Inspection on 22/02/07 for Chamberlain Way, 17

This inspection was carried out on 22nd February 2007.

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

Chamberlain Way, 17 17/02/06

Chamberlain Way, 17 12/10/05

Chamberlain Way, 17 03/03/05

Chamberlain Way, 17 29/11/04

Chamberlain Way, 17 29/01/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Chamberlain Way, 17 17 Chamberlain Way Surbiton Surrey KT6 6JH Lead Inspector Michael Stapley Key Unannounced Inspection 22nd February 2007 10:00 Chamberlain Way, 17 DS0000042884.V329901.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 Chamberlain Way, 17 DS0000042884.V329901.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. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chamberlain Way, 17 Address 17 Chamberlain Way Surbiton Surrey KT6 6JH 020 8399 8254 020 8399 7653 jane.wells@rbk.kingston.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Royal Borough Of Kingston Upon Thames Jane Elizabeth Wells Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing must be provided to meet the assessed needs of all service users. The levels of staffing will vary according to assessed needs and occupancy levels with a minimum of one member of staff on duty at all times. Night time support should be adjusted to reflect assessed needs. Minimum staffing at night must be one sleep in member of staff. Unless waking staff is required as part of a service users` assessed need. The Registered Manager is also registered to manage Woodbury, care home for 15 adults with a learning disability. A qualified, competent and experienced person, other than the Registered Manager, shall be employed to oversee the day-to-day operations of the home. The organisation must ensure that the above minimum staffing levels remain under review and that at all times suitably qualified, competent and experienced persons are working in the home in such numbers as are appropriate for the health and welfare of service users. 17th February 2006 2. 3. 4. 5. Date of last inspection Brief Description of the Service: 17 Chamberlain Way is owned and managed by the Royal Borough of Kingston and provides respite care for up to three adult service users with learning disabilities. The period of stay offered can range from an overnight stay to a number of months, dependant upon the service user’s needs. The home caters for service users of both sexes aged from 18-65 years. The home is part of the Woodbury Community Housing Project, a group of houses linked through management and service provision. Two of the homes within the project are also registered with the Commission for Social Care Inspection. The home is located next door to one of these, namely Woodbury and retains strong links with the service. The Registered Manager oversees operations in all units, and is based mostly at Woodbury. As a condition of the registration of Chamberlain Way, a senior member of staff has been employed to manage the day-to-day operations of the home. There is a large garden to the front and rear of the home. Accommodation for the service users is provided in single bedrooms with a communal lounge, dining area and kitchen. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. • This home was inspected under the National Minimum Standards Care Homes for Younger Adults. The inspection took place over one day on 22nd February 2007. The home is registered for two service users and offers respite care to about thirty service users although there are only twelve regular users. The registered manager, Ms Jane Wells and the deputy manager, Ms Anita Heather was present throughout the inspection. Records examined included service user plans; care manager needs assessments and risk assessments, medication records, complaints, staffing records, health and safety and fire records. All of the requirements from the two inspections during 2005/06 and the have been complied with within laid down timescales and there were no requirements made at this inspection. Overall the home continues to provide a very high standard of care. • • • • • What the service does well: • The staff has been active in critically looking at what has been provided, and examined what may be institutional in practice. ‘Action for Quality’ has focused a person centred approach. Staff work closely with families to ensure that respite breaks are a positive experience. The service is very flexible within the availability of beds; working closely with the parent group has ensured fairness in the take-up of the service. DS0000042884.V329901.R01.S.doc Version 5.2 Page 6 Chamberlain Way, 17 • Emergencies and priorities have been agreed with all parties e.g. special arrangements made for one family where the main carer was sick and in hospital for five weeks. The unit is small and welcoming with a staffing ratio of 1:2. Introduction to the service is planned to ensure that service users are confident and happy to begin to make the separation from home. Individual arrangements are made for all new referrals to the unit i.e. tea visits, getting to know other service users and staff. Care is taken as far as possible to ensure that the service user mix is dynamically positive. Comprehensive support plans and risk assessments are in place. Service users are encouraged to work towards greater independence and are involved in the preparation of meals and maintaining their rooms. Service users are encouraged to bring in personal items to make their rooms more homely. Training and development continues to support a good standard of professional knowledge, regular care ban staff have also been included in this training. Assessor training is being undertaken by the Deputy Manager in addition to advanced medication, key training in moving and handling, risk assessment and POVA. The unit maintains excellent professional links with the wider organisation, families, carers, advocates, befrienders and buddies. • • • • What has improved since the last inspection? • THEMED BREAKS -a variety of themed weekend events which have included trips to the theatre, London Aquarium, Hampton Court boat trip, outing to Brighton in addition a female ‘pampering evening’ and arts and craft event have been thoroughly enjoyed with maximum uptake. Themed activities have been organised for 2007 details are being finalised with service users and their families and carers Additional dates are being added to the programme due to its popularity. QUESTIONNAIRES have been sent to service users and families inviting them to comment on the service they receive. A total of 20 questionnaires were sent out, six were completed and returned. Feedback from returned questionnaires was generally very positive, DS0000042884.V329901.R01.S.doc