Inspection on 18/09/07 for Collinson Court

This inspection was carried out on 18th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Collinson Court 02/03/07

Collinson Court 31/05/06

Collinson Court 21/12/05

Collinson Court 20/06/05

Collinson Court 20/12/04

Collinson Court 05/05/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Collinson Court 56 Longton Road Trentham Stoke-on-trent Staffordshire ST4 8ND Lead Inspector Wendy Jones Key Unannounced Inspection 18 , 19 , 23 & 24 September 2007 15:00 th th rd th Collinson Court DS0000008324.V338637.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 Collinson Court DS0000008324.V338637.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. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Collinson Court Address 56 Longton Road Trentham Stoke-on-trent Staffordshire ST4 8ND 01782 658156 01782 643103 collinson.court@craegmoor.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) Autism Tascc Services Limited vacant post Care Home 10 Category(ies) of Learning disability (10), Mental disorder, registration, with number excluding learning disability or dementia (10) of places Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02 March 2007 Brief Description of the Service: Collinson Court is a purpose-built care home, registered to provide accommodation for 10 adults. The home provides a specialist service to people with an autistic spectrum disorder. Service users’ primary diagnosis must be learning disabilities although they may have a dual diagnosis of a mental health condition. The property provides ground floor accommodation divided into four areas, each with its own entrance. These consist of two four-person apartments, two single-person flats, a staff office, training area, activity room and gym. Each apartment and flat has its own garden area and the gardens to the rear of the property are secure. The home is located off the main Trentham to Longton road; it provides off-road parking and shared drive access. The building is single-storey, providing access to wheelchair users. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection site visit of this service undertaken from the 18/09/07 2007 and included visits on the 19/09/07, 23/09/07 and 24/09/07 in total the visit took approximately 12:30 hours. The purpose of this visit was to assess the services performance and to establish if it provides positive outcomes for the people who live there. The visit included checking that the requirements and recommendations of the previous inspection visit of 02/03/07 have been acted upon; looking at information the service provides for prospective residents, their carers and any professionals; looking at information that the service provides to people who use the service to ensure that they understand the terms and condition under which they have agreed to live at the home and the fees they should pay. Other information checked included assessments and care records, health and medication records; activity and records relating to the menu’s, finances, staff training and recruitment, complaints and compliments and fire safety and health and safety checks. The manager, staff and residents were spoken to during the site visit and a tour of the building was undertaken. Before the visit began, the service provided it’s own assessment of it’s performance, in the form of an Annual Quality Assurance Assessment (AQAA). Surveys were sent out to residents, relatives and any professional that has involvement in the service. Staff surveys’ were handed out during the site visit. The main points from the survey’s are included in this report. Since the last key inspection 02/03/2007, two additional visits have been made to the home, 17/03/2007 with the fire safety officer to look at progress and compliance with Fire Safety Regulations and 22/05/2007. What the service does well: The service provides a safe and specialised service for those people with a learning disability and who may have Autism Spectrum Disorder and or Aspergers Syndrome. Accommodation is in a purpose built single storey building, which is divided into 2 single occupancy flats and 2 apartments that can each accommodate 4 people. The service has a core staff team that provides a dedicated and caring service. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 6 Care plans are detailed and risk assessments relating to the individual needs of people who use the service are of a good standard with evidence that they have been reviewed regularly. The service try’s to ensure that where possible the people who use the service are involved and consulted about their care and the service they receive. What has improved since the last inspection? What they could do better: The service should ensure that any information available to residents and their supporters is up to date and in a format they can easily understand. The resident guide should also contain the details of fees and costs of the service. Residents should be confident that their monies are being managed and used properly. The complaints procedure should be up to date and all residents and relatives should know how to complain if they want to. All staff should be trained to ensure that they know how to safely administer medication. Staffing levels should be kept under constant review to ensure they are adequate to meet the needs of residents, and staff should receive regular supervision sessions. The service should look at how it can improve the garden areas for the benefit and privacy of residents. The organisation should ensure that any maintenance or building work is carried out in a timely manner; this includes the poor ventilation in the two apartment kitchens and odorous bathroom in apartment 2, the carpet in flat 1. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 7 The results of any audits into the quality of care/service provided should be included in the Resident guide and used to inform the annual development plan for the service. The new manager should apply to the CSCI for approval and she should ensure that all staff have been involved in fire drills. 