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Inspection on 08/07/05 for Carwood Residential Home

Also see our care home review for Carwood Residential Home for more information

This inspection was carried out on 8th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People accommodated within Carwood are provided with a very comfortable and safe home to live. The furnishings, fittings, adaptations and equipment are of a high quality and were purchased new following refurbishment of the home in 2004. The home has a clear and consistent care planning system in place based on the person centred planning approach, with evidence of service user involvement in care planning and review. Service users are enabled to take responsible risks within a risk-assessed framework, which is regularly reviewed and updated. The people accommodated are supported to lead full, active and healthy lives with family links maintained wherever possible. The health and personal care needs of the service users are well met with evidence of review and excellent multi-disciplinary working taking place on a regular basis. The service users are protected from abuse and staff enable their views to be taken into account despite the nature of their disabilities. Systems are in place for consultation with service users with an independent advocate visiting the home on a regular basis. The home is managed effectively by a competent manager. Mr Paul Shirley is well organised and this was reflected through the excellent administration and monitoring systems in place. The manager and staff team are very committed to the people in their care.

What has improved since the last inspection?

Since the home was last inspected in October 2004, there have been six admissions to the service. One of these admissions has been an emergency admission with a view of permanent residence. The manager has liaised with the parents of the service user, the CSCI, personnel from the Fire Authority, and a number of other professionals based within the Joint Community Learning Disability Team in relation to the complex needs of the individual concerned. So far the placement is proving to be successful. An Admission/Discharge form has been introduced and this document includes a summary of the service users conditions, professionals involved, needs assessment including a health action plan, communication plan and risk assessment. All introductory visits are clearly recorded to include comments made by the service user and the staff supporting the individual and general comments regarding the introductory visits undertaken and the outcome. Record keeping systems have improved. All records seen as part of this inspection were well organised and presented to a high standard. The service has gained a Healthy Eating Gold Award in November 2004.

What the care home could do better:

Feedback received from two staff indicated that staff sickness is high, placing continued pressure on the rest of the team to deliver the service. Although leisure activities were not assessed at this inspection one staff member commented that activities provided by the home could be improved both in-house and in the community. It was reported that more commitment is required from the social work team in meeting Person Centred Plans and that the communication between the home and day services could be improved.

CARE HOME ADULTS 18-65 Carwood Residential Home 16 Carwood Stirchley TELFORD Shropshire TF3 1YA Lead Inspector Rebecca Harrison Unannounced Inspection 8th July 2005 02:15 Carwood Residential Home DS0000059615.V270280.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 Carwood Residential Home DS0000059615.V270280.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. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carwood Residential Home Address 16 Carwood Stirchley TELFORD Shropshire TF3 1YA 01952 592436 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) Telford & Wrekin Council Paul Andrew Shirley Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Pre-admission assessments must be undertaken on all individuals admitted to the home. For any emergency admissions, assessments must be undertaken within 7 days. An Occupational Therapist report must be produced and forwarded to the Commission within three months from the date of registration. All service users must have a Person Centered Plan initiated within three months from the date of registration. There must be sufficient care staff on site between 9.30 am and 3.30 pm Monday to Friday to support the service users not wishing or able to attend day services. There must be a minimum of four care staff and one senior staff member on duty when the home is fully occupied (excluding the night). There must be a minimum of one waking and one sleep-in staff member on duty throughout the night and a formal on-call system in case of emergency. All new staff must complete the LDAF induction. LDAF foundation training must commence/continue at the earliest opportunity. All staff must attend training in visual impairment, the safe use of tracking equipment, moving and handling and basic food hygiene within three months from the date of registration. All existing staff must receive training on physical intervention within six months. There must be appropriate provision for people who smoke. 2. 3. 4. 5. 6. 7. 8. 9. 10. Date of last inspection 12th October 2004 Brief Description of the Service: 16 Carwood is registered with the Commission for Social Care Inspection to provide accommodation and personal care to a maximum of 13 adults with a learning disability aged between 18-65 years. The home is situated in Stirchley, Telford and is owned and managed by the Borough of Telford and Wrekin Council. Mr Paul Shirley is the Registered Manager and Mr Paul Taylor is Head of Adult Services and is the Responsible Individual. Both the Manager and Responsible Individual are well qualified in the field of learning disability and have numerous years experience working for the local authority. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 5 Carwood was extensively refurbished to create five flats across two floors with a passenger lift available. The home reopened in 2004. Accommodation in each flat comprises single bedrooms with en-suite facilities, a kitchen/dining area, a lounge, laundry room and a bathroom. The home offers access to local amenities, transport and relevant support services. The Mission Statement is To provide support to people learning disability, based on individual needs as identified through Community Care Assessments and Person Centred Plans. We aim to meet individual needs wherever possible. We aim to promote and increase individual service users indepenence, opportunities, choice, dignity, rightd and quality of life. Create a home which is safe, comfortable and personal to individuals. Therefore enabling service users to live and participate within their community. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Carwood is a home for people with learning disabilities owned and managed by the Borough of Telford and Wrekin Council. The home is registered for thirteen people accommodated over five flats. At the time of this inspection ten people where in residence. It was reported that the remaining three vacancies have been allocated. The inspection was unannounced and commenced at 12.15 p.m. and lasted just under five hours. Two service users were at the home until later in the afternoon when people arrived home from a variety of local authority day services. The inspection was carried out by talking to service users, visiting parents of a service user, the manager, the staff on duty, observing activity in the home, inspection of records, case tracking and a tour of the environment. The service users, manager and the staff on duty were most welcoming and co-operated fully throughout the inspection. The purpose of this unannounced inspection was to review the progress made by the home since the last announced inspection undertaken on the 12th October 2004 by Ms Helen Whitehouse, Regulation Inspector. Five requirements and two recommendations were made. No complaints have been referred to the Commission of Social Care Inspection since the service was last inspected. There have been no referrals made to adult protection. The home is considered to be performing well with no requirements and only one recommendation made as a result of this inspection. What the service does well: People accommodated within Carwood are provided with a very comfortable and safe home to live. The furnishings, fittings, adaptations and equipment are of a high quality and were purchased new following refurbishment of the home in 2004. The home has a clear and consistent care planning system in place based on the person centred planning approach, with evidence of service user involvement in care planning and review. Service users are enabled to take responsible risks within a risk-assessed framework, which is regularly reviewed Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 7 and updated. The people accommodated are supported to lead full, active and healthy lives with family links maintained wherever possible. The health and personal care needs of the service users are well met with evidence of review and excellent multi-disciplinary working taking place on a regular basis. The service users are protected from abuse and staff enable their views to be taken into account despite the nature of their disabilities. Systems are in place for consultation with service users with an independent advocate visiting the home on a regular basis. The home is managed effectively by a competent manager. Mr Paul Shirley is well organised and this was reflected through the excellent administration and monitoring systems in place. The manager and staff team are very committed to the people in their care. What has improved since the last inspection? What they could do better: Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 8 Feedback received from two staff indicated that staff sickness is high, placing continued pressure on the rest of the team to deliver the service. Although leisure activities were not assessed at this inspection one staff member commented that activities provided by the home could be improved both in-house and in the community. It was reported that more commitment is required from the social work team in meeting Person Centred Plans and that the communication between the home and day services could be improved. 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. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 The information provided to current and prospective service users is presented in an exemplary clear manner enabling them to make a properly informed choice about the home. EVIDENCE: The home has a Statement of Purpose, revised in February 2005 and a Service User Guide in place. Both documents have been produced to a very high standard using pictorial and symbol formats produced with the personnel based within the Communication and Swallowing Team at Tan Bank, Wellington, Telford. Information in both documents is comprehensive. Care records seen on the file scrutinised, evidence that the service user was provided with a copy of both documents prior to admission to the home. Since the home was last inspected in October 2004, there have been six admissions to the service. One of these admissions has been an emergency admission with a view of permanent residence. The manager has liaised with the parents of the service user, the CSCI, personnel from the Fire Authority, and a number of professionals based within the Joint Community Learning Disability