Version 5.2 Page 7 • Chamberlain Way, 17 discussions at Parent/Carer meetings confirmed all present at the meeting were satisfied with the service. • SERVICE USER INDUCTION CHECKLIST – a checklist is currently being developed to ensure that new staff are inducted appropriately and are familiar with the needs of individual service users. ENVIRONMENT – redecoration of kitchen, lounge, and bathroom has been undertaken as well as the laying of new flooring in the lounge and hallway and landing area. • What they could do better: • • The home could market the service to a wider audience e.g. closer links to transition and local school (Dysart) The home could meet with service users and carers at an earlier stage in the transition process thus averting any crisis management situations arising and alleviating stress to both service users and families. The home could improve communication with families and carers regarding the development and future of the service • Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Chamberlain Way, 17 DS0000042884.V329901.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 Chamberlain Way, 17 DS0000042884.V329901.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a Service User’s Guide and statement of purpose that contain all elements of Standard One. The home provides good information and introduction opportunities for prospective service users, their families and representatives to make an informed choice about moving to the home. The home continues to accurately assess, identify and meet the needs of the people who come to stay for respite care. The home has its own assessment plan to ensure that any new service user’s needs are fully assessed prior to their admission and that staff are aware of how to support them. EVIDENCE: Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 10 The home has a Statement of Purpose and Service User Guide that contain all elements of Standard One. The service user guide provides clear and accessible information in a written and pictorial format. In addition it contains photographs and pictures of the accommodation provided. Service users are consulted when any changes or amendments are made to it. Full details of the homes complaints procedure and how to contact the Commission for Social Care Inspection are included in the service user guide. Two service users’ files were sampled. A specific form is used on which to record an overall assessment of each service user once they have been admitted. This covers all aspects of the person’s life, including strengths, social and cultural needs and psychological needs. Copies of these assessments were on file for each service user as well as detailed needs assessments which are duly completed by the care managers of their placing authorities. This provides staff with comprehensive information about a person’s needs and how they should be supported. An informative needs assessment was available for one service user who uses the service. There were also good records to show that that service users receive appropriate support to familiarise themselves with the home. Staff have received specialist training on epilepsy to enable them to fully support those service users with such needs. Each service user is provided with a contract that outlines the terms and conditions of their occupancy including periods of notice; fees charged, and arrangements for reviewing their care plans. The individual contracts are signed by each service user and/ or their representative and registered manager. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 11 Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning process is well managed and ensures a personalised and consistent level of service provision for the people staying in the home. Risk assessments are duly completed so that service users are provided with the necessary support and independence is maximised as far as possible. EVIDENCE: The personal goals and needs of the service users who come to stay are frequently discussed, recorded and actioned. All service users have person centred care plan. Known as “My support plan” the plans detail what each service user likes to do each day, the things that they like and how the staff should best support them to achieve their personal goals. Daily records of care directly relate to the assessed needs and goal plans identified in each service user’s plan. These were comprehensive and detailed how the service users’ Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 13 identified health, personal and social care needs would be met. In addition information was available on how staff should support a service user in their personal care, or respond to behaviour that may challenge the services they require. As stated earlier all service users have a comprehensive risk assessment undertaken by experienced staff at the home. Such risk assessments inform the staff how to make sure that each of the service users is kept safe from anything that might harm them whilst protecting their individual rights and choice and maximising their independence. Examples seen included safety in the home, managing personal care and accessing the local community. Chamberlain Way, 17 DS0000042884.V329901.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Planned around their needs and preferences, service users benefit from a choice of recreational activities and fulfilling lifestyle both within the home and local community. Meal provision reflects variety and choices, whilst seeking to maintain a healthy lifestyle for service users. Service users benefit from a varied choice of recreational activities both within and outside of the home and in relation to their individual preferences. The daily routines and house rules promote service users’ rights and encourage independence. Appropriate contact between service users and their families and friends is encouraged to help them maintain relationships. EVIDENCE: Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 15 When the service users come to stay, they are encouraged to maintain their usual routines, as they would normally do with their main carer. Some service users attend day centres, college classes and community activities organised by the home. Service users attend independently or with the support of staff where necessary. A list of planned events and activities for the forthcoming year is also sent to the service users so that they can plan their choices when they come to stay at the home. In addition the home informs service users about activities through regular meetings, informal discussions and the use of a notice board. Activities include theatre and restaurant trips, sightseeing in London, cinema and