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. Collinson Court DS0000008324.V338637.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 Collinson Court DS0000008324.V338637.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, 4 and 5. Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service, their carers and supporters have access to information about the service. This ensures they know what type of service they can expect to receive, but not all of this information is provided in a format that can be easily understood or is up to date. They can also be confident that a full assessment of their care needs is carried out to ensure that their needs can be met. EVIDENCE: The service is in the process of revising the Statement of Purpose and Resident Guide to ensure that they are as user friendly as possible. The Statement of Purpose is to be updated, to ensure that the information contained within it is up to date and should also include the services’ policy on emergency admissions. A copy of both documents should be provided to the CSCI and made available in the home for relatives, staff and visitors to the home. Each resident should have their own copy of the guide, which should also contain the terms and conditions of residency including fees and costs and include the correct address details for us. 3 residents returned surveys. 2 of the residents stated that they were asked if they wanted to move into the home, 1 did not comment or was not able to answer the question. 1 resident said, “ my key worker from the other home bought me to look around.” Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 10 There have been no new admissions to the home in the last 12 months. But a sample of assessment records show that detailed pre admission assessments are carried out by the care team and by relevant professionals, copies of which are maintained in the home. Where possible the service supports prospective residents by visiting them in their former place of residence to get to know them, offering visits to the service and making assessments of compatibility with the other resident group. The period of transition from their previous placement can vary, dependent on the individual needs of the resident. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that their care needs will be assessed and care plans put in place to provide staff with the information they need to deliver the type of care necessary to meet the needs of each individual. Residents can also be sure that they will usually be consulted about the plans and risk assessments that are put in place. But there is uncertainty about how residents are consulted about making purchases on their behalf and if the systems are robust enough to ensure that such purchases are appropriate. EVIDENCE: The standard of care planning is good, with lots of very detailed information about the needs of the residents and how those needs can be met. Where relevant there are also risk assessments in place that provide staff with the information they need to minimise any identified risk. Both care plans and risk assessments are subject to regular review. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 12 The records did not always show how residents are involved with care planning and reviews, but the new manager said that the development of “your voice” sessions and 1:1 talk time sessions should ensure that residents are included in discussions about their care Issues around capacity assessments and consent relating to care plans was discussed with the manager and will be looked into when the service starts to introduce a new more Person Centred care planning system. Staff have also to receive training before this new format can be introduced. In addition each resident has a daily diary which is completed by staff for each shift and gives an account of what the resident has done, how they have been etc. These diaries, as well as a unit communication book are used to handover information to the next shift of staff. Samples of resident finances were looked at, to assess if money is being managed properly. At the last key inspection concerns were raised about residents paying for large items of furniture that were used in the communal areas in the 2 multi occupancy flats. The manager said that she understood the monies had been reimbursed where appropriate and in some circumstances agreement had been reached with the individual and their supporters. These items are now included on the individuals property inventory. At this visit, records showed good practice in terms of how residents monies is recorded, 2 staff sign each transaction to indicate they have checked the amounts, receipts are retained with the record as proof of purchase, and there is evidence that periodic audits of finances are undertaken. Matters arising at this visit included a resident who is recorded to have purchased a bedroom door alarm out of his personal monies. This was discussed with the manager for her to look into, and reimburse. For another resident whose behaviour can be destructive it is recommended that the procedure for providing replacement items is clear. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 13 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, 14, 15, 16 and 17. Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that their social, recreational and occupational needs will be assessed and plans put in place to ensure that they engage in suitable activities both in and out of the home. But cannot always be sure that they will be supported to, or have the staffing numbers to engage in the activities that are planned. EVIDENCE: Information in the AQAA states that the service recognises that it can improve in some areas such as providing residents with holidays. In a staff survey a member of staff said “ limited staffing means that residents can not always be involved in activities, I haven’t seen the in-house gym equipment used at all since I’ve been here.” It remains the view from this site visit that although the service now employs two Day Service Facilitators (DSF) to plan and arrange some residents activity in and out of the home. There is more needed to ensure residents are not left for long periods without anything to actively be involved with. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 14 The sensory room has been redecorated and some equipment has been purchased but is not yet complete, the DSF’s and the manager discussed their plans for the use of this facility and hopefully by the time of the next inspection it will be fully functioning for the benefit of residents. The training needs of the DSF’s were also discussed, with a commitment from the manager that any training needs identified will be supported. Daily diaries are in place for each resident these include a record of the known preferred activities for each person, and a plan for each day. Staff complete the diary during each shift. From a sample of those seen, the planned activities are not always being followed and while this is not a significant issue, as it demonstrates residents choice. There was some evidence of limits to the amount of activity residents are involved in and repetition of some activities that did not require engagement of the resident on a day-to-day basis. Ie watching tv or listening to music. The DSF’s also keep a record of the activities they plan for each week and said “we try to ensure that each resident is given the same amount of time per week to ensure equity.” The records showed that residents usually had three sessions per week with the DSF’s and usually went on an activity out of the home at least twice a week. During this visit one resident had been to a residents Forum organised by the company, aimed at seeking the views of residents about the service they receive and any areas that could be improved. The feedback was positive and the resident reported that she felt that her views are listened to. In addition the introduction of 1:1 “your voice” sessions have also provided the service with feedback about how it’s doing. One resident expressed his concern that his flat had not been redecorated when the refurbishment of the unit was being carried out, as he had been promised it would be. The manager stated that she is going to ensure that this is done and has sourced the funding to do so. The resident is going to be involved with choosing the colour scheme paint etc for his flat. Significant changes to the environment in the last 12 months have changed the catering facilities. Each of the flats and apartments now has a fully functioning kitchen, where meals are prepared and cooked. Previously there was a central kitchen for the preparation of the main meals of the day. Staff reported that the changes had resulted in more resident choice of meals, and more resident involvement in planning, preparing and cooking meals. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 15 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, 20 and 21 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that the service manages and administers medication properly, ensuring their health and well-being. They can also be sure that their health care needs are known, reviewed regularly and action is taken to ensure that any concerns are dealt with properly in consultation with the appropriate health professional. EVIDENCE: Resident’s personal care needs are known and met by the service, this was confirmed in the pre inspection surveys received, comments from residents included, “Staff always treat me well.” Relatives said, “The staff have shown great interest in the well being of my relative and have always made sure her needs are met.” “ My relative is very settled I feel the staff have contributed greatly to this.” “Staff seem to have respect for the residents they care for.” Throughout this visit staff demonstrated their knowledge and understanding of the personal and health care needs of residents. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 16 Health issues are recorded in resident care records; all residents are registered with a General Practitioner and have regular reviews from a consultant psychiatrist. Since the last inspection medication reviews have also been undertaken, and the confusion reported in the last inspection report regarding who was responsible for reviewing the medication has been resolved. Pre inspection feedback from the GP shows that he is satisfied that the service provides a good standard of care, feels that staff have are knowledgeable about the needs of residents and act responsibly and promptly to ensure that any healthcare needs are managed properly. Since the last inspection the service has sought advice from a community health care facilitator specialising in supporting people who have a learning disability. It is also recommended that the service seeks further advice about the introduction of Health Care Action Plans which are widely used in Learning Disability services to identify health needs and develop a plan with the individual about the action needed to ensure that health needs are met. In the records available there is evidence that resident are supported to attend health related appointments, this includes dental and chiropody care, and also preventative health screening. Staff also monitor residents weight and welfare and where necessary support residents to eat healthily and become involved in exercise. The service has demonstrated that action has been taken to ensure that all areas of concerns relating to medication management and handling, identified at the last key inspection on 02/03/2007 have been resolved. Medication storage is provided in three of the units, consideration should be given to providing this storage in all of the units in an effort to promote resident independence where possible. Information in the last key inspection concluded that there were some concerns about the