Inspection on 18/05/07 for Curtis Street (87)

This inspection was carried out on 18th May 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Curtis Street (87) 27/02/06

Curtis Street (87) 09/08/05

Curtis Street (87) 17/02/05

Curtis Street (87) 03/09/04

Curtis Street (87) 05/01/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Curtis Street (87) 87 Curtis Street Swindon Wiltshire SN1 5LR Lead Inspector Stuart Barnes Key Unannounced Inspection 17 and 18th May 2007 09:30 th Curtis Street (87) DS0000003234.V335501.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 Curtis Street (87) DS0000003234.V335501.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. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Curtis Street (87) Address 87 Curtis Street Swindon Wiltshire SN1 5LR 01793 420314 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) Community Access Network Mrs Tracey Lynne Parker Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered manager must work a minimum of 64 hours per 4 weeks in this home except on those occasions when they are absent due to sickness, training and annual leave. 27th February 2006 Date of last inspection Brief Description of the Service: It should be noticed that it is the custom and practise in this service to refer to service users or residents as tenants but in doing so the home recognises that those living at the home do not have full tenancy rights. Tenant is the preferred term of the people living and working at the home as it is seen as more empowering and respectful. This report however will use the term resident’ to describe the people who receive care and accommodation. 87 Curtis Road is a care home that provides care and accommodation for up to 3 people aged between 18 years and 65 years who have a learning disability and need support. Community Care Network known as C.A.N. run the home. The house is a small terraced house located within a 5 minute walk of the centre of Swindon. It provides each service user with their own bedroom. Additionally there is a shared lounge, dining area, conservatory/orangery, kitchen and bathroom. One bedroom is on the ground floor the other two are on the first floor. There is a rear courtyard with a small garden and car parking for two cars at the rear. The service replicates principles of ordinary living being a two storey terraced house similar to others in the road. It is typically staffed with one person on duty with additional staff at busy times. At night there is no awake staff presence. Instead staff undertake to sleep at the home in rotation and are expected to meet any night time needs as they arise. Fees are subject to means testing and are typically between £820 and £920 per week. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This inspection was carried out over two days, the first of which was unannounced. Time was spent examining a range of documentation including case documentation in relation to two of the current residents, the homes statement of purpose and various documents in relation to staffing matters. The inspector also spoke to all three residents obtaining their views about living at the home. Observations were made about the way residents and staff interact. Checks were also made on how medication and residents money are managed. At the invitation of two residents their bedrooms were seen, alongside all the communal accommodation was also seen. The service was required to submit a range of information before the inspection commenced. Two relatives and two health/social care professionals were invited to complete a questionnaire but none were returned. What the service does well: What has improved since the last inspection? There has been a general improvement in many areas with no outstanding weak areas to report. Standards are more consistently good or excellent than before. Progress has been made in developing quality assurance, care planning and improving the standard of accommodation. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 6 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. Curtis Street (87) DS0000003234.V335501.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 Curtis Street (87) DS0000003234.V335501.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): N.M.S. 1. 2. 3. Overall this service is being very successful at assessing and meeting peoples needs. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no admissions into this home since August 2003 so this remains a stable group of men living together in an ordinary house. The service has further improved both the range and format of the information that it provides to potential residents and to the people who represent them. The current service users guide is a mix of text and pictorial diagrams as a result of using a specialist software programme. The detail is very comprehensive and it promotes a person centred approach to care planning. The service user guide and the statement of purpose detail expectations and shared responsibilities such as carrying out household responsibilities. People using the service not only attend key decision making meetings that affect them; they also record in there own diaries their feelings, wishes and views. One care worker said this system helps people practice their literacy and numeracy, captures resident’s views and helps everyone. Examination of two case files show that the documentation is maintained to a very high standard for a service of this type. Each file contains a detailed personal profile as well as a detailed assessment of needs. They also include a personal planning book alongside a detailed life story project workbook. All this Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 9 information is supplemented by a personal daily diary which records what a person does each day. The daily diary also includes each resident writing up a weekly appraisal or review of the week that focuses on positive outcomes and achievements rather than problems and behaviours. The life story workbook gives voice to the past and is being used to help people to make connections and to make sense of their past life which might have sometimes been chaotic. The assessment documentation covers many aspects such