house activities such as art and craft hobbies. Although service users do not have an annual holiday as such the registered manager informed the inspector that the home was planning a number of weekend breaks in the summer. As well as the neighbouring home’s own transport; service users regularly access public transport services including buses and trains. The menus at Chamberlain Way are centred on the likes and dislikes of the service users and planned each day. An alternative to the main meal is provided as well as accurate records kept of daily meal choices made by the service users. Records showed that the service users who stay at the home are independent in eating and do not require assistance, but support is available if required. The home retains good links between service users and their families / representatives. Parent/ carer meetings are held every quarter to discuss any relevant issues about the home and the organisation. Service users are encouraged to maintain their friendships. One service user has an established relationship with an individual who lives in one of the other organisation’s homes. Both service users often go out together on community activities and staff support the two service users to maintain their relationship. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Medication is well managed to maintain maximised good health for the service users. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Promotion of health is well observed. Service user’s welfare is closely monitored to ensure that their physical and emotional needs are met. EVIDENCE: Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 17 Each service user’s health care needs are clearly documented in their care plan. Support with personal care needs is recorded in a way that focuses on the unique preferences and personality of each service user. The home operates a key worker system, which takes into account the wishes of the service user. Key staff are responsible for updating care plan records as necessary. The house rules and daily routines are as flexible as possible, bearing in mind the weekday commitments of the service users. The home supports service users to be flexible about when they choose to get up, go to bed, have a bath, and eat. Service users are encouraged to contribute to household management duties including cleaning, shopping and cooking. Information on individual GP contacts and other relevant healthcare professionals is recorded in the service user’s files. Each service user has a written profile to specify what medication is required together with a homely remedy policy, authorised by the individual’s GP. Medication administered is recorded and kept in each service user’s file. Staff receive medication training through the local authority training department. New staff are inducted through their in-house orientation on the safe administration of medication. The medication is stored in individual service users’ bedrooms in a lockable facility. Robust policies and procedures are in place on medication practices. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 18 Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a system in place for the effective handling of complaints and service users and their relatives are encouraged to raise any concerns they have. Service users therefore know that their concerns will be acted upon. Arrangements are in place for handling allegations and instances of abuse. This ensures that service users will be protected from harm. EVIDENCE: There had been no complaints about the home since the last key inspection. Evidence was noted that issues regarding complaints are being effectively managed. Complaints are monitored by a senior member of staff and are inspected on a monthly basis during the course of Regulation 26 visits. The complaints procedure is detailed in the Service Users Guide. It is in plain English and in pictorial form. Signs and symbols are used for ease of reference and there are telephone numbers of agencies, including the commission that service users may contact in the event of a complaint. Minutes of service user meetings held in the home detailed that staff members have explained to service users how they can make a complaint. In addition to the home’s complaints procedure, service users and their family members are Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 20 provided with information about how to make a complaint directly to the Royal Borough of Kingston upon Thames. There are adequate systems in place regarding the protection of vulnerable adults. CRB Checks are completed on all new staff prior to appointment; induction training on the prevention of abuse and numerous policies to safeguard the service users welfare such as management of their finances, dealing with aggression and conflict and a whistle blowing policy to state what action to take should staff suspect anything untoward. The home’s policies are used in conjunction with the Royal Borough of Kingston Protection of Vulnerable Adults Procedure. There had not been any POVA referrals made by the home to the local authority since the last inspection. All notifications made under regulation 37 had been appropriately recorded at the time of the inspection. All staff at the home has undertaken Adult Protection training and has a clear understanding of the underpinning procedures. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, hygienic and in a good state of repair which provides a safe environment for service users when they come to stay. Bedrooms are appropriately furnished and service users are supported to bring in their possessions that reflect their individual lifestyles and preferences. EVIDENCE: The home is situated on a residential road in Surbiton. It is a semi-detached house in keeping with the local area. Accommodation is provided over two floors. There is a small, well kept garden to the rear of the home. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 22 The home was found to be safe and comfortable and to provide suitable lighting, heat and ventilation. Staff members have clearly made good efforts to ensure that the home is bright and cheerful. There is a planned programme of maintenance and renewal. Overall Chamberlain Way is a homely, well maintained house that retains a family type atmosphere. There is one bathroom and two toilets that are lockable, but can be opened with an override devise in an emergency. All areas of the home were clean, hygienic and free from offensive odours. Laundry facilities are adequate, and situated away from the kitchen. All relevant policies and procedures are in place regarding the control of infection. Bedrooms are decorated and furnished to a good standard with comfortable furniture and fittings. Service users are able to bring in personal possessions to personalise their rooms during their stay. Television sets are provided in each room. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a small staff team who have relevant training and support that enables them to meet the needs of the people living at the home. Service users are therefore benefiting from a well-supported staff team who receive regular supervision and guidance. Procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 24 Staffing needs are assessed and are provided according to the level of occupancy and individual service users. Minimum staffing at the home is one staff member whilst service users are at the home. Staffing is generally provided from 7am until 10am, then again from 3pm until 10pm during weekdays, and throughout the waking day at weekends. The deputy manager provides the day-to-day running of the home, supported by regular bank staff who are employed within other homes run by the registered providers. The home has a training and development plan which is updated annually. Staff have the opportunity to undertake NVQ level 2 and 3 following completion of their induction programme. The deputy manager is currently completing the A1 assessor’s course and the registered manager advised the inspector that staff have the opportunity to undertake professional social work training. The deputy manager’s training file was inspected and it was evident that she had undertaken a wide range of training during recent years including developing supervision skills. It was evident that the local authority sees training as pivotal in the development of the service. All staff members receive a structured induction programme. As stated earlier in this report the induction programme has been revised. The ‘skills for care’ programme of induction is comprehensive and staff usually commence this on their first day of employment. The programme of induction includes topics such as Confidentiality, Whistle Blowing, Safe Working Practice and Recording. Staff receive good support and guidance from management and other, more experienced staff members. It was evident that newly appointed staff were not expected to carryout care tasks until they were fully trained to do so. The deputy manager confirmed that all staff received formal supervision. Records are maintained of supervision sessions. Yearly appraisals also occur as evidenced during the course of this inspection. Staff records were inspected during the course of the last inspection of Woodbury dated 20th February 2007. Woodbury is also managed by the same registered manager as Chamberlain Way and records are therefore kept at the main office in Woodbury as staff work jointly across the project. Staff records inspected at random contained all elements of Standard Thirty Four including evidence of CRB checks. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 25 Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is very experienced and has professional qualifications relevant to managing the home. Staff members follow safe working practices in the home, which ensure that the health, safety and welfare of service users are promoted and protected. EVIDENCE: The Registered Manager, Jane Wells, is a qualified social worker and also has a relevant management qualification. Records and discussion showed that the Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 27 manager is experienced and knowledgeable about the needs of the service users. The manager is mainly based at the neighbouring residential home, and has worked at the Woodbury Community Housing Project for many years. The deputy manager has responsibility for the day-to-day running of Chamberlain Way. She too is an experienced senior member of staff who has acquired a varied range of training including the NVQ Level 3 qualification in care. Minutes of staff meetings detail that staff members and service users are encouraged to be creative, innovative and involved in changes in the home. Staff members and service users were observed to share positive relationships with the Registered Manager. There is a detailed risk assessment in relation to fire and records indicate that the fire alarm, fire equipment and emergency lighting are tested on a regular basis. Staff members report that regular fire drills occur and there were records to confirm this. The last fire drill took place on 21st February 2007. The front door, also a fire exit, is kept locked by an electronic keypad access system. The registered manager has developed a locked door policy for the home given such restrictions could be construed that service users are not fully able to exercise their rights within the home. Monthly health, maintenance and safety checks of the premises are carried out by staff. Records of these were examined as part of the inspection process. Records of accidents and injuries were available, as were individual risk assessments for service users. Checks on hot water temperatures are carried out regularly to ensure that they are maintained at a safe limit. Other servicing and maintenance records for the home were checked and all were found to be up to date save for portable appliance testing. Arrangements were made during the inspection for this inspection to be carried out on Monday, 26th February 2007. The system for consultation with service users, families, stakeholders and other interested parties is positive. The quality assurance system includes a programme of ‘Action for Quality’ This comprises of Institutional Questionnaires, Service User Questionnaires and an Organizational Health Check. When all the results are collated the registered manager advised that ‘Outcomes’ would be drawn up for the benefit of service users. The home is shortly to complete a survey for care managers, families and other stakeholders. The home will need to collate the results of these surveys and ensure the outcomes of the surveys are addressed and acted on for the benefit and wellbeing of the service users at the home. Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 28 Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 29 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 3 2 3 3 3 4 3 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 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 30 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. Refer to Standard Good Practice Recommendations Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chamberlain Way, 17 DS0000042884.V329901.R01.S.doc Version 5.2 Page 32 - 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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