Inspection on 07/02/07 for Crossways Residential Home

This inspection was carried out on 7th February 2007.

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

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

Other inspections for this house

Crossways Residential Home 03/11/05

Crossways Residential Home 27/07/05

Crossways Residential Home 16/03/05

Crossways Residential Home 13/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Crossways Residential Home North Terrace Mildenhall Suffolk IP28 7AE Lead Inspector Julie Small Unannounced Inspection 07 February 2007 10:40 Crossways Residential Home DS0000024368.V317804.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 Crossways Residential Home DS0000024368.V317804.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. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crossways Residential Home Address North Terrace Mildenhall Suffolk IP28 7AE 01638 515556 01638 712730 chris.taylor@nas.org.uk www.nas.org.uk National Autistic Society 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) Mrs Christine Joy Taylor Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Crossways is part of the National Autistic Societys Mildenhall Service, which comprises Crossways and Middlefield Manor (the second, larger Care Home situated approximately 2 miles from Mildenhall in Barton Mills). The Home provides residential care for eight young adults with Autistic Spectrum Disorders. The Home is a large detached house (formerly a private residence) in a residential area close to Mildenhall town centre, at the junction of two main roads. The entrance to the Home is from Folly Road and there is a small parking area for the Homes two vehicles as well as for visitors. The Home is well maintained, clean, light and airy and the eight service users are accommodated in single bedrooms; three on the ground floor and the remaining 5 on the first floor. Two bedrooms have the additional benefit of en suite facilities and there are sufficient bathrooms and toilets to meet the needs of the eight residents. The Home has a fitted kitchen, a laundry area, a large lounge, dining room as well as a separate but adjoining quiet room. The residents also have use of a pay phone for incoming and outgoing telephone calls. At the time of the inspection, the manager stated that fees for the home ranged from £900 to £1500 per week. Service users would provide items such as their own clothing, toiletries, activities and holidays. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Wednesday 7th February 2007 from 10.40am to 15.20pm. The inspection was a key inspection, which focused on the core standards relating to adults and was undertaken by regulatory inspector Julie Small. This report has been written using accumulated evidence gained prior to and during the inspection. Prior to the inspection four relatives/visitors comment cards and six service users questionnaires were received. The registered manager facilitated the inspection, two staff and three service users were met and two service users were spoken with. All information requested was provided promptly. Service users and staff made the inspector welcome in the home. A tour of the building and observation of interaction between staff and service users was undertaken during the inspection. Records viewed included three service users, three staff recruitment, training, health and safety related and medication records. Further records viewed are identified in the main body of this report. What the service does well: The environment was well maintained, clean, homely and comfortable. Service users bedrooms viewed reflected their individuality and choice, two service users confirmed that they had chosen the décor and furnishings in their bedroom. Service users also collectively chose the communal décor and furnishings. Staff and service users interaction was observed to be positive, friendly and professional. The training programme available to staff was very good, which provided information for staff to undertake their role. Service users were involved in all in house training and were provided with certificates of attendance, as was the staff that also attended. There was evidence that service users were consulted with regarding aspects of their day to day living. The records, which were viewed during the inspection, were in good order and provided evidence that they were regularly updated and that the manager regularly monitored their upkeep. Service users were provided with a good range of activities which they could choose to participate in. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 6 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. Crossways Residential Home DS0000024368.V317804.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 Crossways Residential Home DS0000024368.V317804.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, 2, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect that their individual needs and aspirations are assessed and that they have an individual statement of terms and conditions in the home. EVIDENCE: The manager said that all the service users living at the home, had done so for over ten years. There had been no new service users admitted into the home. The manager provided a clear understanding of their role and the processes regarding the needs assessment of prospective service users. Three service users records were viewed and evidenced that needs assessments were updated on a regular basis during the regular review process both in the home and by the placing authority. There were records of reviews of service users assessment of needs. There were individual care plans which related to the needs assessments. Service users records viewed included a statement of terms and conditions which was signed and dated by the service user and by the manager of the home. The document included both the service users and the homes rights and Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 9 responsibilities, a summary of the