as family circumstances, behaviours, risk, likes and dislikes, reports and placement reviews, leisure preferences and how finance and medication is to be managed and by whom. A feature of the documentation is how well they manage to engage each resident in the assessment and planning process. For example residents will write up their own summary or review of each week’s progress. As well as providing factual accounts they supplement the story of the persons adult life. It can be seen they also help staff to maintain a focus on the promotion of independence, citizenship, rights and responsibilities, which are core values in the homes statement of purpose. For example in one file there was a comment that the resident likes to “do his own ironing, manage his own breakfast, and prepare his own lunch” and that “they can be helpful but won’t offer to help.” In another example the documentation sensitively outlines past difficulties and sad times when living with the family and how this is to be managed. This service appears especially good at meeting the needs of people who might, on occasions, be described as challenging and complex. It is a service that has over time successfully managed to support a person whose first language is not English. It is also one of those services that are able to strike a balance between giving support and promoting independence and between making decisions for ones self but also considering the consequences for others. Case documentation confirms that people living at the home are supported to access a range of specialist services including specialist health care services, social welfare services, and social security departments. Self advocacy is promoted. Service users consistently report that they like living at the home and articulate, as one resident put it, “helped them with their problems.” The remaining residents also says he is happy at the home. Curtis Street (87) DS0000003234.V335501.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): N.M.S. 6. 7. 8. 9. 10. Care planning continues to be person centred and of a good overall standard. Residents are actively encouraged and supported to make decisions on the running of the home and key areas that affect them. Risk is well managed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This really is a very good service where care planning is person centred and covers all the key areas identified in the person’s assessment and referral documentation. Each person has a plan that includes the use of text and symbols to help their understanding. These documents make good connections between past events, current behaviours and future goals. There is evidence to show that plans are now being periodical reviewed and they generally show that there has been year by year progress for residents in most of the key areas of concern. Plans also seek to address any needs arising from difference or diversity. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 11 Where there are restrictions it can be seen that residents know about why these restrictions are in place and any possible consequences that might arise as a result. It was however noted that one care worker had recorded behaviour using judgemental language contrary to the ethos of the home. They recorded the person, “tells lies a lot.’’ It would be better to record that specific information provided may not always be correct. People using the service confirm that there is a key worker system in place and they describe the special way in which their key worker will support them, citing examples such as, “helping me with my life story workbook or helping me at review meetings.” Service users were observed to come and go as they please. It was observed that one person went to a trade stand about a new fitness centre that was opening in the town. Another went out to get some milk and buy some cigarettes. It was also observed that services users are appropriately reminded and encouraged to undertake responsibilities that sometimes they seek to avoid. Two such examples were observed i.e. a person not wanting take the their pet cat to the vet for an injection and a person not wanting to shop for bread and milk. In both examples staff skilfully supported the resident to examine the reason for these tasks, their importance and the consequences of not doing them, while at the same time allowing the resident time to muster up the required energy and commitment to carry it out. This was done quite skilfully. In a lesser caring home this could have easily created conflict. The service is structured so residents are active participants in decision making in many ways. It is the norm in this home that people using the service will clean their own rooms, share in household chores such as cleaning communal areas or washing up or cooking the main meal for each other on rotational basis or shop for the food that they need to cook. Residents said they choose their own breakfast. But they also make decision on what to do, where to holiday and the décor. It was observed they choose their own television programmes and can take fruit to eat out of the fruit bowl if they want. With some staff support residents are self sufficient in carrying out simple ironing and laundry tasks. Case files also show that some decisions arise from detailed discussion and are shared decisions. Such examples include decisions about budgeting and managing medication. In one case there is a shared agreement about how many cigarettes someone can smoke in a day. The reason for this agreement is to assist with budgeting and to reduce the negative effects associated with smoking. The process for assessing risk and managing the consequences of taking risk is another area where support workers and residents work together in the best interests of the residents. All case files had detailed risk strategies in place and there was evidence of their periodic review. For example residents who may Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 12 like to be at home for short periods without the presence of a care worker are risk assessed first. Another example of good risk management is a reminder to ensure a named resident takes his mobile with him when going out. Curtis Street (87) DS0000003234.V335501.