Inspection on 03/03/08 for Cornerstone Trust

This inspection was carried out on 3rd March 2008.

CSCI found this care home to be providing an Excellent 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

Cornerstone Trust 12/09/06

Cornerstone Trust 07/02/06

Cornerstone Trust 13/05/05

Cornerstone Trust 27/08/04

Cornerstone Trust 04/05/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Cornerstone Trust Thicketford Place 132 Thicketford Road Bolton Lancashire BL2 2LU Lead Inspector Lucy Burgess Unannounced Inspection 3 March 2008 11:00a Cornerstone Trust DS0000009314.V356703.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 Cornerstone Trust DS0000009314.V356703.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. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cornerstone Trust Address Thicketford Place 132 Thicketford Road Bolton Lancashire BL2 2LU 01204 392043 0560 1261103 tracy@thecornerstonetrust.org.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) Cornerstone Trust Tracy Ann Gallimore Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 6 service users to include: up to 6 service users in the category of LD The service should at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 12th September 2006 Date of last inspection Brief Description of the Service: Thicketford Place is a small care home, providing long-term support to six people with learning disabilities. A local, voluntary, Christian organisation, the Cornerstone Trust set up the home in 1993. A group of trustees oversee its running, with the day to day management carried out by the registered manager. The home is on a main road, in a residential area in Bolton. There is good access to local buses and there are nearby shops, pubs and other local amenities within walking distance. Thicketford Place is a large, converted, end-terraced house. There are six, single bedrooms, two on the ground floor, three on the first floor and one on the second (attic) floor. There is a very small garden at the front of the house and an enclosed, patio garden to the rear. There is on-street parking adjacent to the home. The organisation has a contract with the Local Authority to provide the service as a whole. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This was a key inspection, which included a site visit and took place over one day, for a period of 8 hours. The service did not know that the inspector was to visit. During the inspection care and medication records were looked at as well as information about the staff and health and safety including how the home is kept safe. The inspector also looked around the home. As part of the inspection process the provider’s are asked to complete a selfassessment survey information document (Annual Quality Assurance Assessment). This was sent to the home before the inspection and had been completed by the manager and returned to us prior to the site visit. Other information was gathered from the feedback surveys we sent out. We received completed surveys from 4 relatives, 6 residents and 8 staff. Time was also spent during the visit speaking with staff and people who live at the home. Comments have been added to the report. Discussion and feedback was held with the Registered Manager. What the service does well: Thicketford Place continues to provide a homely, comfortable environment for the people who live there. Comments received from people living at the home, their advocates and befrienders showed that people were very happy living at the home. They also expressed that communication with the team was ‘excellent’, ‘they provide a high standard of care’, ‘I’m kept informed through regular reviews and via the telephone’ and ‘good at identifying and providing for personal needs’. The staff team is very stable with some members of the team having worked at the home for a long time. Staff are very knowledgeable about the needs and wishes of people, and are aware of how their needs are to be supported. They are able to interpret the wishes and feelings of the people, even though some are unable to tell them verbally. They use creative ways to help people make their own decisions, for example use of pictures that residents can point to. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 6 Relatives and friends commented; ‘the service is always looking out for different activities to fulfil peoples lives’, ‘a lot of thought is given to what people would enjoy or like to do’, ‘they involve them in hobbies they like’ and ‘staff provide support on a 1-2-1 basis’. Overall people living at the home are provided with an excellent standard of care having their needs well met. What has improved since the last inspection? What they could do better: 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. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 7 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 Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 8 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 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home tells people of what they can expect should they consider moving into the home. The admissions process gives an assurance that a resident will only be admitted if the home can meet their needs. EVIDENCE: Information has been developed with regard to what the home offers to prospective new residents. This includes a small leaflet introducing the home along with contact details. There is also another leaflet that provides information about the people currently living at the home as well as the aims of the Trust. Information is brief, in plain English and with the use of picture, therefore easy for people to read. The current resident group had lived in the home for a number of years and so there had been no recent admissions to the home. As previously identified should a place be available an assessment would be completed. Opportunities for trial visits and stays would also be provided so that people get an opportunity to meet with other people living at the home as well as the staff team. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 9 The home has good working relationships with the Fair Access to Care Team (FACS) who carries out reviews on behalf of the funding authority. Reviews take place on an annual basis to ensure that information is up to date in relation to the assessed needs of people. Information provided on the feedback surveys in relation to sharing information and choice of home included 4 people ticking ‘yes’ being asked about the move and having information about the home. Some people commented, ‘my key worker at the time prepared me for the move’, ‘it was explained to me and I had visits to the home’, ‘me and my family were fully involved in my move into care’ and ‘visits took place and questions were asked by my family’. Relatives also expressed that they too were fully informed. At present the home is in discussion with the local authority about the future plans for the home and living arrangements for some people at the home. Information has been shared with families, representatives and staff so that people are fully informed and aware of what is being considered. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 10 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 excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive information about peoples assessed and changing needs as well as areas of risk are included within their care plan detailing how each individual chooses to live their life. EVIDENCE: Care plans and assessments have been completed for each person and explore all aspects of their daily life including areas of risk. Information is written in the first person and focuses on how each individual chooses to live their life, what their preferences are, their daily routine, what support they need and how they would like it to be provided. Information is provided in an easy to read format and includes pictures. Files are orderly and include personal information, relevant contact details and an outline of the persons level of dependency and level of supervision required. Each person has a named key worker who has responsibility for up dating and reviewing the plans. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 11 Records were looked at for two people with differing support needs and levels of verbal communication. The person centred plan contained little written information and described a person through pictures. This included details about their upbringing, likes and dislikes, important people and events, diet, activities and goals. Essential life plans also provided further information about the individuals including a pen picture, things that are essential and important to them, issues around health and safety, needs, likes and dislikes and routines. In one of the files looked at, the person is not able to verbally express themselves so information had been recorded explaining what some of their behaviours may mean. For example, if the person goes into the kitchen, then staff should offer them a drink. This enables the person to make their own choices about things they make like. Additional records are also held including health information, daily records and personal correspondence. Risk assessments had also been completed. This explored a large number of areas exploring activities both in and away from the home, behaviours, support needs, travel etc. All plans are reviewed on a regular basis. A formal annual review is held at the home and a further review involving the local authority reviewing team. Other people are also invited to the meetings. This may include relatives, befrienders, advocates as well as members of the day centres where people attend. This provides a method of open communication between all those involved in the delivery of care and support ensuring continuity is provided. Relatives, advocates and befrienders confirmed that they were actively involved and had the opportunity to attend meetings. The manager also holds a person centred plan review 4 times a year. This is carried out with each person along with his or her key worker so that information is kept up to date and reflects the needs and wishes of people. As most of the people are not fully able to fully express their views and opinions verbally, time was spent briefly observing people. One person spoken with said they ‘very happy at the home’ and ‘liked the staff’. Team members have a good understanding about the running of the home and the needs of the people who live there. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 12 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): 11 to 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Opportunities for personal development as well as social and leisure activities are made available enabling people to lead a full and active lifestyle as possible. EVIDENCE: Discussion was held with the manager with regards to the daytime routines of people. Due to recent changes in funding, money previously available for holidays etc has been cut. The team is exploring other alternatives that they can offer so that this does not impact on the opportunities offered to people. The lifestyles of people living at the home are varied and based on the individual preferences of each person. Four of the people attend local day centres whilst two people are supported by staff to pursue activities from home. This includes; the gym, cook and eat group, computers, allotment, occasional day trips, dance and movement and nail care. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 13 Leisure activities include people attending Church and the Hindu Temple. Some people also attend the Gateway club, Jubilee swimming pool, light sensory room and visit local parks and pubs. One person continues to attend a local weight watchers group. People also access local amenities such as the supermarket, local shops and hairdressers The team continually explore different activities, which people may like to join. Two staff have recently had training with ‘Wheels for all’. This is a charity, which provides cycling equipment, which have been adapted for people with disabilities. At home, people engage in whatever they were interested in, for example looking at magazines, watching TV, listening to music, or relaxing with sound and light therapy. There is also a computer at the home, which has a touch programme so that everyone is able to get involved. The evening newspaper is delivered to the home each day and one person takes responsibility for going to the shop to pay. Visits are also made to the home from the ‘Pet therapy’ group. People are visited by a dog, named ‘Henry’, which is enjoyed. Holidays have been taken over the last year, consideration was given to the places visited due to the budget available. Places visited have included Last Drop Village, Lake District, Wales, Blackpool and Ribby Hall, near St Anne’s. Regular discussion is held at the home involving everyone. Resident meetings are held and ideas are discussed. Pictures are used to enable people to be more actively involved so that they can express their views. Contact with family and friends are maintained. Some regularly visited their families, or sometimes their families visited them. Some also have regular telephone contact with family members. Having access to the community gave them opportunities to meet new people. Positive feedback was received about the opportunities offered to people. This included; ‘the service is always looking out for different activities to fulfil peoples lives’, ‘a lot of thought is given to what people would enjoy or like to do’, ‘they involve them in hobbies they like’ and ‘staff provide support on a 1-2-1 basis’. Meal times vary due to the routines and plans that people have in place. Records are maintained with regards to individual menus. Everyone is able to take part in shopping for the home if they wish and those able too are encouraged to assist with basic tasks around the home including tidying the kitchen, filling the dishwasher etc. Healthy eating is encouraged, with plenty of fruit and vegetables. As already stated one person attends a weight watchers group and is helped and encouraged to follow a healthy diet. Another person needs a gluten free diet, appropriate food items were provided for this. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. Personal, emotional and health care support is provided in way that safely and effectively meets the individual needs of people living at the home. EVIDENCE: The health and personal care needs of people living at the home vary and support is provided in varying degrees. People’s care plan showed what support people needed and how they wanted staff to assist them. The 5 people who returned surveys stated that they are ‘always’ treated well by staff. Relatives also expressed that communication with the team was ‘excellent’, ‘they provide a high standard of care’, ‘I’m kept informed through regular reviews and via the telephone’ and ‘good at identifying and providing for personal needs’. Health action plans were in place providing information about each person. Individual records are also kept in relation to health appointments, including GPs, continence advisor, dentist, podiatrist, and asthma nurse. From observations made and talking with a staff member it was clear that staff are fully aware of individual health needs. An example was given with regards to one person who responds well to certain staff, therefore appointments are Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 15 made when they are on duty so that reassurance can be given during appointments and reduce the persons anxiety. The home has introduced the medication policy developed by the local authority. Some of the staff have received training in line with the new procedure and further sessions are to be undertaken by the remaining members of the team. Each of the people living at the home are supported in managing their medication and information is recorded within the care file. Medication is supplied by BOOTS pharmacy. A monitored dosage system was being used which included pre-printed MAR (Medication Administration Records) and a photograph to identify, which person items had been prescribed for. The (MAR) sheets were appropriately completed. Records were kept of medicines received into the home and a returns book is used when returning items to the supplying pharmacy. The policy also outlines the procedure with regards to homely remedies. Some additional items not specified within the policy had been discussed with the persons GP and a form had been signed to state that they were safe to administer. Separate handwritten administration sheets were completed for these items. Following the last visit alternative arrangements have been put in place with regards to one person who requires medication during the day, which is administered by day centre staff. Following discussions with the pharmacist inspector, an alternative storage and recording method was advised. This was put in place along with clear records. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 16 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. Clear procedures and training are in place ensuring that people are listened to as well as being protected. Information is also provided for people living at the home in a way that they can understand. EVIDENCE: Information provided on the AQAA stated that there had been 2 complaints and 1 safeguarding issue since our last visit. The complaint issues had been in relation to a persons and how this was impacting on others. Action had been taken by the manager to resolve the matters. One person said if they had a concern they ‘would tell one of the staff, then ask for it to be put in the complaints book’. Another person stated, ‘my key worker would help me with this’. A relative said ‘I have not needed to raise any concerns’. A copy of the homes complaints procedure is displayed in the hall way and therefore easily accessible to people. Information needs to be updated to include the change in manager and the details on how to contact the commission. Opportunities are made available for people to raise any issues they may have either during the residents meeting or within the person centred planning meeting. A complaints book is also available so that any issues raised can be recorded. One person living at the home was aware of the book and has previously requested her concerns be recorded. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 17 In relation to the safeguarding issue this was explored and action agreed. Information was passed to us as well as the local authority safe guarding team and reviewing team. Staff have received training in adult protection. One staff member spoken with confirmed that she had done the training. During the visit the inspector discussed how peoples finances are managed. Computerised records are maintained by the finance officer who also acts as appointee for each person. Individual savings accounts have also been opened. Daily expenses are paid from the petty cash, receipts are requested and then charged to the relevant account. Information clearly evidences income and expenditure. Audits are carried out to ensure that the information held is correct. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 18 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, 25, 26, 27 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thicketford Place provides a comfortable homely environment for those that live there. Aids and adaptations have been provided to enable the necessary support required in meeting the needs of people. EVIDENCE: The home is situated in a residential area of Bolton near to bus stops, local shops, and other local amenities. The house is a three storey terraced property and is similar to other properties in the area. Outside there was a small garden at the front, and a yard at the back with patio area and seating so that people can sit out in nice weather. There was no passenger lift so access to upper floors is by stairs. Since our last visit there have been considerable improvements to both the internal and external environment. Over the last year work has included; full new central heating with Low surface temperature radiators, new ground floor bedroom, new ground floor bathroom, new floor coverings to the communal areas, redecoration of communal areas, improved door entrance to Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 19 conservatory, fire safety glass in lounge and kitchen door, new wall lights, new call system, back gate ramp light and hand rail, some bedrooms have been decorated and have new sinks, furniture and carpet fitted and new funiture to some rooms. One relative stated, ‘the recent refurbishment has been appreciated’. The managers office has also been relocated as part of the refurbishment. This enabled one person to have a larger bedroom. Work has also been completed in relation to fire safety. As part of the refurbishment there have been additional fire points, smoke detectors and extinguishers fitted throughout the home. The area in which the home is has also been part of a regeneration programme. Homes were asked to contribute 25 of the cost towards the improvements. These included re-roofing, new gutters, re-rendering and painting, new walls and gates. The work has enhanced the overall appearance of the home and provides comfortable accommodation for people to live. Further work has been identified to complete the upgrade of the home. This will include new flooring and redecoration of the lounge. Bedrooms were looked at during the visit. All the bedrooms are single with 4 on the 1st and 2nd floor and 2 provided on the ground floor. These were nicely decorated and had been personalised with people’s own belongings. Where people have specific needs/behaviours, rooms had been set out to reflect this. Bathrooms are also provided on the ground and 1st floors. The ground floor bathroom has been completed as part of the recent refurbishment and provides a walk in shower which is easily accessible to people. To ensure that hygiene standards are maintained staff are provided with protective clothing when assisting people with their personal care needs. Sufficient hand washing facilities are provided in bathrooms and the kitchen. Bins and waste disposal is in place for managing cross infection and consideration is being given to the home purchasing a macerator. The laundry facilities are provided in a separate out building at the back of the home and therefore sited away from the kitchen area. Comments received included, ‘my room is very clean and shared areas are clean most of the time’, ‘sometimes the varying needs of others impact on cleanliness but staff act promptly to rectify this’ and ‘good standards of cleanliness’ Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 20 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. Staff employed by the home have been appropriately recruited and trained ensuring that the needs of people are supported by competent and efficient staff. EVIDENCE: Staffing ratios are good and vary depending on the planned arrangements of people at the home. Generally 2 people are supported from home during the day whilst 4 other people go out to college or day centre. On examination of the rotas 3 staff are provided throughout the day with a wake in and sleep in staff member at night. The manager’s hours are supernumery. At times the home uses agency staff, however where possible the same people are requested so that continuity can be offered. Where possible existing members of the team will cover the shifts. Considering this the manager has developed a ‘grab file’, which provides an over view of the people living at the home, their routine and things they like. This is to be used to assist agency staff during their shift. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 21 There is also an on-call system in place, which is undertaken by the senior support staff. The manager is also contactable should further assistance or advice be required. Since our last visit only one number of staff has joined the team. Turnover is low and offers continuity to the people living at the home. Information was looked at in relation to the recruitment process. A detailed application form was provided, including a criminal conviction declaration and health declaration. Two written references had been requested and were satisfactory. Checks had been completed in relation to POVA 1st and Criminal Record Checks. All checks had been completed prior to them commencing employment. Other information included interview questions, which was carried out by the manager, a relative of someone who lives at the home and a person who lives at the home. On commencing their