complaints procedure which included the contact details of CSCI (Commission of Social Care Inspection), what services were provided by the home, who could live at the home, fees and arrangements available for the safe keeping of their finances. The document was in picture and text format. Six service users questionnaires were received and five stated that they had received a contract and one stated no with the comment, ‘contract signed a long time ago and I forgot’. A question asked if service users were provided with enough information about the home before they moved in, four said yes, one said no and one was left blank. One questionnaire stated ‘I have been at Crossways for 10 years and enjoying it’. The Statement of Purpose was viewed and included the required information which included the staffing of the home, staff qualifications, referral and admission to the home, the structure of the home, what services the home provided and methods used when providing the services. Crossways Residential Home DS0000024368.V317804.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, 8, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users can expect that their assessed and changing needs are reflected in their individual plan, that they are supported to make decisions about their lives, that they are consulted with on aspects of life in the home and that they are supported to take risks as part of an independent lifestyle. EVIDENCE: The manager said that the service users questionnaires were completed by the service user with support from their family or from their advocate. One question was ‘do you receive the care and support you need?’ Five said always and one was left blank. There was a comment, which was that the service user…’has a good relationship with the staff who are caring and supportive and very committed’. Another question was ‘do the staff listen and act upon what you say?’ four answered always and two answered sometimes. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 11 Four relatives/visitors comment cards answered yes to the questions ‘are you kept informed of important matters affecting you relative/friend?’ and ‘if your relative/friend is not able to make decisions are you consulted about their care?’ There was a concern raised that the previous committee for parents and carers was no longer taking place and that they no longer had a voice. The manager was spoken with and provided documentary evidence that there were partnership meetings two times each year to which parents and carers were invited to, quality assurance questionnaires, regular steering group meetings and that parents and carers could contact staff at the home or organisational managers at any time to discuss the service. Three service users plans were viewed and were noted to be detailed, easy to understand, clear and there was evidence that they were updated regularly. There were clear references to the service users needs, aspirations and preferences. The plans included information such including medical details, communication methods, religion, behaviour to beware and suggested actions, main words and actions to avoid, routines and rituals, motivators, likes and dislikes, fears and phobias, the levels of supervision required when in the community, religious and cultural needs, dietary requirements, arrangements for managing their finances, socialisations skills, sleeping patterns and obsessions and compulsions. The care plans provided a clear pen picture of the individual, which would provide the required to staff providing care to the service user. The service users records included a behaviour support plan, including strategies that staff must use in supporting them, such as methods in diverting service users from self-harm or aggressive behaviours. There were summaries of lifelong learning goals. There was evidence that all records were regularly updated with their changing needs, preferences, achievements and progress. There were clear and detailed risk assessments which identified risks that service users may be vulnerable to in their day to day living and methods of preventing the risks that should be used. The risk assessments stated that they should be used with the support plan. An example of the risk assessments included a service user who travelled alone on public transport to their family home and that visited the local pub alone. The service user was spoken with and said that they had chosen their lifestyle and that the staff at the home listened to their choices and wishes. Observation of interaction between staff and service users was positive, friendly and professional, and demonstrated a clear understanding of the service users communication methods and understanding. There were records of regular care reviews which were attended by the service users and their family. This provided the opportunity to comment on the care they received. The manager said that service users could speak to staff when they chose to about their care and make changes where required. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 12 Records for weekly service user meetings were viewed, and evidenced that they were routinely consulted with regarding the home and the services they received. Service users had chosen the food that they would eat, where they would go on holiday and who with, what activities they would participate in and what furnishings and décor was in the communal areas of the home. Two service users said that they had chosen how their bedroom was decorated. The manager said that the home had an advocate from a local advocacy service who service users could speak to if they chose to. They said that each service users preferences were listened to, including when they did not wish to participate in a planned activity and if they wished to change their usual arrangements with their changing preferences and needs. The manager said that service users were consulted with regarding the use of bank/relief staff at the home and their views were listened to regarding if they were used at the home in the future. Daily records were viewed and evidenced that residents choices and preferences were asked for and listened to on a daily basis. One service user was observed collecting their money from the office to go on a shopping trip. The manager said that they managed their own finances but preferred to store them in the office. The records for service users personal finances were viewed which included where they and staff had signed to show that they had taken money and what it was spent on, receipts were present where appropriate. Crossways Residential Home DS0000024368.V317804.