storage temperatures of medication in particular in apartment 2. The storage facility has now been relocated in an attempt to remedy this problem and daily records of room temperature are maintained. These show that the storage temperature for the medications currently in stock is within an acceptable range. The manager was asked to ensure that all staff receive training in the safe administration and handling of medication as described in the last key inspection report and in keeping with the guidance from the CSCI and the minimum standards from www.Skillsforcare.org.uk. It is anticipated that all staff will be trained within the next 3 months. The service has indicated in the AQAA that it doesn’t have a policy and procedure for staff to follow in the event of a death, this should be developed and residents and families should be consulted about any preferred arrangement in the event of an individual’s death. These instructions should be recorded in care records. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 17 Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Residents feel their views are listened to and acted on. Residents 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 (adequate) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that there is a procedure in place should they or their supporters and relatives need to make a complaint, or if staff need to report a Vulnerable Adults issue, but cannot always be sure that relatives have been informed of the procedures to follow. This could place residents at risk. EVIDENCE: No complaints have been received by the CSCI and no Vulnerable Adults referrals have been made since the last key inspection. The information in the AQAA indicates that staff have received some training in recognising and reporting abuse, but others have yet to attend training sessions. The organisation has produced it’s own procedures; this also includes a whistleblowing procedure and contact number, both of which are displayed prominently in the home. The information in the AQAA also confirmed that all staff have pre employment checks undertaken prior to appointment, this was confirmed during the site visit, when a sample of 3 recruitment files were checked and from the 8 staff survey’s. Pre inspection feedback included: A social worker said, “ I have not experienced any concerns with this service.” 1 resident said, “ I know who to go to if I am not happy, but I don’t know how to make a complaint.” Another said, “I know how to make a complaint and if I am not happy I will go to the staff or manager,” a third resident wasn’t sure. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 19 In relatives surveys comments included mixed feedback from 3 relatives indicating that they may not know how to make a complaint if they needed to. One relative said, “I haven’t had to make a complaint, and am not sure what I should do if I had to make one,” “ I can’t remember how to make a complaint,” and “ I Don’t know how to make a complaint, I wouldn’t know what to do or who to talk to.” 4 relatives said “ the service always responds appropriately if I have any concerns about my relative,” 2 said “ they usually do.” Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Residents live in a homely, comfortable and safe environment. Residents’ bedrooms suit their needs and lifestyles. Residents’ bedrooms promote their independence. Residents’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement residents’ individual rooms. Residents 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, 25, 27 and 30. Quality in this outcome area is ( good) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that the environment will usually be well maintained, comfortable, warm and clean, and they will be supported to personalise their own bedrooms and units as much as possible. They can also be sure that they will be consulted with, if any other changes are needed and be certain that their views are listened to. EVIDENCE: In the last 12 months major environmental works have been carried out at this service, many of which had been outstanding for some considerable time. Liaison with the fire safety officer and environmental health officer has been necessary as well as meeting with the provider and their building officer to determine the schedule and timing of the work to be undertaken. At this site visit the majority of environmental work had been completed, much of which is to a good standard and has improved the quality of the environment for the benefit of the people who live there. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 21 This site visit did not include a detailed inspection of the environment and did not include a visit to all of the apartments and flats. Those bedrooms looked at are and pleasantly decorated with evidence that, where appropriate residents have been supported to make their bedroom their own. With evidence of personal photo’s and other items, co-ordinating fabrics and furnishings. Where appropriate residents can have their own key to their bedrooms. The other areas of the home are well maintained, decorated and furnished to a good standard. In pre inspection surveys a social worker said, “ the outdoor space available to residents does not seem sufficient.” A relative said, “ The outside area needs to be looked at, the garden at the front could be made to look tidy and the brambles cut back from the rear of the garden.” Another said, “ I would love to see the front garden area to be paved to allow my relative to use it more.” The manager discussed possible ways in which the gardens could be developed and how their appearance could be improved including methods of improving resident privacy from passers by when they were using the garden, as the current metal fencing doesn’t do this. The resident currently residing in flat 2 has requested that his home is redecorated, this is being organised by his key workers, and he will be involved in choosing the colours he wants. Matters to be resolved and agreed with the manager included the continuing problem in apartment 2’s bathroom (malodour). The ventilation in the apartment kitchens must be resolved, a new system recently fitted is not working properly, and the service has made contact with the contractors who are working to resolve the problem. The carpet in flat 1 remains stained and should be deep cleaned or replaced, this has been discussed at previous visits to the home. Further efforts should also be made to maintain this flat, to ensure that it presents a homely and well-presented environment for the resident who lives there. It is recognised that due to the specific needs of the resident aversion to anything new this process will have to be dealt with sensitively. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Residents benefit from clarity of staff roles and responsibilities. Residents are supported by competent and qualified staff. Residents are supported by an effective staff team. Residents are supported and protected by the home’s recruitment policy and practices. Residents’ individual and joint needs are met by appropriately trained staff. Residents 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, 34, 35, 36Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. People who use the service can be sure that they receive care from an adequately trained staff team but cannot always be sure that there are sufficient staff provided to meet their needs. EVIDENCE: Staffing levels equate to a minimum of 6 staff per shift during the waking day, with additional hours provided by the manager and deputy, the 2, day service facilitators and the handy person. 3 waking night staff are deployed between the hours of 10pm-7.30am. It is recommended that the staffing levels are kept under review to ensure that contracted hours for individuals are provided. This is because some residents are funded for 1:1 support or more for periods of time. It is also important that there is some flexibility built into the staffing establishment to support people who use the service to be spontaneous, in terms of the activities they choose to be involved with. In the relatives survey’s, one relative said, “ I have felt for some time now that the staffing is short and I am not sure that my relative receives the 1:1 support he is funded for.” Another resident said, “more trained staff should be available.” Others said, “the staff are great and seem to have the skills they need to meet the needs of residents who live in the home.” “ staff always Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 23 discuss my relatives needs with me and make me aware if there are any problems, I trust them to make the right decisions on behalf of my relative.” “All the staff seem to be very good and caring, they try to put things discussed into action, but can’t always due to the staffing problems. They look after my relative well, but I feel that staffing could be improved to provide my relative with more support in areas such as independence, activities and contact with the family.” Staff survey’s included comments such as, “we need more staff so we can use all of the activity equipment with the residents due to staff shortages it doesn’t get used.” “ Staffing shortages are creating problems and because we do not use agency or bank staff the team feel obliged to fill any vacant shift which can mean that we don’t get enough time off.” “ I feel the company needs to be more proactive when dealing with staff sickness.” “We need to employ skilled staff who are committed to the service.” The service has an induction programme, which includes basic information about the service. In the AQAA it said that this is an area where the service could improve. Staff comments about their experiences of induction included, “ my induction partly covered everything I needed to know.” “ My induction didn’t cover all the information I needed as you learn a lot by doing the actual work and learning from the more experienced staff.” “ My induction partly provided enough information, I was told to read the care plans and risk assessments of resident when I started.” “ My induction gave me all the information I needed.” A sample of 3 staff recruitment records shows that the service takes it’s responsibilities seriously by carrying out relevant pre employment checks such as Criminal Bureau Records Checks, Protection Of Vulnerable Adults checks, written references and application forms include details of the individuals, qualification, work history and queries regarding physical and mental health. 17 of the 30 staff are reported to have achieved a National Vocational Qualification (NVQ) at level 2 or above with 4 others undertaking this training. Records of mandatory training show that most staff have attended all training or training is planned. Gaps are noted in Health and Safety training, COSHH, Moving and Handling. In addition it is of particular importance that all staff received comprehensive training and guidance in the care needs of people with Autism and Aspergers Syndrome, this is fundamental to ensuring that the service appropriately meets the needs of the people who live at the home. A programme of regular staff supervision and team meetings should be re introduced, the records show that there have been gaps, this is attributed to the lack of a manager for a period of time. Other comments from the 8 staff surveys, for the manager’s attention included, “Stress among staff is high, and we could do with more support,” Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 24 “communication is not always good, and there are never enough staff,” “internal promotion should be encouraged, as should NVQ training.” “Sometimes there are not enough skilled staff to ensure that resident needs can be met.” “ Communication between shifts and each other could be better,” “ Limited handover can mean that information isn’t passed on properly between shifts.” Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Residents benefit from a well run home. Residents benefit from the ethos, leadership and management approach of the home. Residents are confident their views underpin all self-monitoring, review and development by the home. Residents’ rights and best interests are safeguarded by the home’s policies and procedures. Residents’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of residents are promoted and protected. Residents 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, 40, 42 Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that all equipment in the home including fire safety items are checked and serviced regularly, but cannot be sure that all staff know how to evacuate the home in the event of an emergency, this potentially puts them at risk. They can also be confident that the organisation checks the quality of the service provided regularly and seeks their views. EVIDENCE: Since the last key inspection the previous manager has left and a replacement has been recruited in August 2007. The new manager took an active part in the inspection process and is aware that she must apply to us to be approved and registered. She stated that she is a qualified nurse, Registered Nurse In Learning Disabilities (RNLD), and has had previous experience as the manager of a registered care home. She is also supported by a deputy manager who has also trained to National Vocational (NVQ) Level 3. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 26 Information in the AQAA states that the service had the majority of policies and procedures required and recommended in place, although there were a few that they should develop, and some had not been reviewed for a few years, examples include dates of 2003 and 2004. The AQAA also includes details of all dates when equipment in the home is serviced and tested. Random checks of this information was undertaken during the site visit and found to be satisfactory. E.g. Fire safety checks showed that the monthly and weekly tests are undertaken by home staff and contractors carry out servicing checks regularly. A record of fire drills shows that 5 drills had been organised since the beginning of 2007, but there was also evidence that some staff had not been involved in a fire drill for at least 12 months. The manager is asked to ensure that all staff are involved with fire drills, it’s recommended that each staff is involved in at least 2 per year. The recommendations of fire safety officers during visits to the home in June 2006 and March 2007 have now been acted upon, emergency contingency plans are in place and a fire safety risk assessment for the building and for each resident. In relation to quality auditing it is recommended that the views of residents, relatives and other interested parties are also taken into account and inform any annual development plan. The Resident Guide should also include comments from people who use the service about the quality of service they receive. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 3 28 x 29 X 30 3 STAFFING Standard No Score 31 x 32 2 33 2 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 x LIFESTYLES Standard No Score 11 x 12 2 13 2 14 x 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 2 2 X 3 2 X 2 x Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 28 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. 1 Standard YA33 Regulation 18 Requirement Staffing levels and numbers must be kept under review to ensure that there are sufficient staff to meet the needs of the residents. Staff must be in receipt of regular supervision. The manager should apply to CSCI to be registered as a fit person to manage the service All staff must be involved with fire drills to ensure that they know how to evacuate the building in an emergency. Timescale for action 30/11/07 2. 3. 3. YA36 YA37 YA42 18 9 23(4) 30/11/07 18/12/07 30/11/07 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 2 Refer to Standard YA1 YA1 Good Practice Recommendations The Statement of Purpose should be reviewed to ensure it contains accurate and up to date information about the service The Statement of Purpose should be amended to ensure DS0000008324.V338637.R01.S.doc Version 5.2 Page 29 Collinson Court 3 4 5 6 7 8 9 10 11 12 13 14 15 YA1 YA1 YA7 YA14 YA14 YA22 YA24 YA24 YA24 YA24 YA33 YA6 YA20 that it provides residents with the correct address and contact details for the CSCI. Both the Statement of Purpose and the Resident Guide should be produced in format that resident can easily understand. Each resident should have their own Resident Guide that details their terms and conditions of residency and the costs and fees they pay. The home should ensure that residents’ monies are managed in their best interests. The service needs to ensure that residents are provided with a range of activities in house as well as out in which they can be actively engaged. The service should look into arranging holiday’s or short day trips for residents. The service needs to ensure that residents and people who support them know what to do if they have any concerns. The ventilation issue in the apartment kitchens should be resolved. Minor redecoration should be carried out to ensure that the home is well maintained throughout. The stained carpet in flat 1 should be deep cleaned or replaced Further thought should be given to how the gardens to the front of the property can be better utilised. The service should review the methods it uses to communicate between shifts to ensure all relevant information is passed on. Decisions around capacity and consent should be looked into, this relates to care planning and medication. Staff should all be trained to administer medication. Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection 1st Floor Ladywood House 45-56 Stephenson Street Birmingham B2 4UZ 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 Collinson Court DS0000008324.V338637.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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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