employment staff complete a comprehensive induction programme. This includes attending the seven day induction programme ran by the local authority. This includes all mandatory training courses. Whilst at the home an in-house induction is completed so that new staff are able to familiarise themselves with the procedures within the home and the support to be provided. Further training is then offered with regards to the completion of the Learning Disability Award Framework (LDAF). Evidence of the induction and training was found on staff files. This provides staff with relevant knowledge and information needed to carry out their roles effectively. One person commented, ‘the induction training was very enlightening’. The manager also explores other areas of training and development, which is relevant to the needs of people living at the home. This has included; medication, adult protection, managing challenging behaviour and mandatory courses. Two staff members have also completed training in ‘wheels for all’, which is an activity for people with disabilities. Further training is to be planned including refresher courses, medication for those yet to attend and a total communication course. The manager is developing a training matrix so that she can monitor the training needs of staff. Staff commented; ‘we are constantly on courses to update our knowledge’ and ‘management ensure all staff attend mandatory courses and are up to date, I think all staff have completed the LDAF and NVQ’. NVQ training has been undertaken. All but two of the staff team have either completed and currently working towards level 2. One member of staff would like to complete level 3. Funding is being explored. Arrangements are in place for the supervision and appraisal of staff. Record had been completed where the staff member and manager had discussed issues in relation to work practice, training and development, approach to work along with an area of action required. Staff spoken with felt very supported Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 22 said that they were able to speak with the manager at any time if they had any issues. Eight members of the team completed the feedback surveys. Surveys were completed in detail and confirmed that they each felt fully informed about the needs of people and were supported in carrying out their role. Other comments included; ‘most of the staff have worked at the home for a long time so the people and staff have a good relationship and staff support and communicate well together’, ‘the staff are conscientious’, ‘I have contact support and the manager is available anytime’. One relative said, ‘the personal commitment of staff is outstanding’. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 23 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 management and conduct of the service ensures the safety and well being of residents. EVIDENCE: The manager has worked at the home for two years and was appointed manager in April of 2007. She has recently completed the registration process and was approved as registered manager in January 2008. She has completed training in NVQ Level 4/Registered Manager Award. Prior to joining Cornerstone Trust she worked within learning disability services in both a management and supervisory capacity. Feedback from staff was that the manager is ‘very supportive’, ‘a good motivator’ and ‘gets things done’. All the staff that provided feedback confirmed that they have an opportunity to meet with her on a regular basis to Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 24 discuss their work or any issues they may have. One relatives also expressed; ‘excellent management’. Through discussion with the manager it was clear that she has a good understanding of the needs of people living at the home and aims of the organisation. At present she is in discussions with the local authority about developing the service. Systems are in place for checking out the quality of the service. This includes monitoring visits by a member of the trust, staff meetings, resident meetings, reviews with relatives and health and social care professionals. Management and Trustee meetings also take place. These enables all parties to express their views and opinions about the service provided. The home also records any concerns that were raised. Periodically questionnaires are also sent out so that further comments, ideas and suggestions can be made. This information is collated and informs the development plans for the home. Records were examined in relation to safety checks, which are carried out. These included electrical installation, gas safety, portable electrical appliance tests, servicing of fire alarms and fire fighting equipment, and weekly checking of fire alarms, lighting, fire fighting equipment and means of escape. One of the staff members takes responsibility for health and safety and carries out inhouse checks around fire safety and other related areas. There was a query about the 5 year electric certificate. A number of points of action were identified, which required attention. The manager is to confirm to us that these have been dealt with. A valid Employers Liability Certificate was seen. Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 25 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 X 4 X 5 X 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 3 25 3 26 3 27 3 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 4 3 X 4 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 2 X 3 X 3 X X 2 X Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations Staff need to identify on the MAR sheet the number of tablets being administered so that records clearly show that people are only given medication for which they have been prescribed. The complaint procedure needs to be updated in relation to manager and CSCI contact details. The manager needs to confirm that the action identified on the 5year electric check has been addressed. 2 3 YA22 YA42 Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Cornerstone Trust DS0000009314.V356703.R01.S.doc Version 5.2 Page 28 - 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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