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, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users can expect that they take part in appropriate activities, that they are part of the local community, that they maintain appropriate relationships, that their rights are respected and that they are provided with a healthy diet. EVIDENCE: During the inspection service users were observed returning to the home and preparing to go out to their planned activities and day provision. Day provisions included college, music therapy, horse riding, speech therapy, work placements and various day centres. Evidence of service users day provisions and leisure activities were viewed in their individual records and a weekly planner which was displayed on the office wall. Evening activities attended included visits to the pub, meals out, shopping, swimming, snooker, bowling and golf. There were various arrangements for transportation to activities Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 14 which included using public transport, taxis, walking and using the homes vehicles. A service user said that they had chosen what they wanted to participate in during the day, which was cooking at a day centre and completing projects and IT at a local college. They said that they enjoyed going to the pub and knew most of the ‘regulars’ at the pub, which was in walking distance to the home. The manager said that service users chose what they wished to take part in and were supported to participate in what they had chosen to do. They said that service users could take part in any in house training, which was provided to staff, and that some had their first aid and food hygiene certificate from the training. There was information displayed on the service users notice board about voting and the manager confirmed that four of the residents living at the home chose to vote. They said that three newspapers were delivered to the home on a daily basis, one was for communal use and two were what individual residents had requested be delivered. The manager explained that service users choose the holidays which they wish to participate in. Service users meetings minutes and discussion with a service user confirmed this. They said that they had planned to go to Derbyshire for a holiday this year and that all their peers were going too. They said that the group had decided on a group holiday, but could go on individual holidays if they wanted to. There were collections of photographs which were displayed in the home of activities and holidays which the service users had attended. During a tour of the building it was noted that there was a television and DVD player and a range of films in the lounge and also in the extension which provided the opportunity for service users to watch different programmes. Some service users had television in their bedroom. There were a range of puzzle books, books, jigsaws, music centres, CD’s, a keyboard and computer with computer games which were in communal areas or service users bedrooms. A staff member was observed in discussion with the manager about the support they had provided to a service user about purchasing a sky plus system or a DVD recorder for their bedroom, which they had requested. A question in the service users questionnaire was ‘are there activities arranged by the home that you can take part in?’ one had not answered the question and five had answered always. Comments in the questionnaires were ‘I have a full programme in the week’ and ‘I like the lounge, I like doing crosswords, I like going out, I think the staff are friendly, I am happy living at Crossways’. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 15 Service users records viewed evidenced that they maintain regular contact with their families and friends. Four relatives/visitors comment cards answered yes to the questions ‘do staff welcome you into the home?’ and ‘can you visit your relative/friend in private?’ Service users said that they had a key for their bedroom door and that staff respected their privacy, they said that staff never walked into their bedroom without being invited in. Interaction between staff and service users was observed to be positive and respectful and staff included the service users in their discussions. Service users assisted in the domestic duties in the communal areas of the home and their bedrooms. They could help themselves to drinks when they wanted to. Service users meetings minutes viewed included discussions about the choices of meals which included the theme nights, take away meals and meals in the home. The night of the inspection service users had chosen curry for the theme night. During the inspection lunch consisted of fresh rolls and a choice of cold meats. There was evidence that a balanced diet was provided, a list of what each service user had eaten each day was in their records, there was a variety of cultural foods, such as Mexican, Indian and Chinese, which residents had chosen to eat. There was a good range of fresh fruits and vegetables in the home. Care plans included details of each service users dietary needs and likes and dislikes. A service user spoken with said that the food was good at the home and they tried lots of different food. They said that they did not like to cook and only cooked once a week at their day centre. One service user was observed telling staff what time they were making themselves a cup of tea. The manager said that they had their own routines for drinking and reassured themselves by telling staff what time they were having their drinks. There was an attractive dining area with sufficient seating for service users and staff. The service users questionnaire asked ‘do you like the meals at the home?’ One was not answered and five answered always, a comment received was ‘sometimes we go out for meals and takeaways’. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 16 Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users can expect that they receive personal support in the way they prefer and require, that their physical and emotional needs are met and that they are protected by the homes medication policies and procedures. EVIDENCE: Service users records viewed included details of the personal support they should be provided with which meets with their individual needs and preferences. The records identified any rituals which service users may have and how staff should support them in these to ensure that they do not become distressed and identified methods of maintaining their independence. Their preferences with regards to daily routines were clearly documented and explained the importance of maintaining their usual routines and what could be the outcomes if they were not maintained. Records were regularly updated with service users changing needs and preferences. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 18 A service users spoken with said that they chose their own routines and did not requires support with personal care. They said that they chose their own clothing and toiletries and went to bed and got up in their own time. They said that if they were ill, they would be helped to make a doctors appointment. During a tour of the building it was noted that service users had their own clothing and toiletries in their bedrooms. Daily records viewed evidenced that staff supported service users in the methods identified in the care plans. Daily records evidenced that staff monitored the well being of the service users on a regular basis and recorded any deviations from their usual behaviours. Records identified each service users key worker, who completed weekly reports which identified significant events in their lives. There were clear records which identified support from specialist services such as speech therapy and support from a community nurse. One service user had injections, which were administered by a community nurse. This was clearly documented and the nurse had signed medication records when the injection had been administered. The medication records and care plan clearly identified that staff were not to undertake this task and what the arrangements were. Storage of the injection was in a locked cabinet inside the medication storage in the home. The homes medication storage and recording were viewed. Medication was stored in a locked cabinet which was attached to the office wall. The medication cabinet had a reminder guide on the door of important information to be aware of when administering medication. The home used an MDS (monitored dosage system). MAR (medication administration records) were viewed and all were completed appropriately and the numbers of medication remaining coincided with the MAR charts. Medication records included a list of staff signatures who administered medications and photographs of each service user who had prescribed medications. There was a separate record for each service user when to evidence when they had taken unprescribed medications which included paracetomol and cod liver oil. There was a procedure for the safe keeping, administration and recording of medication and a separate procedure for homely medicines. The manager said that senior staff were responsible for administering medication. Training records viewed evidenced that staff had been provided with training which related to medication, health and safety, first aid, SPELL (which was specialist autism training) and autism and Aspergers syndrome. There was also evidence that staff were provided with regular in house coaching sessions on issues such as medication and health and safety. The records identified the date, the staff involved, the individual who was coaching and the outcomes to the session. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 19 There were records which identified all healthcare appointments each service user had attended and outcomes were documented. There was documented evidence which identified all the healthcare professionals involved in individuals care. Service users care plans and daily records included details of staff observation and any issues of changes in condition which may cause concern. Service users questionnaires asked ‘do you receive the medical support you need?’ Six answered always and one comment was ‘I am taken to the doctors if I am ill’. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 20 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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect that their views are listened to and acted on and that they are protected from abuse, neglect and self-harm. EVIDENCE: The homes complaints procedure was viewed, which was clear and included in the homes Statement of Purpose. A summary of the complaints procedure was included in the written terms and conditions which was signed by service users and was stored in their records. The procedure was displayed on the service users notice board with complaints forms. Each document included CSCI contact details. A service user was spoken with and said that they knew what to do if they were unhappy about something in the home and how to make a complaint if they needed to. Six service users questionnaires said that they always knew who to speak to if they were not happy. The questionnaires asked ‘do you know how to make a complaint?’ two did not answer, three said always and one said sometimes. Four relatives/visitors comment cards said that they were aware of the complaints procedure and that they had never had to make a complaint. The homes complaints records were viewed and since the last inspection there was two records. One was that a service user had used inappropriate language Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 21 to and about a staff member and a member of the public had knocked the homes door and said that one of the service users was standing at the bottom of the garden looking through the bushes. Both were appropriately dealt with within timescales and well documented. Training records viewed evidenced that staff had received POVA (protection of vulnerable adults) training. During the inspection the manager said that four members of staff were at a POVA training course, some were observed returning to the home and they discussed the contents of the course with the manager. Staff were provided with Studio 3 training which was a challenging behaviour course, the manager explained that it highlighted diversion and distraction techniques for dealing with aggression. The home routinely forwarded notifications to the CSCI with regards to any concerns about service users. There were no excessive notifications received from the home. Service users records viewed clearly identified strategies for ensuring their safety and protection. There was clear information included in the care plans which identified strategies for working with individuals if they self harmed and if they had issues with their behaviour management. Records included details of each service users financial arrangements and how they would be protected. Records of expenditure were maintained. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 22 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect that they live in a homely, clean, hygienic, comfortable and safe environment and that their bedrooms promote their independence. EVIDENCE: Service users spoken with said that they had chosen the furniture and decoration in their bedrooms. They said that they had chosen, as a group, the décor and furnishings of the communal areas. A service user said that the local town was within walking distance of the home. Service users bedrooms viewed during a tour of the building and reflected their individuality and each room was very different. All bedrooms contained the appropriate furniture and fittings such as a table, chest of drawers, wardrobe and lockable storage space. The bedrooms had their personal belongings and Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 23 memorabilia, each room reflected service users interests including newspapers, jigsaws, music keyboard, music centres and televisions. The home was clean, homely, comfortable and well maintained. The home was an attractive environment both inside and the outside grounds. There were no unpleasant odours in the home. During the inspection two service users were observed sitting in the comfortable lounge area and were watching the television. The laundry area was viewed and had a washing machine with a sluice facility, drying machine and hand washing facilities. There was a store of disposable gloves in the laundry and there was hand wash gel and disposable paper towels. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 24 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, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect that they are supported by competent, qualifies and appropriately trained staff and that they are protected by the homes recruitment policies. EVIDENCE: Three staff recruitment records were viewed and all included a satisfactory CRB (criminal records bureau) check, two written references, applications form, and interview notes. One record did not have a photograph and identification, such as a copy of the birth certificate or passport. There was written evidence that they had been seen at interview and recruitment and that they were originally recruited to work at another home. The manager telephoned the administration team during the inspection and said that they were told that the records were in the original recruitment records and were in the process of being transferred to the home. Following the inspection the manager informed the inspector that they had received the records and forwarded them to the inspector to evidence this. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 25 The manager said that the service regularly updated CRB checks. They said that when using bank/relief staff, service users were asked about their opinions of them and this was considered in future staffing of the home. One recently recruited staff member was 18 years old. The manager confirmed that they would not be responsible for running a shift, drive, or administer medication or personal care. The manager said that they ensured that they worked with experienced staff at all times, this was also due to their probationary period of work. There had been two staff members recruited at the home since the last inspection and there was evidence that they were in the process of working on their LDAF (learning disabilities award framework). The manager said that they would be provided with the opportunity to complete their NVQ award when their LDAF was completed. The home had met the 50 target of staff to achieve the minimum of NVQ (National Vocational Qualification) level 2. The home had ten staff and eight had achieved an NVQ level 3 in care. There was documentary evidence which showed that staff regularly received 1 to 1 supervision meetings and team meetings. Team meetings records were viewed and showed that staff spoke about any new information they should be aware of and the well being and care of the service users. The manager showed the inspector a document where staff who had not attended the team meeting had read the minutes and signed to say that they had. Staff received six supervision meetings each year and a yearly appraisal meeting. Discussions included training and development, progress, issues and specific information