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): N.M.S. 12. 13. 14. 15. 16. 17. Residents are getting consistently good outcomes in all of the above areas and as a result it can be seen that over time each residents personal development is being further developed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two individuals are being helped and supported to access therapeutic work and to take part in educational opportunities. The other resident presents a greater challenge preferring a semi retired life style. Never the less it was observed that care workers actively encouraged this person to access the wider community and from his case documentation it is clear care workers have supported this person to maintain past friendships. Where there are therapeutic work placements, agreements are in place as to what can be expected of from all parties. These agreements are periodically reviewed. The approach is really one of continuous life learning with unobtrusive one to one support and monitoring. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 14 Residents practice numeracy and literacy skills through the experience of daily living. For example this might be done by shopping and by keeping daily diaries. The location of the home permits easy access to the centre of Swindon [and beyond] with its range of shops and civic amenities. The town centre is a few minutes walk away and one service user said he is able to ride his bike to work or to the shops if he wants – an activity that has been appropriately risk assessed. The home is indistinguishable from other houses in the street. This enables users of the service to feel part of their immediate neighbourhood. Records show service users are registered to vote. Staff report that the staff rota is constructed to accommodate resident’s preferences and take into account planned activities. At the same time the rota is designed to ensure the service is not over staffed. According to the manager this balance is seen as being very important as it helps to avoid setting up a culture of dependency and by so doing risk institutionalising residents. All service users are actively supported to budget and to use building societies to save their money. Policies and procedures make it clear that for example staff must not open a person’s mail unless the residents requests this and that residents are permitted [subject to any identified risk] to have a front door key and/or bedroom key. There is a detailed written policy that guides staff what to do should a person go missing. However the policy does not include the duty to inform the Commission of any such event. Case files show that care workers actively support each resident to manage contact with their own family in a way which supports kinship but recognises that not all family relationships are easy relationships to manage. The system in place appears to provide a structure which helps men cope with the challenge of “self sufficiency” with their domestic responsibilities in a way that is fair and simple. All current residents gave positive accounts of the food arrangements. Two residents described their duties and obligations to help with the cooking and shopping. One resident spoke about what happens if a resident doesn’t feel inclined to take his turn or wanted something different; something he said did not happen very often. Food stocks were checked and were found to be adequate. No service user made any adverse comment about the food arrangements, meals or menus. Two praised the food arrangements. A care worker was observed to patiently support a service user that appeared a little anxious about cooking and he encouraged them to carry out tasks in a step-by-step approach. The care worker appeared to maintain a proper focus on supporting the resident to complete the task, ensuring a safe working environment and always explaining what needed to done next. This was done using the hob to cook fresh fish and vegetables and not using processed food Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 15 cooked in the oven. So it can be seen the way this activity was carried out helped the development of life skills and promoted healthy eating. Residents were also observed to make themselves a hot drink or take fruit from the fruit bowl without reference to care staff. Residents are encouraged to plan their own holiday. One resident confirmed that he had recently had a holiday in Spain and that he was supported by the staff. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): N.M.S. 18. 19. 20. Medication is being properly managed and properly administered. There is strong evidence to show that resident’s social, psychological and health care needs are being well met and that challenges are being well managed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A very strong feature of this service is the way it is successfully supporting each resident to promote their general well being and dignity. Residents report that they can share their concerns, get help with problems and are encouraged to meet challenges. Care planning is highly individualised and the smallness of the service allows for people to be seen as unique individuals; something that comes through in care planning and daily living. Case documentation shows that each person can access a range of specialist services. People with “high expressed emotions” are helped to manage anger and any outbursts they may have in a constructive way. Case files indicate that people are supported to attend medical appointments, including dentists, opticians, including annual health checks. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 17 The service has a detailed medication policy that promotes service users retaining responsibility for their own medication, but only if it assessed as being safe to do so. Care workers report that the medication procedure works well. Care workers appear to understand that significant behavioral changes may require a doctor to review medication. Medication is stored appropriately and securely. Checks were made on whether there were any out of date medication being stored and none were found. The record of when medication is giving to residents appeared in order and benefits from having two staff signatories as an additional protective measure. Case file shows that residents are asked to give their written consent if they want staff to assist them with their medication needs. Staff state and training records further verify that care workers receive appropriate training in managing medication. The policy file also includes patient information leaflets about drugs used and certain medical conditions. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 18 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): N.M.S. 22. 23. Overall this appears to be a home where residents are safe and listened to and a service rarely complained about. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a detailed written complaints policy that meets our requirements. This service is rarely complained about. The last recorded official complaint was dated May 2003. Service users report that they know who to complain to. Care workers impress as people who would take any complaint seriously and will take forward any expressed concern. Documentary evidence was seen that shows a resident was invited to report an assault on them by another resident to the police. Discussion with the manager shows that she has a good understanding and working knowledge of the local safeguarding adults procedures. Staff training records indicate that staff receive awareness training in adult protection. Care workers also confirm that they are provided with copies of the General Social Care Councils code of practice, which they are expected to adhere to. Details were available in the home on the reporting procedures should any allegation of abuse of neglect be made concerning any resident. The home has a policy not to use restraint. Instead all staff receive practical and awareness training in non-violent crisis interventions. (NVCI) The system for looking after residents’ money was checked and found to be in good order. The home has a system whereby at each shift change two care workers check any money held on behalf of each resident. Receipts are kept for any large expenditure and a record of any cash deposit and withdrawals is Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 19 maintained. Discussion was held with one resident about the way the service supports him to budget by helping him put money away in brown envelopes for later use. This resident explained that he liked this system as he did not get a lot of money and it helped him budget and it helped him to save for his holidays. All residents have their own account with a local building society where they can deposit larger sums for safekeeping. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 20 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): N.M.S. 24. 30. This is an improved area with standards of accommodation that generally meets the needs of those residing at the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection a number of improvements have been made to the environment. They include some redecorating, some new carpeting and some new furnishings, along side some remedial repairs. This is not a pretentious home: but it is comfortable and was found to be generally clean throughout. The men living at Curtis Street appear to respect it as their “home” and they clearly take some pride in it. There are plans to replace the dining room furniture in the coming months. One resident invited the inspector to view his room. It appeared clean, personalised and comfortable. Another resident’s room was found to be tidy, clean and pleasant. Both occupants said they liked their room. Discussion took place with the manager about how care workers support a resident who likes to clutter his room. This problem currently presents some Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 21 challenges but it appears it is being worked through in a way that balances aspects of health and safety with individual choice and life style preferences. The fire safety log was checked and it was generally in good order; though records show that during a four-month period the fire alarm was not tested on one week. The manager said this must have been an oversight or possibly that it was tested but not recorded. Staff report that they practice fire evacuation and records show that evacuation procedures involve all the residents and that they take place at least quarterly. There are records to confirm fire equipment is periodically checked and serviced. There are also records to show checks are made on the gas boiler and electrical tests for portable equipment (PAT). Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 22 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): N.M.S. 32. 33. 34. 35. 36. Staff demonstrate overall competency and appear to be sufficient in numbers, properly recruited, inducted, supervised and trained. Residents speak positively about the staff and appear to have a good rapport with them. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In the previous year one staff member resigned and it took a while to replace them. It was reported that for several months the home had been short staffed and were dependent on using agency staff to provide additional cover. The home was fully staffed when the inspection took place. No resident or any staff member expressed any significant issues of concern regarding staff cover or staff shortages. One resident said he didn’t mind having agency staff, as he liked having someone different. One care worker said that rotas were flexible and that there was always sufficient staff on duty to meet the residents needs. It is clear from residents that they have an attachment to the staff team as well as their key worker. From observation and comments made by residents and workers there appears to be a good rapport between them. Records confirm that the service is on track to have 100 of current care workers trained up to National Vocational Qualification level 2 by the end of Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 23 the year. The current staff team appears to be a good mix of age, experience and gender and represents the racial mix of the local community. The records of two