personal protective equipment for tasks in the home. Food safety practices appeared satisfactory and the home was on the whole clean and hygienic. Carlton Road Care Home DS0000008815.V302648.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 3 4 X 5 3 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 2 25 X 26 3 27 3 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 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 4 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 4 X X 3 X Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 28 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA7 Good Practice Recommendations Ensure any limitations within care plans are fully agreed with the service user or their representative and they provide written evidence of this. Further improve the systems in place for the management of medicines Provide a facsimile machine for the home Further develop the record keeping in relation to maintenance work records and risk assessments for surface temperatures. One first floor bedroom window was noted not to be restricted. This should be rectified promptly. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 29 2 3. 4 YA20 YA24 YA24 5 YA42 Copies of the electrical certificate and the fire risk assessment should be available in the home for inspection. Include on the fire drill record the names of people involved. Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Carlton Road Care Home DS0000008815.V302648.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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