Inspection on 22/07/08 for Edgeview Nursing Home

This inspection was carried out on 22nd July 2008.

CSCI found this care home to be providing an Excellent service.

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

Other inspections for this house

Edgeview Nursing Home 03/10/06

Edgeview Nursing Home 29/11/05

Edgeview Nursing Home 25/05/05

Edgeview Nursing Home 03/02/05

Edgeview Nursing Home 28/09/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOME ADULTS 18-65 Edgeview Nursing Home The Compa Comber Road Kinver Nr Stourbridge Staffordshire DY7 6HT Lead Inspector Keith Jones Unannounced Inspection 22nd July 2008 09:00 DS0000022324.V368857.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 DS0000022324.V368857.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. DS0000022324.V368857.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Edgeview Nursing Home Address 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) The Compa Comber Road Kinver Nr Stourbridge Staffordshire DY7 6HT 01384 872804 F/P 01384 878980 juliajasper@edgeviewhomes.co.uk Edge View Homes Ltd Mrs Julia Ann Jasper Care Home 24 Category(ies) of Learning disability (24), Mental disorder, registration, with number excluding learning disability or dementia (24) of places DS0000022324.V368857.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) 24 Learning disability (LD) 24 2. The maximum number of service users who can be accommodated is: 24 3rd October 2006 Date of last inspection Brief Description of the Service: Edgeview nursing home provides 24 hour nursing care to twenty-four adults aged 18 to 65 years of both genders who have a learning disability, mental disorder, autistic spectrum disorder and associated physical disability, these may be further complicated by the presentation of behaviour, which challenges services. Edgeview is located in a residential area of Kinver in three acres of land, approximately one mile from the village centre in an area of outstanding natural beauty. Road links to nearby Stourbridge and Wolverhampton are good, with regular services. The service is divided into three sections; the Main House accommodating sixteen people and the Bungalow and the Stables, the latter two are semi dependent units, which provide accommodation for three and five people respectively. All people using this service are encouraged and supported by staff to develop their independent living skills, enabling some, in time, to move to environments of lesser support. The full range of charges were not detailed in the service’s Statement of Purpose’ or Service User Guide’ documents as routine, but are assessed DS0000022324.V368857.R01.S.doc Version 5.2 Page 5 according to need, and presented with the commissioning Authority approval. The reader may wish to contact the service to obtain more detailed and up to date information about fees. DS0000022324.V368857.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. We conducted this unannounced inspection with input from the Registered Provider, Operations Manager and the Registered Care Manager. We also had the full cooperation and contribution of all staff, people who use the service and relatives present. Our inspection of the building allowed us free access to all areas and open discussion with people who use the service, relatives and staff. There were 24 people in residence on the day of our inspection. Each person was able to communicate to varying degrees, happy to chat, or assisting us throughout our inspection. We looked at how care is being arranged and supported for a range of people with learning disability and mental health needs. To do this we looked at (case tracked) three residents’ files from referral to the present time, and three staff files were examined. We also looked at other information such as complaints, incidents, events and other professional reports. We acknowledged receipt of the Annual Quality Assurance Assessment (AQAA) and nine survey forms, returned by residents and two from visiting medical staff. The distribution and collection of surveys had been assisted with the help of the recognised link resident for Edgeview. We also inspected a sample review of administrative procedures, practices and records, confirming consistent good practice and effective management. There followed a report feedback, in which we offered an evaluation of the inspection, indicating those recommendations resulting from the inspection. What the service does well: Edgeview’s aim to provide a ‘homely’ environment that will give people greater security, choice, independence and a good quality of life. It’s primary objective is to meet individual people’s holistic needs, while maximising the services that it offers . Edgeview offers people a range of opportunities, both in-house and through their onsite activity centre and as part of the community, encompassing the essential human needs for stimulus and peace, work and leisure, occupation and relaxation, togetherness and solitude. People using this service are encouraged to take an active role in their life planning. DS0000022324.V368857.R01.S.doc Version 5.2 Page 7 We found the service to be extremely well organised, with a committed care management team, combining daily, short-term and long-term aims and objectives, providing an excellent service of an independent model of living. There is an established person centred approach to developing a service that meets people’s holistic requirements. The people we spoke with confirmed their acceptance in the daily routine, and their personal involvement. Comments received on the day included: “I love this house and my nurses”, “I have a new bedroom when I want one, and like talking to everybody”. The link resident was very pleased with the way she was involved with everything “I like a smoke and the staff are very helpful in making it safe for me. The whole of the staff and other people are really nice and helpful”. We found that great emphasis goes into involving people who use the service and their families in the process of care, ensuring a highly personal approach to meeting individual