staff were examined in detail. Their recruitment records appeared in order including satisfactory references, a criminal record bureau check and a protection of vulnerable adult check. There were records in place which detailed the discussion and action plans arising from one to one supervision meetings, which in both cases appear to have been at least every six weeks; more often for newer staff. Records of these meetings show that proper attention to performance, progress and validation by the manager of work well done. The company has an appraisal system in place that appears to be working well. Staff (team) meetings take place approximately every four/six weeks. Examination of the agenda of some of these meetings shows that relevant issues are debated including issues relating to the needs of service users. One of the staff meetings took the form of a team building ‘away-day’ which staff reported as being a great success. One of the staff said, “staff meetings are “lively and good.” Another said, “we are lucky to have such a good staff team.” Care workers praise the company for the training they arrange or provide. The manager maintains a training schedule/diary that serves as a training plan. It includes providing more training in NCVI, fire safety, safe handling of medication, promoting healthy eating and National Vocational Qualification level 3 for selected staff. Training provided in the previous 12 months included National Vocational Qualification level 2, NCVI, first aid, safe handling of medication, and fire safety. The overall impression is that the staff team is a cohesive, well-managed unit and that it is being appropriately supervised. The company have recently updated their induction arrangements to comply with the Learning Disability Award Framework. Care workers report getting job satisfaction. One said, “[working here] can be very hard work; it is not an easy job but it is rewarding.” This person went on to explain how they try to keep a positive focus and how important it is to motivate residents. What he described appears to be what the service strives to do. Another worker who appeared to have an excellent rapport with a resident said she was, “very happy working at the home.” Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 24 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): N.M.S. 37. 38. 39. 40. 41. 42. 43. This appears to be a well managed service that is striving to provide good outcomes for its residents. There is good balance between managing risk, dealing with behaviours that challenge, promoting independence, ensuring a presence in the community and respecting difference. The care workers are getting appropriate guidance and support they need to assist the residents to maximise their opportunities. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager meets the requirements of the Commission to manage a home of this type. The company obtained the ‘Investors In People’ accolade during 2006. It takes seriously it responsibility to quality assure its service and to improve it over time. There is a detailed quality assurance policy. It emphasises quality is the responsibility of every member of staff. Examination of the company’s quality survey which was last carried out in September 06 shows generally good satisfaction levels but the form could be further Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 25 improved if it gave more consideration to issues such as comfort, activities, access to health care and how people get on with each other. There is scope to also develop a questionnaire more suited for health care and social care professionals. Findings from the survey are assessed independently of the company. Almost all of the policy files have been reviewed since the last inspection and where appropriate amended or updated. These policies are now better at cross-referencing to other related policies. The policy file has in effect three chapters. One chapter covers general health and safety, another chapter has policies in relation to needs of service users and there is a section covering staffing issues. The manager and the staff on duty confirmed that staff meetings usually include discussing at least one policy; a system that was said, “helps to keep them alive as a working tool.” The home is considered to be safe. Residents report that the fire evacuation is practised from time to time and they were able to explain what they must do when the call bell sounds. Records indicate that there is a low number of accidents and incidents occurring and when they do occur such incidents are being reported to the Commission. The company has a well-established system of carrying out monthly management reports as to the conduct of home, which have also copied to the Commission. There are records that show that potential risks are evaluated. Such examples include the radiator covers, home alone, shopping alone, self medication and preventing accidentally scalding. Overall risk appears to be a well managed and documented. The service appears committed to developing practices that promote equality and challenge discriminatory practice. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 26 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 4 3 4 4 X 5 X 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 4 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 2 LIFESTYLES Standard No Score 11 4 12 3 13 2 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 4 3 3 4 4 3 Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? None 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 YA13 Regulation 37 Requirement The policy concerning missing person’s must state that when such incidents occur they must be reported in writing to the Commission. Timescale for action 01/07/07 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 Refer to Standard YA10 Good Practice Recommendations Consideration should be given how best to record any resident’s difficulties with telling the truth. Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Curtis Street (87) DS0000003234.V335501.R01.S.doc Version 5.2 Page 29 - 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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