Team in relation to the complex needs of the individual concerned. A further admission was referred to the home from the Community Services Team. The person was initially placed in the service following a bereavement in the family. However due to health needs he was then placed in another Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 11 local authority residential home on an emergency admission basis before, moving into Carwood on 21.02.05 with a view to returning to his flat. Discussions held with the manager and records seen evidence that there has been a gradual deteriation in behaviours, whereby it is considered person is challenging both his day service and residential provision leading to police involvement. Care records seen on file were very comprehensive to include a Community Services Housing, Health and Care assessment incorporating a overview support plan dated 20.12.04, a Community Care Assessment of 10.01.05, to include a nursing assessment of needs. Although staff employed individually and collectively have the skills and experience to deliver the service and care which the home offers to provide, a series of meetings have taken place since the person was first admitted to the home in February 2005. The manager has sought advice from the managers of the previous services to ascertain information in relation to previous placements in addition to the manager of the day service where the person currently attends three days a week. It was reported that such behaviours are putting the placement at risk. Professionals based within the Joint Community Learning Disability Team and the police are also working with the home and the individual concerned. A strategy plan to manage behaviours is now in place which the individual has signed up to. A lengthy discussion took place between the manager and inspector concerning the vulnerability of the other people occupying the other flats. The manager stated that the person is currently in a flat on his own and is unable to access the four other flats unless invited. The person is also declining staff support and a record of such is being maintained in his daily records. The inspector was assured that no further admission to this particular flat would take place until the current situated is resolved. The inspector had the opportunity to speak with the service user who stated that he is very happy living at Carwood. A comprehensive Transitional Plan was seen on the care file with a series of introductory meetings taking place prior to the person moving into the home. An Admission/Discharge form has been introduced and this document included a summary of the service users conditions, professionals involve, needs assessment including a health action plan, communication plan and risk assessment. A record of introductory visits and the staff supporting the individual and general comments regarding the visit undertaken. In addition to this was an induction checklist discussed at the introductory stage dated 14.02.05. This induction to the home included the complaints procedure, layout of the home, what to do in the event of an emergency, access to advocacy services, service user comments which were “Very positive, I like Carwood”, in addition to general comments made by the manager. This induction to the home was signed and dated by both the service user and registered manager. The pre-admission and induction to the service documentation is commendable. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 12 A contract between the home and the service user was seen on file. This has been produced in a format appropriate to the people currently accommodated at the home. The contract included a photograph of the service user, the manager, responsible individual and advocate. It also contained photographs of the service users bedroom and the flat occupied. The contract included all the elements required by The CSCI and was signed by the service user, manager and independent advocate. Again this document is commendable. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 13 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 and 9 The home has a clear and consistent care planning system in place based on the person centred planning approach, with evidence of service user involvement in care planning and review. Staff are provided with the information they need to satisfactory meet the individual needs of the people accommodated at the home. Individuals are enabled to take responsible risks within a risk-assessed framework, which is regularly reviewed and updated. EVIDENCE: As previously stated a pre-admission assessment had been undertaken and the file of the person case tracked contained a comprehensive care plan using the person centred approach including a pen picture of the person, general likes and dislikes in addition to meals, routines, the management of medicines, aids/adaptations required, risk taking, cultural needs and future needs and goals, hopes and dreams. Records evidence that a care review was held on 11.04.05, to include the service user, social worker and the manager. As previously stated a number of Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 14 meetings have since taken place to discuss behaviour management with the individual and professionals involved including the police. It was reported that more intensive support is required. A matrix of planned Person Centred Planning meetings for all service users accommodated at the home, general reviews and reviews held by day services, was seen displayed in the main office. The home has a service user committee, who meet on a monthly basis with an advocate from “Taking Part Advocacy Service”. Minutes of a meeting were seen and these include discussions about social events, meals and the service generally. Involvement in decision-making is