needs. Nursing care is of a high standard many people are on a one-to-one dependency contact, with named nurses and keyworkers. We found that assessment procedures and care planning is of an excellent standard, offering detailed information on each person’s progress in the meeting of objectives. The staff and people who use the service all contribute to the team approach to care. The support services all contribute to the team approach, and are recognised by the management for their efforts. We recognised the maintenance of good staffing levels, with in-depth staff training and supervision well established in safeguarding the interests of residents. Policies and procedures were found to be reviewed regularly, and we found evidence of a willingness to seek advice from other health professionals in order to maintain a service which encourages best practice. Overall the attitude in meeting caring and organisational demands is commendable, with forward thinking, planning and application contributing to an excellent service. What has improved since the last inspection? Each requirement and recommendation made following our inspections have been complied with. Information gathered from the AQAA and discussed during our inspection included: Staff having received training on Autism, Communication, Sensory Integration, and the Mental Capacity Act. We were informed of the introduction within the home of the Sexual Awareness Group and the Lifestyle Workshops, and of evening clubs, the Laughing Ladies and the Neo Club for the male residents. DS0000022324.V368857.R01.S.doc Version 5.2 Page 8 A review of the service’s Statement of Purpose, Service User’s Guide and Contract of Residency was confirmed. All care and support plans have also been reviewed and now include risk assessments which help to keep people free from risk. 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. DS0000022324.V368857.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 DS0000022324.V368857.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 excellent. This judgement has been made using available evidence including a visit to this service. The needs of people who may wish to use this service are thoroughly assessed before they are offered a place. In this way they, and their relatives can be confident that the service will be able to meet their needs. EVIDENCE: We examined the service’s revised Statement of Purpose, Service User Guide and pictorial Guide, and found them to provide a very informative description of Edgeview’s aims, objectives, and the way it operated. We were told that an audio version is being prepared to complement the package. We noted that contracts of residence had been reviewed, and specimens of appropriate contracts were presented to us for examination. We found the documents sensitive and informative, offering clear terms of reference of residence. It was agreed that future documents would contain information confirming the room allocated to the new person on pre admission visits. During the course of our inspection we had ample opportunity to sit and talk with people who use the service, staff and a couple of visitors. We found DS0000022324.V368857.R01.S.doc Version 5.2 Page 11 evidence that much care had been taken in involving people and their families in the admission process. “I came for short visits and I liked the home, I have lived here for a long time”. We spoke with a new person who had been admitted to the service, with his family visiting. This person expressed his pleasure at the easiness of fitting in, and the general friendliness around. “First of all I came on visits during the day to talk with other residents, and then stopped over on the weekend”. This was in support of comments received from our completed survey’s which included “I’m satisfied with the care I’m getting in this hotel, I’m satisfied and I like it here everything is fine and alright”. Our examination of three people’s care records and plans clearly demonstrated the extensive efforts to see through the pre-admission and admission procedures and assessments. We found each record showed the attention to individuality and their unique needs, with the assessment formulating a care support plan, based on individual needs, with aims and interventions. On examination we found each area of need was assessed and a support plan generated, such as: • Planning daily activities • Prompting in ensuring the ‘job is done’ satisfactorily. • Assistance with physical and medical health • Prompting in maintaining appropriate social behaviour. • Assistance with laundry skills, budgeting for food, shopping skills, public transport, and general community activities. • Assistance in self-medication, and in tackling more difficult tasks. Similar support care planning from assessment were evidenced from the case tracking of two other people. DS0000022324.V368857.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, and 9. The quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service are involved in decisions about their lives and play an active role in planning the care and support that they receive. EVIDENCE: We examined care plans and found that they offer an excellent record of daily living. They were comprehensive and included a provider assessment; ‘Person Centred Plan, health and safety assessment, and a planned intervention, rehabilitation and therapeutic programme. We found that individual care plans clearly identified the key worker, designed to maximise attention to the specific areas relevant to the person. They were detailed, meaningful, well thought through, reviewed on a three-monthly basis or more often dependant on change. Each record identified to us any specialist input required by the person. We saw that individualised procedures were in place focusing on positive behaviour for people who had the potential to become aggressive. Evidence of health care professional visits showed us an attentive awareness to peoples’ needs. We saw that each day had a different schedule of events DS0000022324.V368857.R01.S.doc Version 5.2 Page 13 encouraging therapeutic and social