Inspection on 28/03/07 for Downing View

This inspection was carried out on 28th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Downing View 27/01/09

Downing View 27/01/06

Downing View 15/10/05

Downing View 14/01/05

Downing View 25/05/04

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 Downing View 1-3 Loring Road Dunstable Beds LU6 1DZ Lead Inspector Mr Ian Dunthorne Unannounced Inspection 28th March 2007 10:00 Downing View DS0000033029.V331066.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 Downing View DS0000033029.V331066.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. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Downing View Address 1-3 Loring Road Dunstable Beds LU6 1DZ 01582 604416 01582 670226 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) Bedfordshire County Council Mr Mark Anthony Edmunds Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. No of residents: 2 Gender: Male & Female Age: 18 - 65 years Category: Learning Disability Period of stay: Respite only - up to a maximum of 6 weeks Until reprovision of this service takes place, the premises must be safe, and meet the service users` individual and collective needs. 27th January 2006 Date of last inspection Brief Description of the Service: Downing View is a respite service located on the outskirts of Dunstable. The accommodation and grounds are owned and maintained by Aldwyck Housing Association, with Bedfordshire County Council providing the staffing and care support. The long-term plan for this service is re-provision. This is because the building does not meet the National Minimum Standards for Younger Adults (18-65) environmental requirements. It is hoped that the service will remain in the local area. The accommodation comprises of a small flat, which is intended to provide respite care for up to 2 adults with learning disabilities at any one time. Stays are limited to a maximum of six weeks. There are two single bedrooms, a shared kitchen, bathroom (with shower facilities only), and living/dining area. The accommodation would not meet the needs of all individuals with a physical disability. Community facilities and shops are a short distance from the home, which is also in easy access of local transport routes. There is ample parking to the front and rear of the property, and there is a small enclosed garden. Information regarding the home’s range of fees and the manager’s figure provided in the pre-inspection questionnaire in January 2007 stated that the weekly fee ranged from £64.65 to £639.00. Any additional fees not included Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 5 were not specified within the information provided. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours during the morning and afternoon and it was unannounced. Prior to the inspection time was taken to review the information gathered since the last inspection and plan this inspection visit. This report also includes feedback from relatives and service users obtained from postal questionnaire surveys. The inspection included a tour of the communal areas and bedrooms, inspection of certain records, discussion with staff and the manager, discussion with service users and observation of the routines of the respite service. No relatives were available during the inspection to speak with. The method of inspection was to track the lives of several service users. This was done by speaking to them about the service they receive, observing their life in the home, talking to staff and reviewing their records. What the service does well: The home was able to help service users make a choice about whether the home was right for them and indeed if they could meet their needs. The relative of a person using the service commented in their postal survey questionnaire that, “staff came to our home to discuss the respite home and what was involved in respite care and our son who uses the service was involved in all the conversations”. The manager said that the service acknowledges and recognises cultural diversity, which was evident during the inspection. The service enables people using the service to be given a choice and make decisions about their lives whilst staying at the home, with the support of staff if necessary. The relative of a person using the service commented in their postal survey questionnaire that “within the staff’s ability, personal choice is always forefront and striven to be met to the full”. Suitable risk assessments were in place to ensure risk to people using the service was minimized, whilst their independence was promoted. The meals provided in the home were home cooked, balanced and varied and suited the tastes of the people using the service, who were supported to plan, prepare and cook their chosen menu’s using effective tools in a format suitable to meet their needs. All staff were observed throughout the inspection to have formed good relationships and a good rapport with service users. Comments received in Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 7 completed postal questionnaire surveys sent to people using the service included “all staff are friendly, caring and approachable”. The complaints procedure was accessible and in a format suitable for people who use the service, one relative commented in their postal survey questionnaire that “the manager encourages us to say if we are not happy”. What has improved since the last inspection? What they could do better: Some of the things that the home could do better include: • • • Making sure that service users are clear about anything they will have to pay for. The manager felt that the service’s range of communication methods to suit service users needs could be improved. Ensuring that any money looked after by the home for people who use the service whilst staying there is done so safely; to protect those people, by making sure that accurate records are kept and receipted. Making sure that all the information about the home is accessible and available. Making sure that the registered responsible individual visits the service each month and produces a report about the visit, which is then made available in the home for CSCI to view when they visit. • • Please contact the provider for advice of actions taken in response to this inspection. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 8 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. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 9 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 Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The respite service provided sufficient information for prospective people using the service, however it sometimes failed to identify the fees payable, which did not allow all service users to be aware of the fee and what they may need to pay. EVIDENCE: Seven out of ten of the respondents to the postal questionnaire surveys sent to the service users, said that they felt they were given enough information about the home to make an informed choice about whether to stay there. The homes statement of purpose and service user guide had been reviewed, although only the statement of purpose was available in a suitable format for some of the service users intended and provided information to enable prospective service users to make an informed choice about where to live. Service users who were spoken with as part of the inspection supported that evidence. The homes last inspection report was available within the home, but only accessible upon request. There was evidence that the home had assessed the needs of prospective service users and demonstrated that the method and system for doing so provided a satisfactory form of assessment and involved appropriate communication methods. The method of assessment involved the service user, Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 11 the family and other individuals referred to as part of the service users care management process. The home was able to demonstrate that it could meet the assessed needs of people staying at the home. Staff individually and collectively demonstrated that they had the skills and experience to deliver the service and care which the home said it could provide. Staff were observed communicating with people using the service in different forms of communication to suit their individual preferences and needs, which included ‘Makaton’ sign language and picture cards. The needs and preferences of specific ethnic minorities had been considered and recognised and was demonstrated by information the service provided about various religions, beliefs and faiths, which extended to the menu’s the service offered and provided. Evidence from the postal questionnaire surveys sent to service users, identified that they were given the opportunity which most undertook, of a trial introductory visit to the home before making any final decision about moving there. One relative of someone using the service commented in their returned survey, “we were given the opportunity to visit the site and meet the main carers, we were made very welcome and updated about the situation”. The records of people using the service also verified that introductory visits took place and it was evident that the service considered them a very important part of the transitional process for beneficial, successful and supportive respite stays. Each service user had an individual contract, which had been signed by them as well as their relative, and the manager of the service. There was evidence that the service had introduced contracts in a format appropriate for the needs of most of the service users. The service had failed to include fees charged within the terms and conditions. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 12 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 good. This judgement has been made using available evidence including a visit to this service. People using the service were supported by staff to participate in the running of the home and enabled to make decisions whilst staying there. Suitable risk assessments were completed by the home, to ensure people using the service were protected whilst their independence was promoted. EVIDENCE: A sample of the service user’s plans and supporting documentation were examined and found to contain suitable and sufficient information to help meet their changing needs and personal goals were identified and reflected in their individual plan. A suitable keyworker was allocated for each service user. The plan was made available in a format the service user could understand and a person centred planning (pcp) approach was used successfully. In some cases people who used the service had been encouraged and were able to complete their own ‘Planning Your Stay’ form of care plan, which supplemented the services one. The plans had been reviewed at regular intervals and there was Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 13 clear evidence that people using the service and their relatives or advocates had been included and consulted in drawing up the plan. All respondents to the postal comment cards said they either always or usually made their own decisions about what to do each day. There was evidence from speaking with service users and records examined that service users were assisted as necessary to make decisions about their daily lives. Some information provided by the home was in a suitable format to support service users to make decisions about their lives whilst staying at the home. Staff were observed communicating in ways appropriate to each individual service user, to enable them to make an informed decision in a way the service user could understand. One person using the service commented, “the staff are great, they always ask what I would like to do if it is possible”. It was evident by observation, that service users were offered the opportunity and participated in the day to day running of the home and contributed towards any proposed changes within the home, to influence any decisions reached. The home had a notice board for service users, which provided information in a suitable format about various activities, services, policies and procedures. There was evidence that service users were consulted about all aspects of life within the home at service user meetings that were held regularly. A customer comments board was available for people using the service and satisfaction questionnaires were issued annually. There were suitable risk assessments in place as part of the homes risk assessment strategy to enable service users to take risks supported by staff and they had been regularly reviewed. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 14 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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The meals provided in the home were home cooked, balanced and varied and suited the tastes of the people using the service as they were supported to plan, prepare and cook the meals using a range of effective tools. This enabled them to maintain choice and provide them with an opportunity for personal development. EVIDENCE: Due to nature of the service being a respite facility, most service users continued to take part in activities engaged before coming in to the home for a respite stay. Therefore staff supported people who used the service to continue with their chosen and preferred activity during weekdays whilst staying at the home. This included activities evidenced by staff who supported people to prepare their packed lunches by using visual recipe cards. There was evidence Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 15 that staff supported people using the service to find about learning, education & training that they may be interested in. Any social and community links established by people using the service before staying at the home were maintained and supported by staff at the home, enabling service users to continue to pursue them. In addition the service also supported people using the service to create new links and introductions, some opportunities were advertised in the home on a notice board for people using the service, on which a calendar of events was displayed. There was evidence of this demonstrated by speaking to people who used the service and staff. Recently staff had supported some people to in the home to attend a disco. As described in ‘Individual Needs & Choices’ section of this report there was clear evidence demonstrated of the homes values, which reflected the racial and cultural diversity of people and the community. People using the service were supported to access a variety of meaningful activities inside and outside the home; one person who used the service said, “I like doing different things here like cooking”. There was evidence that the home supported service users to maintain family links and friendships inside and outside the home, in accordance with their wishes, which included personal relationships. This evidence was supported by responses within service user surveys and service user plans, which identified relationships. Staff were observed knocking on service user’s bedroom doors before entering and waiting to be invited into their bedrooms. Those service users who wished to were supported to keep their own room keys. Service users responsibility for housekeeping tasks was specified within individuals’ service user plans and generally within the person who used the service ‘Planning Your Stay’ record which was a chart detailing their preferences and choices during their stay, including their individual activities of daily living skills. One person using the service was observed being supported by a staff member to do their laundry, which was tracked to their care plan and a completed risk assessment for this activity. The relative of a person using the service commented in their postal survey questionnaire that “My daughter can do what she wants within reason, if she wants to go to her room she can, she likes to have her own space sometimes”. Service users were observed during a mealtime enjoying well prepared and presented, home cooked and appetising food in suitably sized portions. Service users were observed enjoying their meal and the mealtime itself that they had participated in preparing for, planning the menu for the week, shopping and laying the table. There were no set mealtimes as such, as the service users preferred the flexibility. The menu’s choices were in a suitable format for service users to make an informed choice and decide what they would like to eat. There was a visual rota displaying whose responsibility the mealtime was on any given day and a visual checklist of people’s general food Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 16 likes and dislikes. Laminated picture cards were available and used for meal planning by people who used the service, whilst being supported by staff. There were several effective visual tools used by the service to enable people who used the service to have choice in most aspects of their meals. Downing View DS0000033029.V331066.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 good. This judgement has been made using available evidence including a visit to this service. The staff had a good understanding of people’s support needs. This was evident from the positive relationships, which had been formed between the staff and people who used the service. EVIDENCE: Service users spoken to said they enjoyed living at the home and that they felt supported by the staff. Records viewed suggested service users received personal support in the way they preferred and most were encouraged to maximise their independence. This was supported by observations and discussions held with service users. Each service user had a key worker, who they were each able to identify and those service users spoken to said they were happy with the support from them and the relationship they had developed with them. All respondents to the service users surveys said that they were treated well by staff and several positive comments were made. Due to the nature of this respite service their families or main carers supported the majority of service users health needs. However, evidence was clearly demonstrated that the service had the skills, training and information to meet Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 18 those personal health care needs of people who used the service if and when required. The home had ensured that care staff had received awareness training in medication administration and practises, however this did not constitute full and accredited training. As previously reported staff from the adjacent domiciliary care service, were required to support with the administration of medication within the respite unit. This was because the medication policy required two staff to administer medication, and there were not always two staff on duty within the respite unit. This arrangement was still in place at the time of this inspection, and a member of staff from the adjacent domiciliary care service came in to support with medication during this inspection. Agency staff that worked directly within the respite service had received medication training. The procedures implemented suggested that service users safety was being maintained in most areas. Medication consent forms had been completed for people using the service, which obtained their agreement to administer their medication, and provided evidence of consultation. However there was no evidence of those service users whose lives were tracked as part of this inspection that this was the case, as the form had not been signed by the person who used the service or their relative or representative. The manager explained that full training is being sought for staff working within the respite unit, to enable them to administer medication to service users themselves. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 19 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. The arrangements for protecting service users were good. However, further development was needed to ensure service users money were looked after safely and accurate records maintained to protect service users from potential abuse. EVIDENCE: The home had a satisfactory complaints procedure that ensured service users felt their views were listened to and acted upon. The complaints procedure was produced in a format appropriate for service users to understand and access. There had been no complaints since the last inspection. People who used the service, who were spoken with, were aware of the service’s complaints procedure and felt comfortable and confident to use it and that they would be listened to. All respondents to the postal survey questionnaire’s said they knew how to complain and who to speak to if they weren’t happy, one commented, “the staff are always happy to help if I have any questions”. Those service users who were spoken with during the inspection verified this evidence. The home had a Protection of Vulnerable Adults (POVA) policy in place, which included whistle blowing and staff spoken to demonstrated they were aware of the procedure. Most staff had also attended POVA training, which was also included and formed part of the homes induction process for staff. Since the last inspection there had been one notifiable incident at the home in Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 20 accordance with the POVA policy and guidance, which required reporting to CSCI. Evidence examined, supported a process that had been followed to safeguard and protect service users The homes policies and practices regarding service users money and financial affairs were generally satisfactory and protected service users from abuse. However some records examined identified inappropriate amendments to one service users financial transaction records and a duplicate record, which detailed different transactions and did not correlate with the first one. This system was confusing and could provoke further recording errors. In addition the local policy detailed that staff were not required to obtain purchase receipts when supporting service users to handle their money, for any items at a cost of less than £3.00, this practise was not satisfactory or in accordance with good safeguarding practise. There was evidence that the home was about to introduce a revised policy for the management of service users money and finance, to improve and ensure robust practices were followed. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 21 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, 27 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home does not adequately meet the National Minimum Standards (NMS) for Younger Adults (18-65), suitable steps have been made to provide a homely place to stay. EVIDENCE: Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 22 As previously reported, the respite unit was part of the existing Downing View building which had been ‘made good’ until re-provision of the service took place. The unit operated in conjunction with Aldwyck Housing Association, who were responsible for the maintenance and upkeep of the building, fabrics and furnishings. The accommodation did not adequately meet the NMS environmental requirements, and would also not meet the needs of all individuals with a physical disability. Therefore home’s long term plan remained reprovision. At the time of the inspection, there were still no definite plans for reprovision to take place. Therefore there was no change since the last inspection and as previously reported CSCI had agreed that the environment must at a minimum, meet the needs of the service users. The home’s conditions of registration were updated accordingly. The inspector was shown both bedrooms of people who used the service. Each room appeared to be equipped with adequate fixtures, furnishings and equipment for the purpose of a respite service apart from a suitable table. There were no en-suite facilities or washbasins in bedrooms. One bedroom had undergone some minor works demonstrated by the ‘boxing in’ of pipe work, however the ‘boxing in’ had not been decorated, which gave an unpleasant appearance and detracted from an otherwise homely environment created by the service and those who used it. The bathroom was safe and suitable for its intended purpose and was in an appropriate location. The bathroom had recently undergone some adaptation work providing a new adapted walk in shower room, however there was no availability of a bath. The bathroom was lockable and maintained service users privacy, however staff were able to override this feature in an emergency. Clinical waste facilities were provided. The home appeared clean and generally free from offensive odours, service users, care staff and night staff were responsible for ensuring this was maintained. All respondents to the postal survey questionnaire’s said that the home was always fresh & clean. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 23 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. After a period of some instability in staffing, there was now a good match of well qualified staff offering consistency of care within the home and the arrangements for the induction of staff were good, with the staff demonstrating a clear understanding of their roles. EVIDENCE: There was evidence that staff had received specialist training to support them to meet the needs of the service users. The percentage of staff qualified at nvq (national vocational qualification) level 2 or 3, was 60 which met the national minimum standard. The service was able to demonstrate that staff had the skills and experience to support the needs of the service users. Staff were being recruited according to County Council policies and procedures. Staff vetting documents were being held centrally and arrangements were not made to examine them as part of this inspection. Staff spoken to confirmed they had received a copy of the General Social Care Council Code of Practise and The County Council’s employee handbook. However it was disappointing to see that the service had still not produced its own service specific staff Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 24 handbook for the respite service. The home was using staff from an agency to supplement the existing staff team. Profiles were received for all external agency staff prior to working at the home, demonstrating that checks were made on the external agency staffs’ suitability, one was examined and found to be suitable and comprehensive during the inspection. The home also benefited from the same regular agency staff that they referred to as ‘core’ agency staff. The home had recently held a recruitment campaign, which the manager explained was successful as several new staff had been recruited; some were still waiting to start their new positions. Comprehensive records of staff training & development were examined and identified a suitable induction process, which was supported by staff spoken to and included LDAF (a specialist induction program for staff supporting service users with a learning disability), a corporate induction and work based induction. Staff spoken to identified varied & some specialist training which they had undertaken at the home and this was supported by evidence in their training records. There was evidence examined of a structured training & development plan for individual staff and for the service. Staff spoken to and records examined, provided evidence that staff received regular supervision and annual appraisals. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. 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, 38, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The systems for service user consultation were good, with a variety of evidence that indicated that service users views were both sought and acted upon. EVIDENCE: The registered manager Mark Edmunds was present throughout the inspection. It was evident that the manager was qualified, competent and experienced to run the service and home. The manager undertook periodic training and development to update their knowledge, records of this were provided prior to this inspection. The manager was observed to communicate effectively with both service users and staff and appeared approachable. Service users and staff who were Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 26 spoken to supported this view. The home had an inclusive atmosphere. The manager of the home maintained an effective leadership ethos that both service users and staff were able to benefit from. Opportunities were available in several formats and methods, using different tools to enable service users, staff and relatives to affect the way the service was delivered. The CSCI had not received any reports in accordance with regulation 26 of the Care Homes Regulations 2001, since the last inspection of this home and none were available to examine during the visit to this service. The manager said that there had been no improvements made in this area, this was a requirement at the last inspection. The service had developed a quality assurance and monitoring system, from which it had developed an action plan from the information it had collected from several sources and included this within its business plan; eleven key performance indicators were included within the action plan for the service. There was evidence that the home had begun a cyclical system of regularly monitoring and reviewing service users views, amongst others. There was evidence that safe working practices were promoted and maintained within the home. Various records were examined to support adequate compliance with the following safe working practices, regarding health & safety. COSHH (Control of Substances Hazardous to Health), Fire, Food Hygiene, Moving & Handling, First Aid, Risk Management & associated Assessments and Accident records. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 2 X X 3 X Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? YES 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 YA5 Regulation 5 (1b) & (1c) Requirement Each service user must be provided with an individual written contract or statement of terms & conditions, which must include the amount and method of payment of fees. Timescale for action 31/05/07 2. YA23 13 (6) The home’s policies and 30/04/07 practices regarding service user’s money and financial affairs must ensure that people who use the service are protected and safeguarded from abuse. The Responsible Individual must carry out monthly unannounced visits to the home and prepare a report of findings. Copies of the report must be available for CSCI to examine and kept in the home. [Previous timescale of 31/3/05 and 30/11/05 not met.] Ensure that the homes written policies and procedures are cover all the topics set out in appendix 2 of the national minimum standards for younger adults. DS0000033029.V331066.R01.S.doc 3. YA39 26 31/05/07 4. YA40 17 30/06/07 Downing View Version 5.2 Page 29 Policies must include those relating to death of a service user, smoking and alcohol, sexuality and relationships and individual planning and review. [Previous timescales of 31/8/04, 31/3/05 and 30/11/05] Not assessed on this occasion. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA1 YA1 YA20 Good Practice Recommendations The home should ensure that a copy of the most recent inspection report is made available to both service users and their families. The home should ensure that information about the home in the form of the service user’s guide, is available in formats suitable for each service user. The service should ensure that consent obtained from people using the service to administer their medication is recorded and signed by them or their relative / representative / advocate as appropriate. Downing View DS0000033029.V331066.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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. 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