Inspection on 29/09/08 for Chy An Towans

This inspection was carried out on 29th September 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Chy An Towans 11 Upton Towans Hayle Cornwall TR27 5BJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynda Kirtland     Date: 2 9 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Chy An Towans 11 Upton Towans Hayle Cornwall TR27 5BJ 01736754152 Telephone number: Fax number: Email address: Provider web address: Barr423@btinternet.com Name of registered provider(s): Name of registered manager (if applicable) Mr Ian James Leonard Barr Type of registration: Number of places registered: Mrs Jacqueline Ann Barr,Mr Ian James Leonard Barr care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 11. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Chy An Towans is a care home providing accommodation and care for up to eleven adults with a learning disability. The registered provider is Mrs Jacqui Barr who has many years experience in managing a learning disability service. Mr Barr is the registered manager who is an experienced nurse. They purchased the home in April 2008 and have set up as a home where people who already have a reasonable level of independence can continue to develop their personal and social skills.The home is located in the village of Upton Towans just outside of Hayle. The home has a vehicle to provide transport for people who use the service who need to access resources in the Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 11 Brief description of the care home wider community. The home is one storey and all bedrooms are for single occupancy. However in one room two people choose to share the bedroom. All rooms are personalised and have their own sink. Some rooms are en suite and the new owners plan to upgrade all the bedrooms so this facility is in each room.There are two communal bathrooms, plus a lounge, dining area, access to the kitchen and a large front and smaller rear garden. There is parking to the front of the home. The home is well staffed with sleeping in staff at night. The registered provider stated that the current range of fees is in the region of three hundred and twenty pounds to nine hundred pounds per week. People who use the services are responsible for purchasing personal items such as toiletries. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The new owners purchase Chy An Towans in April 2008. This was the first key inspection, which took place on 29 September 2008 and lasted for approximately seven hours. The purpose of the inspection was to ensure that people who use the service needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus is on ensuring that peoples placements in the home result in good outcomes for them. Information received from and about the home since its opening has also been taken into consideration in making judgements about the quality of outcomes for the people living there. The inspection included meeting with the people who use the service currently living at Chy An Towans. Other activities included an inspection of the premises, examination of Care Homes for Adults (18-65 years) Page 6 of 30 care, safety and employment records and discussion with the staff and registered person and registered manager. We talked to the people using the service, and asked staff about those peoples needs. We also looked at the care plans, medical records and daily notes for these people. This is called case tracking. Of which we case tracked two people who use the service. There were opportunities to directly observe aspects of peoples daily lives in the home and staff interaction with them. We received a survey from relative and two from professional agencies the overall view from these surveys was that they were satisifed with how Chy An Towans provided care, level of activities, and staff skills. Some comments regarding the new management of the home are a lot of things have improved and better communication with the local authorities. The Commission received the Annual Quality Assurance Assessment, which is a questionnaire that the registered person completed. The AQAA describes the services and facilities that Chy An Towans provide and identifies what areas they do well in and where they want to make further improvements. What the care home does well: The management team have provided written information about the home and aim to introduce a pictorial, easy to read summary for the People who use the service. The home operates like a shared domestic dwelling with staff support provided where it is needed to assist them to develop and maintain their skills and independence. People who use the service are encouraged and supported to develop their skills and independence in many ways. As their care plans are being reviewed they are now involved in their formation with assistance and support from staff. They attend reviews so that they know why they are placed at the home and via the introduction of person centred planning process this identifies what aspirations they are aiming to achieve e.g. developing a particular element of self-care to promote their skills and independence. They have opportunities to make decisions about important aspects of their lives, with assistance from staff, if they need it and are supported to take risks so that they can enjoy fuller and more active lives in and out of the home. Access to health care is appropriate for the individuals needs. From records and in discussion with People who use the service show that they have active and busy educational and social lives both in the home and in the community. People who use the service have clear information on what is expected of them and their rights as residents of a care home. They are aware, for example, that they will be expected to help out with household tasks such as cooking and cleaning, so that they can develop their skills and independence and know what to do if they wish to make a formal complaint about something they do not like. People who use the service participate in the food shop and were observed to make choices of what to have for lunch during the inspection. They have access to the kitchen so that they can make drinks and snacks for themselves when they wish, with staff support and are encouraged to live and eat healthily. People who use the service are appropriately supported with their personal care so that they maintain their dignity. Staff were observed to assist them with their needs quietly and unobtrusively. The management team are booked to attend multi-agency training in the protection of vulnerable adults from abuse to enhance their knowledge and skills of working together with key agencies involved in this. The staff team demonstrated throughout the inspection positive interactions with people who use the service and assisted them with personal care needs in a discrete manner. Staff have had a comprehensive and valuable induction to the home. Staff confirmed access to training is available. The management team are now aware and will ensure that all events notifable under regulation 37 of the care Standards Act 2000 must be reported to the Commission as per legislation. Care Homes for Adults (18-65 years) Page 8 of 30 The inspector was welcomed to the home in a friendly manner by staff and People who use the service. All were aware of the reason of the inspection. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service needs are assessed prior to their admission so that they can be confident it will meet their health, personal and social care needs, including needs relating to their age, religion, cultural and ethnic backgrounds, abilities, gender and sexual orientation. Evidence: When the new owners purchased the home the current People who use the service remained resident at Chy An Towans. Therefore there have been no new admissions since the owners involvement. However the owners have introduced a policy and procedure in how to manage new referrals and admissions to the home. From observations and talking with people who use the service it was evident that they are settled in the home, and that they get on well with each other and with the staff. A copy of the homes statement of purpose is on display as is the Service Users Guide. These were inspected at the time of registration in April 2008 and were seen to be satisfactory and therefore not inspected on this occasion. Contracts in relation to the Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: placement identify individuals rights and what services they will be provided with. It is recommended that if there are costs that the individual needs to pay as well as their benefit entitlements, these should be included in the contract. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team are developing people who use the service individual care plans, to ensure that they address their health, personal and social care needs, including needs relating to their individual and diverse backgrounds. The management team are also developing the risk assessment process so that people who use the service are able to take safely managed risks and make important decisions about their lives so that they develop their skills and independence. Evidence: The management team are reviewing the care planning documentation as they have found that some of the care plans that they have inherited do not accurately reflect the persons individual changing needs. In addition they want to make the care plans more person centred and involve the individual, their family and other professionals in this process. The management team want to incorporate in the personal care plan with specific goals for the people who use the service to work towards, and inform and direct staff in how to support the individual to achieve this goal to encourage them to Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: fully maximise their skills for independent living. The current care plans are sufficient but the management team are aware that they need developing further, which they are currently addressing and aim to complete within six months. From inspecting the new format and in discussion wiht care staff they felt the new format of care plans would be easier to understand, as they will reflect the persons individuals needs more accurately. People who use the service, their family, advocate and relevant professionals are involved in the individual care plans reviews. People who use the service participate in making decisions about important aspects of their daily lives, according to their individual abilities and this was observed during the inspection. There have introduced residents meetings so that they can discuss issues and make household decisions as a group. Staff were observed supporting individuals who required it, to make decisions about what to do during the day. Daily care records provide further evidence of the choices they make in their daily lives. Residents can choose the level of privacy they wish to enjoy in their private accommodation. The management team are also developing the risk assessment process further so that people who use the service are able to take managed risks, backed up with written risk assessments and risk management plans, particularly with regard to their engagement in higher risk activities. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management team are developing people who use the service individual care plans, to ensure that they address their health, personal and social care needs, including needs relating to their individual and diverse backgrounds. The management team are also developing the risk assessment process so that people who use the service are able to take safely managed risks and make important decisions about their lives so that they develop their skills and independence. Evidence: Individual care plans and daily care records provide good evidence that the persons interests and abilities are fully considered in planning their daily activities, which are planned with them individually. This is written up as a guide but as was observed during the inspection, discussions with People who use the service occurred as to where they wanted to go out for the day and on return to the home it was evident that Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: all had an enjoyable time. Some activities include attendance at college, clubs, cinema, swimming, and walks, attending religious services, and pub lunches for example. At the time of the inspection people who use the service were engaged in a variety of different and appropriate activities in and out of the home, with staff support provided as necessary. In addition daily care records show that they access a wide range of community resources with staff support, depending on their individual needs and abilities. People who use the service are encouraged to maintain valued relationships with their families and friends, with staff support as necessary, which was observed at the inspection. In addition their daily care records, discussions with People who use the service and surveys from a relative confirmed this. People are able to make telephone calls in private if they wish. People who use the service are supported and encouraged to eat healthily. They undertake shopping, planning for and preparing meals with assistance from staff. Observations of people who use the service were seen to choose what they wanted to have for dinner and where they wanted to eat it. Nutritional needs and preferences are considered as part of the care planning process. People who use the service looked healthy and well nourished. The home has an ordinary, domestic kitchen, which they can access with staff support, to prepare drinks and snacks when they want them. A recent visit from the Environmental Health Officer concluded that they were satisfied with the food arrangements in the home. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service personal and healthcare needs are well met so that they are able to live full and active lives in and out of the home. Medication systems are robust so that people who use the service health needs are managed safely. Evidence: Care plans address their individual personal care needs and with sufficient bathroom facilities the person is able to attend to their personal care privately. Healthcare needs are considered as part of the care planning process and regularly reviewed. In discussions with people who use the service, staff and management team plus documentation showed that they access external healthcare providers, including specialists, when they need to. People who use the service records provide evidence that they access a range of local NHS healthcare providers on a regular basis so that they maintain good physical health and emotional wellbeing. The registered person described how the home links with local specialist services to assist people with specific behavioural and emotional needs Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: and regularly consults with external professionals to ensure their needs are managed effectively and appropriately. There is appropriate storage for medication. Medication received into the home, administered and returned to the pharmacist is recorded. The home uses the Monitored Dose System (MDS) and therefore the majority of tablets are blister packed which staff stated minimises medication errors. The management team were advised that if they use when required medication that they ensure that they carry over any surplus medication from the previous month so that a audit trail of medication can be followed, as currently this is not able to occur. The managers said they would address this immediately. In addition if when required medication is used a protocol for staff to know when this medication is to be administered i.e. under what circumstances should be cross referenced to the individuals care plan. All staff that handles medication are appropriately trained and there are certificates to provide evidence of this. It is recommended that the homes medication policy be expanded to include the management of when required, controlled drugs and homely remedies guidance to staff. It is also advisable that the home gain a copy of the Safe Handling of medicines in Care Homes document for reference. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are listened to and respected so that their views, concerns and complaints are taken seriously and acted upon. There are formal and informal systems in place to ensure that they are able to feel safe in the home. Evidence: People who use the service were encouraged to speak to the inspector if they wished so that they could make their views known or raise any concerns. No concerns were raised. People who use the service are aware of how to raise any concerns and Chy An Towans has a formal complaints procedure and informal opportunities (e.g. house meetings, care plan reviews and 1:1 time) to raise any concerns with staff before they become serious complaints. The home has received compliments from family members and professionals since opening and no complaints. The management team were aware that the homes safe guarding and whistle blowing policies need to be reviewed following their attendance at the multi disciplinary safeguarding course the next week (and the policy was present in the home). The management team verbalised a sound knowledge of what to do if a allegation of abuse was received and knew what processes they should follow. All staff have undertaken some safe guarding training at different levels. The staff team knowledge of Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: safeguarding issues is sound. From inspecting people who use the service monies it was recommended that the policy and procedure should be reviewed so that staff are aware of what procedure they need to follow if they are involved in any purchases, or deposits on behalf of the individual and how to record this. In addition the management team agreed that a second person would audit the monies on a regular bases to ensure that the system is safe and people who use the service monies are protected. From documentation inspected records tallied with monies kept in the home and people who use the service were actively involved in the decision to withdraw/ deposit money and signed to this effect. As a recommendation is made later to review all policies and procedures these recommendations are included under the management section. When the owners purchased Chy An Towans all the staff decided to leave. The managers in consultation with us agreed that they would employ staff that they had worked with in previous care settings due to the staffing crises at that time. Therefore POVA and CRB checks made on behalf of the home were not completed prior to a person starting work as we agreed that these documents could be used from their previous employment until new ones had been issued, These have now been issued. People who use the service are not isolated in the home, but take part in a range of activities in the local community and have relationships with people from outside of the home that they can communicate serious concerns to. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes environment provides people who use the service with an ordinary, domestic setting so that they can develop their skills and independence in a non institutional setting. Consultation with people who use the service is in progress to improve the decor and furnishings of their private and communal space to a comfortable standard. It is safe and clean so that people who use the service are protected from risks of cross-infection. Evidence: A person who uses the service showed us around the home. It was observed that the home was furnished and decorated to a satisfactory standard. The management team have stated that they wish to upgrade the current facilities and are starting this in January 2009 in the older part of the home with a rolling programme of maintenance work carried out until all the home has been upgraded. Due to this no recommendation has been identified at this time. People who use the service were particularly pleased with their bedrooms that they had personalised. Suitable equipment to promote independence has been gained following consultation Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: with relevant health professionals. The registered person has completed environmental risk assessments to ensure that the premises are safe. Staff were aware of COSHH and relevant lockable storage was in place to store these items. Staff have attended infection control courses. It is recommended that paper towels are provided for staff use in toilet and kitchen facilities areas in particular to further promote infection control practices. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient numbers of qualified staff on duty so that people who use the service can have confidence in their competence and skills. Staff training is encouraged so that up to date research and knowledge can be gained for the benefit for the people who use the service The homes recruitment policies and practices are fair, safe and effective so that people who use the service can be assured that staff are suitable to work in a care setting. Staff receive regular, formal supervision. Evidence: In discussions with people who use the service and staff all felt that there were sufficient staff on duty at all times. There is a minimum of two staff on duty, and two people on duty at night with a member of the management team on call at all times. Care staff undertake all personal care duties, a domestic is employed three hours a day five days a week. People who use the service assist with some cleaning and cooking tasks as per the agreement in their personal care plan to further develop their independence skills. From observations of staff interaction with people who use the service it was evident that they communicate with them in a competent, fair, patient manner and work with them at their pace. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: This is a new staff team and all spoke positively about their recruitment, induction, and access to training and management support. There has not been a need to employ agency staffing. The management team are actively recruiting for another care worker and want the people who use the service to be involved in the recruitment process. The staff team are experienced in working in the area of learning disability. Five staff members have achieved NVQ level 2, which means that they have met the national minimum standard in NVQ qualifications. The registered provider is near completion of her Registered Managers Award and the registered manager will be enrolling on the Leadership and Management course (which replaces the Registered Managers Award). The management team undertook a lot of in-house training due to the need of a new staff team needing to get to know the people who use the service and provide care for them. There is now a clear programme of training available for all staff and staff stated that they had attended recent training in infection control, manual handling, first aid, fire, POVA, person centred planning training and are booked to attend food hygiene and managing challenging behaviour. It is planned that all the staff will enrol on the learning Disability Qualification starting in May 2009. Due to the quickness of employing staff at the home as explained earlier in the report the homes recruitment records in the main meet the requirements of the Care Standards Act. All staff now has a POVA/CRB and a minimum of one reference (should be two). The management team are aware that with all future applications they must gain all relevant documentation as per the requirements of the Care Standard Act to ensure compliance and officially record the induction process. Staff, confirmed by documentation, stated that there is regular formal supervision. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered person and registered manager are qualified and experienced to run a care home. The home is well run for the benefit of people who use the service. There are formal and informal systems in place to ensure that people who use the service views are accounted for in the day-to-day running and ongoing development of the home. The development of policies and procedures is ongoing. There are systems in place to protect People who use the service, staff and visitors from avoidable harm and injury. Evidence: Between Mr and Mrs Barr they have the skills and competence to manage a care service effectively. Mrs Barr is a manager for day care services and Mr Barr is a qualified nurse. Both have worked in the social care, health setting for a number of years. Mrs Barr is near completion of her Registered Managers Award and Mr Barr is enrolling on its equivalent course, Leadership and Management. They ensure that their training is up to date so that their knowledge and skills base is increasing for the benefit of people who use the service. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Staff and people who use the service spoke highly of their skills and felt that they are approachable and listened to their ideas or concerns. From observations, all interacted with them in a relaxed manner. In addition surveys from professionals commented on the improvements that have already been made to the lives of the people who use the service under their management. As the service is new the management team aim to undertake a quality assurance review in the next six months, as they would have been operating for a year. However they have started this process by introducing resident and staff meetings and by having discussions with family and professionals the facilities the home offers as they welcome feedback to improve the services further. The management team also completed the Annual Quality Assurance Assessment that they sent to us on time, which is also part of a quality assurance review, and they highlighted areas where they have improved the services and areas where they want to make further improvements. Following this inspection the management team also sent us a action plan of when they aim to complete certain improvements i.e. refurbishment, training, and development of care plans as they are keen to work with us and ensure that the needs of the people who use the service are paramount. Records are stored confidentially, and recordings adhere to the data protection act. Advise was given to clarify when to notify the Commission of particular incidents under regulation 37 so that in future all incidents are reported. The management team are also aware and is working on improving the homes polices and procedures so that they are appropriate to the service they provides and inform and guide staff accurately as to what is expected of them. The homes environment appeared safe and there are written individual and environmental risk assessments in place to minimise risks to people who use the service and staff working in the home. Maintenance of the home and its equipment are satisfactory. The homes fire safety records were completed and up-to-date. There are records of regular tests and checks of safety equipment and procedures in the home to ensure people who use the service, staff and visitors safety. All staff have attended fire training advice has been sought to ensure that the homes fire risk assessment is in line with the new legislation. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 care plans should be developed further to ensure that service users needs are accuratley recorded and that staff are informed, guided and directed in how to meet these needs in a manner so that servie users are provided with consistent care. Risk assessments should be developed further both in individual and group settings so that staff are aware of how to minimise risks for the health and safety of the servie user when partaking in a activity. it is recommended that when there is a surplus of when required medication from the previous month this is carried over so that a audit trail of medication can be followed, and therefore all medication is accounted for in the home. It is recommended that the homes medication policy be expanded to include the management of when required, controlled drugs and homely remedies guidance to staff. It is also advisable that the home gain a copy of the Safe Handling of medicines in Care Homes document for reference for staff. 2 9 3 20 4 30 is recommended that paper towels are provided for staff use in toilet and kitchen facilities areas in particular to further promote infection control practices. Page 28 of 30 Care Homes for Adults (18-65 years) 5 34 Recruitment checks should be more robust in future job applications to the home, as per the Care Stanadrd Act to ensure people who use the service are safe. The homes policies and procedures should be reviewed, in particular adult protection, medication, management of peoples monies and whistel blowing to ensure that they direct, inform and guide staff on what they are expected to do and are accounatable for. 6 40 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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