activities geared to meeting resident’s sense of belonging. Comments received from visiting medical staff indicated: “Works well with service users to enable them to move independent living situations whenever possible”, “Most patients are appropriately placed and needs are met. But some may need change as their state improves. Very cooperative with professionals in making changes”, and “The home appears to give individual needs high priority. Maybe the attention to faith needs of patients can improve”. We case tracked three people who use this service with a full examination of care records, health records, including general practitioners and consultant visits, risk assessments, dependency charts, records of reviews and action plans. The records we inspected showed that people freely make decisions about their life in the home. We recognised that there has been a radical review of care planning arrangements, introducing a needs based monitoring and review process, founded on ‘Person Centred Care’. Risk assessments were carried out on an individual basis, with individual residents, and reviewed as and when needs determine. Included in the care records were applications of established monitoring systems following a process of goals, care and evaluation models. We found the activity centre provided a wide range of facilities for independent expression and facilitating life skills for individuality. During our inspection a lively occupational therapy session was in full swing with a team led by the activities co-ordinator. It was clear to us that much work had gone into promoting personal awareness and a sense of belonging. DS0000022324.V368857.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): 11,12, 13, 14, 15, 16 and 17. The quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The goals, wishes and choices of people who use this service are met at all times. The service views the full meeting of peoples’ needs as a priority. EVIDENCE: Throughout our inspection we saw that people were enjoying the high degree of encouragement to express themselves in positive and meaningful ways. It was most encouraging to see the advances made in social and occupational therapy initiatives, with the activity centre continuing to provide a range of life skills training events, led by an enthusiastic full time activity co-ordinator with two activity assistants. The service’s Annual Quality Assurance Assessment (AQAA) states that the activity programme is agreed with potential residents, and takes into consideration their interests, desires, stated choice, availability, level of supervision and transport requirements. People benefit from new and DS0000022324.V368857.R01.S.doc Version 5.2 Page 15 additional opportunities to develop existing interests further, and experience new activities, and are afforded the opportunity to reach their optimum level of independence. On examining records and speaking with people and staff we found that the information provided in the AQAA was correct. We also found a very strong influence of creativity, not only in the centre, but also throughout the service. Several people were eager to show us their handiwork and achievements. Some comments received from people stated: “Attend workshops, jam pots, packing sweets, play pool, sensory room, day trips, shopping for clothes, make cakes”, “ Staff need to talk to me because I get angry sometimes” and “ Quite often like the Kate best she’s the art lady”. A visiting psychologist said: “Using external professionals, working with people as individuals, addressing peoples health needs”. We were pleased to see that the service has developed an effective ‘Snoezelan’ room, a multi sensory room where individuals can watch light displays, listen to music for therapeutic relaxation sessions. We found opportunities to engage in and experience a whole range of activities to include art and craft, literacy and innumeracy, computer skills, music therapy, keep fit, relaxation and holistic alternative therapies. Our discussions with the Care Manager and people provided evidence of holidays taken, and planned for, to different parts of the country, funded and planned by the people themselves. Routine was seen as flexible to acknowledge individuality, yet maintain a focal point for people to latch on to without dictating events. Relations with the local community, local police and other public bodies were discussed, and considered to be constructive and meaningful. We discussed with the management the service’s policy on sexuality, equality and diversity. There was evidence to show that they were issues dealt with in a sensitive and responsible manner, acknowledging that people are able to develop and maintain intimate relationships with people of their choice. We acknowledged this policy, which was clearly documented in the support plan. We were told that male residents benefit from being invited to and attending a Men’s Health Group, a Sexual Awareness Group for female people, which commenced in January 2008 and ran for eight weeks, and that people are offered a Lifestyle Workshop, facilitated by the Occupational Therapist, a nurse, and two personal assistants. We discussed diversity with the cook, who indicated an awareness in meeting individual needs, there were no special needs at the time. Individual preferences were recorded in assessment and conveyed to the catering staff, who met with, and discussed their requirements DS0000022324.V368857.R01.S.doc Version 5.2 Page 16 We were informed that people living in the independent living bungalow are able to prepare and cook their own meals, in well-equipped kitchenettes, observed by their key worker, under risk assessment. DS0000022324.V368857.