about service users. The newly appointed staff had received probationary supervisions, which were documented. Training records were viewed and evidenced that staff were provided with a very good training programme which included POVA, health and safety, food hygiene, studio 3, medication, first aid, equality and diversity, fire safety, SPELL, autism and Aspergers syndrome and person centre planning. There was evidence that staff had attended training courses included human rights, care planning, advocacy and rescue and resuscitation (swimming). There was a training programme available for senior staff which included training on appraisal, supervision, managing attendance, grievance and dismissal and managing people. There were records viewed which evidenced that staff were provided with in house coaching sessions, which were provided by the manager and included medication health and safety. The manager said that some training was provided to the whole staff team at the home and that service users could attend the training if they wished to. Training records included a matrix of what training courses each individual staff member had attended and the dates. The manager said that staff were provided with regular updates. During Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 26 the inspection four staff had attended POVA training, and planned training including medication (26th February 2007), food hygiene (27th February 2007) and first aid (28th February 2007). Staffing rotas were viewed and the manager confirmed that they had used the staffing forum to work out the numbers of staffing required at the home. The manager said that the home had a rolling rota. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 27 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, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to benefit from a well run home, that their views underpin self monitoring, review and development of the home and that their health, safety and welfare is promoted and protected. EVIDENCE: The manager had achieved NVQ level’s 3 and 4 in care and the RMA (Registered Manager Award). There was evidence that they had updated their training and knowledge through attendance at courses such as management specific training. They said that the training included recruitment, dismissal and supervision. They had a clear knowledge of their roles and responsibilities. There was evidence in records viewed that the manager regularly monitored and updated records. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 28 There was a concern in one relatives/visitors comment cards that the manager was called away to support another home and that there was no deputy manager. The manager confirmed that there were times in their role that they were required to attend managers meetings and training in other homes and that there was two senior staff members at the home who deputised for the manager in he absence. One senior staff member was spoken with and understood their role and confirmed that they deputised for the manager if they were not present. The manager said that staff were available to speak to parents and visitors regarding the care of the service users. The home provided many quality assurance exercises which informed the way the home was run. These included satisfaction questionnaires forwarded by the homes providers and their results were published and made available to those who had an interest in the service. The results were viewed and were pie diagrams identifying the results from each home. There were monthly Regulation 26 visits, the reports were viewed, and evidenced that service users were spoken with about their satisfaction of the service. There was a local management review which was completed by the homes manager and identified actions that were taken in the home. Service users had weekly meetings and the minutes were viewed, where they made decisions about the home such as what they were going to eat and activities they wished to participate in. Parents and carers were invited to steering group meetings and partnership meetings which were held twice a year, where they could raise concerns about or discuss the service. The home had a quality assurance policy. A staff member spoken with explained how they regularly undertook water temperature and food temperature checks. Records were viewed which evidenced that they were routinely undertaken. The home had a fire risk assessment and fire records were viewed which evidenced that fire safety checks and services were regularly undertaken. Documentary evidence was viewed which showed that electrical appliance testing and gas appliance testing was undertaken. The homes environmental risk assessments were viewed and identified all possible risks of the home and risks of external activities. The risk assessments identified the risks and how they could be prevented. The home used the ‘safer food, better business’ recording and health and safety system. The documentation was viewed and evidenced that staff had received training on the system, that regular checks and precautions were undertaken. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 29 The accident book was viewed and storage and recording of accidents was appropriate. One first aid box in the kitchen was looked at and it was noted that it was well stocked and in an accessible position. There were regular health and safety audits completed by the home. Training records viewed evidenced that staff were provided with health and safety related training such as fire safety, health and safety, food and hygiene and first aid. Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 30 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 3 X X 3 X Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 31 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Crossways Residential Home DS0000024368.V317804.R01.S.doc Version 5.2 Page 33 - 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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