included in the homes Statement of Purpose and the contract identifies if individuals require support with managing their finances. The home has also produced a service user questionnaire in a pictorial format in order to ascertain the views of the service users in relation to how the home is managing. A designated advocate from ‘Taking Part Advocacy Service’ is currently supporting service users with this questionnaire. The home has a keyworker system is in operation. Evidence was seen on the care documentation reviewed that individual’s are enabled to take responsible risks within a risk-assessed framework. Risk assessments seen were comprehensive and are reviewed regularly by the manager, signed and dated. The minutes of a team meeting held evidenced that the manager had acknowledged that the individual currently challenging the service has had an impact on staff morale however, the team had a duty of care and a number of professionals are involved. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 15 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): 2, 13,15 and 16 Service users are supported to lead full, active and healthy lives. Family links are well maintained. EVIDENCE: Records pertaining to the individual case tracked indicated that the person accesses local authority day service provision three days per week. However, due to increased behaviours this placement is now at risk. Records seen evidence that the manager of the home and the day service are in regular contact and meetings held in relation to the person. The manager reported that the home is currently looking into employment and college opportunities in consultation with the service user. It was reported that all other people accommodated at the home attend local authority day service provision to include Employment, Community Participation and Social Education and a number of people also access Telford College. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 16 The last inspection highlighted a need to monitor the anti-social behaviour and vandalism directed at the home and if necessary install CCTV as recommended by the last inspection. The manager reported that new perimeter fencing has been erected and that the situation has improved. The manager will continue to monitor the situation and record any incidents. The manager informed the inspector regarding the lease of a vehicle for the service users to which a charge will apply. Such charges are stated in the Service User Guide and Contract. The home has liaised with the CSCI and the Benefits Officer for the Borough of Telford and Wrekin Council in relation to this. Service users also access buses provided through the Integrated Transport Unit (ITU), taxi’s and public transport. Leaflets, the Statement of Purpose, Service User Guide, complaints procedure, CSCI information and most recent inspection report and a number of other leaflets are all displayed in the reception area of the home and available to service users, families and visitors. The home maintains family links as much as possible. The parents of a service user admitted to the home in February 2005, visited the home during the inspection. Discussions held with them evidenced that they are regularly kept informed of their daughter’s progress and always made welcome during their visits to the home. They were very complimentary of the level of care and support provided, the staff, managers and the service in general. Service users are able to see their visitor’s in the shared spaces provided or in the privacy of their own bedrooms. A visitor’s book is held at the home and is well maintained. Visitors are welcome at all reasonable times. All bedroom doors are lockable are service users provided with a key to their bedroom and flat upon request and according to their ability. All flats have their own individual letter box and staff support service users to read their mail if required. Daily routines were seen on the care file scrutinised and were comprehensive. Preferred form of address was seen recorded on the care documentation. Service users have unrestricted access to the flat they occupy and are able to choose when to be alone or in the company of others. Smoking is not permitted in any of the flats, however a new designated area in the garden is now provided as required by the conditions of registration. The manager reported that one individual declines to use the new designated area and continues to use an area at the front of the building through choice. Standard 17, Meals and mealtimes was not assessed on this occasion, however it is positive to report that since the home was last inspected, the service has gained a Healthy Eating Gold Award in November 2004. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 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 and 20 The health and personal care needs of the service users are well met with evidence of review and excellent multi-disciplinary working taking place on a regular basis. EVIDENCE: A Health Action plan was seen on the file of the person case tracked in addition to a Person Centred Plan (PCP). Records seen provide staff with comprehensive information relating to the service users preferences for personal support and preferred routines for the morning, afternoon, evening and night-time. A nursing care assessment has been undertaken; in addition to a risk assessment for the management of epilepsy, by a Community Learning Disability Nurse. Records pertaining to the person case tracked, evidence that the individual is supported to access NHS Healthcare facilities in addition to receiving specialist input from the professionals based within the Joint Community Learning Disability Team based in Wellington, Telford. All health appointments and outcomes are recorded. A personal information sheet for the admission of the service user in case of an emergency has also been completed to include allergies, current prescribed and PRN medication, medical history and next of kin details. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 18 Medication procedures appeared satisfactory at the time of this inspection. As previously stated information in relation to medication is well documented. The CSCI Pharmacist Inspector visited the home following the refurbishment in July 2004, to provide advice to the team in relation to appropriate medicine storage facilities. Such facilities have now been installed in each bedroom. A controlled drugs cabinet is available, however the manager reported that none of the current service users are prescribed controlled drugs. Medication Administration records are held centrally and the home maintains a record of staff signatures for the staff who are responsible for the administration of medicines. The manager and senior staff have attended a two-day course on medication, held at Staffordshire University. The manager is currently looking into accredited training for the remainder of the team. A procedure is in place for drugs taken to local day services. A comprehensive medication policy is in place and approved by the CSCI’s Pharmacy Inspector following minor amendments and additions made. The standard in relation to aging and death was not reviewed on this occasion, however it was reported that the person admitted to the home following the death of a family member has been supported through the psychology team. A number of staff have received training in bereavement and loss. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 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 and 23 The home has a good complaints procedure in place, which has been developed in an appropriate format for the people currently accommodated at the home. The service users are protected from abuse and staff enable their views to be taken into account despite the nature of their disabilities. EVIDENCE: No complaints have been referred to the Commission of Social Care Inspection since the service was last inspected on 12th October 2004. The manager reported that he has represented a service user with making an official complaint against another agency, which was upheld. It was also reported that a complaint was made by a service user against a care agency, which again was upheld. It was reported that the home has no outstanding complaints. It was recommended at the previous inspection of this service that information be displayed throughout the home, in a suitable format for the residents, on how to make a comment, complaint or compliment. This recommendation has been met with evidence of such included in the homes Statement of Purpose, Service User Guide and Service User Contract. If a service user is dissatisfied with the outcome of a complaint, they will be supported with making a formal complaint via the Telford and Wrekin Council’s Complaints Department. There have been no referrals to Adult Protection made. The home has a copy of the local Multi-Agency Adult Protection policy and procedures, which was seen in the office. The manager reported that staff have attended adult Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 20 protection seminars. Staff sign to say that they have read and understood the local adult protection policy and procedures. The Service User Contract identifies if an individual requires support with managing their finances. Each individual has their own bank account and a record of all transactions maintained. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28 and 29 The standard of the environment is very good providing service users with a safe, attractive and homely place to live. EVIDENCE: 16 Carwood is situated in Stirchley, Telford. The home offers access to local amenities, local transport and relevant support services. The home was extensively refurbished to create five flats across two floors and re-opened in 2004. A passenger lift is available for people who are unable to access the stairs. Through a tour of the environment it is evident that people are provided with a very comfortable and safe home to live. The furnishings, fittings, adaptations and equipment are of a high quality and were purchased new following refurbishment of the home and are suitable for the needs of the current people living at the home. The home meets the requirements of the local fire service and environmental health department. All service users accommodated at Carwood are provided with a single room with en-suite facility. Room sizes are stated in the homes Statement of Purpose. Flats 16B and 16D are situated on the ground floor, accessible for Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 22 wheelchair users and have an overhead track hoist facility. Flat 16C is also situated on the ground floor and provides accommodation for two people without mobility needs. Flats 16E and 16F are located on the first floor with a passenger lift provided. Bedrooms seen were very personalised. The furniture and furnishings and are of a high quality and rooms are lockable and can be overridden by the staff in the event of an emergency. Service users are provided with lockable toilet and bathroom facilities which meet their needs and offers personal privacy. En-suite shower facilities are provided in each room in addition to a main bathroom in each flat. Staff undertaking sleep-in duties are provided with a bedroom with en-suite facility on the ground floor. Service users accommodated in each flat are provided with a range of comfortable, safe and fully accessible shared space. Accommodation in each flat comprises a kitchen/diner, a lounge, laundry room and a main bathroom. Outdoor space is proportionate to the number of service users and the staff group on duty