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, 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Principles of respect, dignity and privacy are at the forefront of the approach of this service when meeting the personal and healthcare needs of the people who use the service. Medicine administration systems are safe and secure, which helps to prevent risk to people who use the service and promotes their well- being. EVIDENCE: We found that professional and personal support is offered through key workers and named nurses to maximise each person’s life style, with as much privacy and dignity as possible. We found that each care plan is individualised to match personality and personal expectations. We confirmed through case tracking, that this has established that the service operates a clear policy of a flexible routine, founded to meet and encourage self-determination, tailored to meet their needs, in a non-patronising manner, and delivered with an observed empathy of close bonding. DS0000022324.V368857.R01.S.doc Version 5.2 Page 18 Case tracking confirmed to us that specialist support and advice are sought as needed, with each resident being registered with a local Doctor, Dentist, Optician, Chiropodist, and Occupational Therapist. They were seen to have access to appropriate physical and mental health services, as required, including a psychiatrist, who visits weekly, and a psychologist attending on a fortnightly basis. Through case tracking, our discussions and inspection of records, it was recognised that should special health care needs be recognised, the relevant service was consulted. Comments received from completed surveys showed: “Go The GP for hearing aid - checked by the staff, sunglasses - don’t like sun, medication given by staff”, and “When I need to see the doctor I need to see him, medication also given for constipation pain”. Medical comments were: “Very keen to access outside guidance, very keen to address al health needs well”, “ Using external professionals, working with people as individuals, addressing peoples health needs”, and “Always seek my advise or other professionals involved with regard to health care needs”. From examination of records we found that personal choice and relative selfdetermination are respected in policy and action, with those who wish to bring in personal possessions encouraged to do so. All rooms we examined showed a uniqueness and individual selection of décor and ornaments, trophies and mementos. We felt the general atmosphere throughout the home was one of family, confidence, warmth and contentment. Staff were observed in addressing people in a respectful and dignified way. We confirmed that the administration of medicines adhered to procedures to maximise protection people who use the service. Since our last inspection there has been a full review of procedures and practice. We found that a senior nurse is responsible for overseeing all matters relating to medicines. He has effected a smooth process of ordering, receiving, storing, administering and disposing of medicines. Records were seen to be complete and easy to follow through, with no observed breaches in the system. Controlled Drug management was comprehensive. There had been some difficulties in getting the drug disposal contractors to sign for received medicines, thereby failing to complete the audit trail – this issue will be followed up by the Manager. The Homely Medicines arrangements would be further complemented with a full acknowledgement of all the doctors attending people at Edgeview. A medical comment received stated: “Extremely good in ensuring medication compliance and reporting problems with compliance”. The individualised style of care provided we found, openly addresses the issues of serious illness and death. Care records showed to us that residents were aware of the concern that care staff hold, to ensure that all appropriate care and attention would be given. We acknowledge that residents and their family DS0000022324.V368857.R01.S.doc Version 5.2 Page 19 views are sought in relation to ageing, becoming terminally ill and dying. Their wishes in respect of this are considered paramount from the basis for support planning. The spiritual affiliation of each resident is determined and recognised with dignity DS0000022324.V368857.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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a meaningful complaints policy. People are given opportunities to freely express any concerns and these are quickly responded to. People are protected from abuse and their human rights are promoted. EVIDENCE: We found that peoples’ legal rights are protected by the systems in place in the service to safeguard them, including their contract, the continual assessment of care planning and policies in place, for example, the complaints procedure, which we examined. There were a few minor complaints, which we feel would be better dealt with through a ‘record of concerns, complaints and safeguarding’, to record peoples’, and their families’ concerns in a meaningful and effective manner. From our talks with people who use the service, and staff, it was evident that any small matters were handled immediately, discretely and to the satisfaction of all concerned. All people had received information on the procedure to complain, including reference to us. This process was evidenced through the Service User Guide, on examination and case tracking and discussion. We identified that there had been no complaints made to us since the last inspection, and one referred safeguarding issue, resolved with no further action considered necessary. Our case tracking confirmed the effectiveness of a Provider, Care Manager and staff sensitive to people’s needs, and a readiness DS0000022324.V368857.R01.S.doc Version 5.2 Page 21 to test the robustness of their information and report structures. We found the policy and procedure for handling issues of abuse (safeguarding) to be effective, and recently updated with a recognised link nurse coordinating contact and action, as well as influencing policy. The Operations Manager of the home has a qualification as a Crisis Prevention Institute Instructor for Nonviolent Crisis Intervention. Other members of staff are actively pursuing the qualification. We examined three staff records to confirm that staff were suitably checked through Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) disclosure. We found staff received training on abuse at induction, this includes the right to ‘whistle blowing’ consistent with the Public Disclosure Act 1998. DS0000022324.V368857.