at any one time. Since the last inspection perimeter fencing has been erected and a new pathway developed. The inspector advised the manager to contact the Environmental Health Department in relation to the domestic kitchens not having a separate handwash facility. This has since been done and the EHD are happy with the current arrangement as hand-wash facilities are available in the laundry areas, which are in close proximity to each kitchen. Staff have been advised to use such facilities for hand-washing. The home offers a variety of environmental aids and adaptations to meet the needs of the service users to include over head tracking in two of the ground floor flats, hoists, bathing equipment, weighing equipment, lowered light switches and call alarm systems throughout the home. The kitchen work surfaces are not adjustable in height for people in wheelchairs, despite the CSCI recommending this at the initial consultation project meetings held. Accommodation on the ground floor is wheelchair accessible. A passenger lift is also available. Bed rails were seen on one bed without the necessary bumpers in place. The manager immediately actioned this during the inspection by ordering the appropriate bumpers. This will be reviewed at the next inspection of the service. The manager stated that a risk assessment for bed rails has been undertaken. The parents of a service user were spoken with during the inspection. Their daughter uses a moulded wheelchair and they expressed their concerns regarding their daughter’s comfort. It was reported that an assessment has recently been undertaken in order to provide a more suitable chair. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 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): x EVIDENCE: The intended outcomes for Standards 31 – 36 were not reviewed on this occasion. No requirements or recommendations were made at the previous inspection of this service in relation to staffing. A new employee who does not provide direct care to the people accommodated at the home, provided the inspector with positive feedback in relation to the service, the people accommodated, managers, staff team and the extensive training opportunities that she has accessed since commencing work with the local authority. To date she has attended ten courses to include Equal Opportunities, Adult Protection, Health and Safety, Training in Physical Intervention (TPI) in addition to mandatory training. An NVQ Assessor was at the home in the late afternoon of the inspection to assess a candidate who is working towards her NVQ 3 award. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 41 The home is managed effectively by a competent manager who leads his team with confidence creating an open and positive atmosphere from which the service users benefit. The management information systems developed and maintained by the manager, in conjunction with two other service managers are commendable. EVIDENCE: The Registered Manager of the home is Mr Paul Shirley. Mr Shirley is currently joint Acting Operations Manager sharing responsibility with two other managers of the organisation until September 2005. Mr Shirley has extensive experience with working and managing services for adults with learning disabilities and complex needs. He has obtained his Registered Managers Award and is nearing completion of the NVQ level 4 Care Award. In addition to this he has obtained the D32/33 Assessors Award and the In Service Certificate in Social Care qualification. Mr Shirley is also a Person Centred Facilitator and has attended numerous courses relevant to his role and the Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 25 client group whom he manages in order to maintain and update his knowledge, skills and competence while managing the home. Mr Shirley works very closely with Ms Judith Pagett, Registered Manager of Downing House and Ms Hazel Crooks, Community Services Manager, based at Tan Bank, Wellington. It is evident that such close networking has benefited the service users. A requirement was made at the previous inspection in relation to ensuring that any reference to records used within the home be amended to reflect the new title of the regulatory body. Records seen and discussions held with the manager evidenced that the home had complied with this requirement. The recommendation made at the previous inspection in relation to accident recording to be in line with the Data Protection Act has been met. All accidents are now logged in compliance with the Act and cross-referenced with the care or personnel file held in the home. The manager is very well organised and this was reflected through the excellent administration and monitoring systems in place. A new team Secretary has been appointed to assist the manager. All records relating to the service users and the home are presented to a commendable standard. Evidence of service user involvement in care planning and review was seen throughout this inspection. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 26 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 4 4 3 4 4 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 3 4 4 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Carwood Residential Home Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X 4 X X DS0000059615.V270280.R01.S.doc Version 5.0 Page 27 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 YA3 Good Practice Recommendations That the person currently challenging the service be closely monitored with regular multi-disciplinary reviews held to ensure the service is able to fulfil his needs. Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Carwood Residential Home DS0000059615.V270280.R01.S.doc Version 5.0 Page 29 - 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. 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