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): 24,25,27, and 30 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Edgeview provides a safe, well-maintained and comfortable environment for the people who use the service, with a layout that encourages independence. EVIDENCE: The service is situated in three acres of land close to the picturesque village of Kinver. We found that people who use the service benefit from the extensive size of the property and surrounding gardens, and are able to easily access the local community. Our consideration is that Edgeview is well appointed to meet the needs of people with learning difficulties, in providing a safe and comfortable environment. We were informed that on admission the Care Manager assesses each individual’s needs for equipment and necessary adaptations, we found this to DS0000022324.V368857.R01.S.doc Version 5.2 Page 23 be correct and saw those facilities available throughout the Home. Efforts had been made to provide a homely atmosphere and the décor in most areas of home was found to be of a good standard. “I had my room painted blue and a new carpet”, “this nice home is nice and clean and comfortable, I like this home”. Comments from visiting professionals indicated: ” The sheer size of the building necessarily imposes some limitations”, although “I would recommend this home for placement when stepping down from a low secure placement”. We recognised that the home provides several lounge areas including a Snoezelen (sensory room), computer and satellite television lounge, a quiet area used frequently for occupational therapy needs and a recognised, risk assessed smoking room. We found each were pleasantly decorated, providing essential furnishings and items to provide comfortable areas where people were able to interact, or to entertain their guests. There is a social activity area offering a selection of recreational facilities to complement a popular activity centre. Our inspection found that each room offers single accommodation, each person encouraged to bring their own personal possessions and furniture if they so wish. We recognise the intention as achieving a sense of identity, a place of comfort and privacy. When looking around the premises we acknowledged that bedrooms were highly personalised, with their own televisions, a range of electronic games and players, all found to have been PAT (Personal Appliance Tested). On examining the Stables and Bungalow we observed an ongoing redecoration and repairs in progress. The kitchenette areas are well presented, adequately stocked and equipped with suitable domestic appliances. We confirmed through case tracking that all people had been suitably risk assessed. The service’s policies and procedures complied with the fire service requirements, having complied fully with a recent fire officer’s report. Adequate attention has been given to ensure maximum privacy within riskassessed boundaries. We found that toilets were located on both floors, in close proximity to bedrooms and communal areas; although we found one of the toilets requiring repair, and one a smoke detector. We saw that all bathrooms and shower areas were of a good standard, clean and pleasantly presented. We inspected the kitchen, and found it to present a well equipped and organised area. All of the fridges and freezers were well maintained and checked daily by the kitchen staff. The kitchen was clean and considered secure, although a cleaning schedule needs to be established to evidence an effective standard. We found the laundry area to be clean and very well organised; procedures were in place for coping with soiled or infected linen with the provision of alginate bags to minimise handling and cross-infection. Disposable gloves and DS0000022324.V368857.R01.S.doc Version 5.2 Page 24 aprons were seen in use, and liquid soap and paper towels were evident throughout. The service presented a clean and pleasant atmosphere, much to the credit of staff. DS0000022324.V368857.R01.S.doc Version 5.2 Page 25 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36. The quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing levels ensure that suitably trained staff are provided to meet the needs of people who use the service. Recruitment processes are consistent and robust, protecting the people who use the service from harm and abuse. EVIDENCE: We found that the service has maintained staffing to consistent levels to ensure equilibrium between numbers, skills and qualifications, with a strong presence of long serving, stable and experienced staff. There were 23 people using the service in the home on the day of the inspection. We found evidence through case tracking of a multi-disciplinary approach to holistic needs, with staff appreciating each other’s contributions, well presented in their staff induction programme, and reinforced through continued supervised training sessions. Our discussions with staff also confirmed their commitment to providing a quality service, and their awareness of the principles of good practice and Code of conduct. DS0000022324.V368857.R01.S.doc Version 5.2 Page 26 We acknowledged that the Registered Provider continues to present a high profile in the management and organisational process, working closely with a highly committed Operations and Care Managers. This team offers a consistent, detailed, knowledgeable presence, essential to the efficient running of a demanding service need. Comments we received included: “I feel to turn to a member of staff”, “I am happy with the staff, and completely happy with what they say”, although one stated: “I would like to have less one to one”. We examined three staff files, each providing satisfactory evidence that the process of appointing new staff were well organised, consistent and contributed in safeguarded the interests of residents. There is a satisfactory staff induction programme, which we found initiated a formal in-house training schedule. NVQ programmes continue with a commitment of internal assessors and the contribution of Dudley and Kidderminster colleges. We accept the commitment to care education as sustained and enhanced. Staff have received training on mandatory and specific issues, including Autism, Communication, Sensory Integration, and in Non-violent Physical Crisis Intervention. Residents diagnosed with schizophrenia are supported with training delivered to staff by a link nurse supported by a Clinical Psychologist. A comment from the medical staff stated: “The staff I have interacted with have a wealth of experience and skills in managing challenging behaviour as well as mental health problems”. The supervision programme is firmly established, which involved establishing a shared aspect of responsibility between staff and trainer, with the involvement of mentor trained staff. DS0000022324.V368857.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): 37,38,39,40,41 and 42 The quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care team promote the health, safety and welfare of people using the service, and working practices are safe. People who use the service can be assured that the home is run in their interests. The ethos of the service is based on openness and respect. EVIDENCE: We recognised that the Registered Provider and the management team present an active leadership in management style and direction, engaging at a day-today level of involvement. The care manager, Julia Jasper has demonstrated to us her wide experience, and is well qualified in meeting the aims and objectives of the service. As previously stated she is a member of a strong and effective management team. DS0000022324.V368857.R01.S.doc Version 5.2 Page 28 We found a confidence in the interaction between people, relatives, staff and the service’s management that demonstrated a positive relationship that pervades throughout the service. This open style of management was mentioned to us by several people, which provided a source of trust and mutual respect. “I’m satisfied with the care, I’m getting in this hotel, I’m satisfied and I like it here everything is fine and alright”, “I go to see Julia and Jane and speak to them if I am not happy”. The consultant psychiatrist stated: “Individuals are given opportunity for a good quality of life’ within the limits of risk assessment”. We recognise that quality assurance complements this arrangement, in that we found extensive monitoring in areas as care planning, staff meetings, staff training and people who use the services suggestions. The case tracking undertaken reinforced the effectiveness of people’s involvement in their care and environment. People who use the service were aware of our inspection’ and several asked to speak with us, showing us their rooms and involvements in daily life. Nine peoples’ and two professionals’ surveys were forwarded to us, with comments being mainly complementary and constructive. We had a meaningful discussion with the ‘link resident’, who told us of general issues of daily life, her environment and her relationship with members of staff. We were informed that each person has a personal file containing contractual, financial and personal information. The three files we inspected evidenced a satisfactory standard. We sampled administrative, maintenance and care records and found them to offer an accurate reflection of a service, committed to providing a safe and comfortable environment. Staff training programmes were presented to us, showing evidence of Health and Safety, first aid, moving and handling and fire training, each were recorded satisfactorily. Servicing records of essential equipment were examined including gas and electrical maintenance, including ( Portable Appliance Testing (PAT) testing. We found that all accidents and incidents were recorded for staff and people, looking at the effect on care planning and risk assessment. We found that the administration and management of the service is efficient, uncomplicated and sensitive to the needs of people who use it. Relevant legislation was discussed, and has been implemented by the management. DS0000022324.V368857.R01.S.doc Version 5.2 Page 29 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 4 2 4 3 4 4 3 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 4 26 4 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 4 34 4 35 4 36 4 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 3 12 3 13 3 14 4 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 3 4 4 3 3 4 4 3 DS0000022324.V368857.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA5 Good Practice Recommendations The service should make sure that contracts offered to people contain the agreed room number allocated prior to admission to make sure that people are guaranteed the room that was offered to them. To increase the safety of medication management the service should review arrangements with disposer of unused medicines to accept responsibility for the hand over of unused drugs to complete the audit trail of medicines. To further increase medication safety the service should make sure that the Homely Medicines checklist be signed on behalf of all the medical staff that attend Edgeview. To further improve processes a ‘Concerns, Complaints and Allegation’ book should be established to more effectively monitor incidents. To improve the environment further attention should be given in upgrading one upstairs toilet, to safeguard against possible injury to people who use the service. DS0000022324.V368857.R01.S.doc Version 5.2 Page 31 2 YA20 3 4 5 YA20 YA22 YA42 6 7 YA42 YA42 To make the environment safer the service should attach a smoke alarm in an upstairs toilet to facilitate effective fire prevention systems. To make the environment safer and reduce any risk to people who use the service the kitchen manager should establish a record of cleaning to evidence observed standards of cleanliness. DS0000022324.V368857.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 DS0000022324.V368857.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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