Inspection on 07/11/08 for Finland Street 63

This inspection was carried out on 7th November 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Finland Street 63 11/12/07

Finland Street 63 20/11/06

Finland Street 63 20/02/06

Finland Street 63 08/03/05

Finland Street 63 09/11/04

Finland Street 63 10/03/04

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Ashlong House

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Finland Street, 63 Finland Street, 63 London SE16 7UA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Meaker     Date: 1 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Finland Street, 63 Finland Street, 63 London SE16 7UA 02072523875 02082998598 choicesupport@choicesupport.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Choice Support care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 4 Date of last inspection Brief description of the care home 63, Choice Support, who also provides other care homes in the borough for people with learning difficulties, manages Finland Street. The home is a modern, purpose built, single storey building where each service user has their own bedroom. There is also a range of communal areas, a small patio and garden in the front of the house and ample on-street parking. The home is situated in the heart of Surrey Quays, a relatively new development that has transport links, a shopping complex and leisure facilities. The home has room for four service users who all have complex support needs and high dependency levels. At the time of inspection there were no vacancies; information was not available on weekly fees for the home. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 11th December 2007, it was a key inspection. This was a statutory unannounced key inspection; a site visit was made on the 7th November 2008, the visit lasted five hours; the inspector was joined by an Expert by Experience for the last two hours of the inspection. The manager of the service had completed the Annual Quality Assurance Assessment giving evidence to what the service does well and gives them an opportunity to say what they feel they could do better and what their plans are for the future. Documentation was looked at relating to pre admission assessment, the care plans, the risk assessments, medication, health and safety, the menu and the activity programme. Staff files, training records and rotas were discussed with the home Care Homes for Adults (18-65 years) Page 5 of 29 manager. During the visit there was some communication with the people who use the service; and conversations with the home manager and staff. Checked that the staff had the knowledge, skills and training to meet the assessed health, personal and social care needs of the people who live in the home. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit to the service. A number of questionnaires were sent out prior to the visit to ascertain the views of the people who use the service, their relatives, staff and other healthcare professionals who visit the service. What the care home does well: What has improved since the last inspection? What they could do better: The service is to access specialist training around pressure sore care and prevention. Access the use of assisted technology around epilepsy care by researching available Care Homes for Adults (18-65 years) Page 7 of 29 products and applying for funding. To access different activities that the residents may enjoy within the local community. To redecorate the house to change its outlook by liaising with the owners of the property and involving the residents in choosing colours and furnishings. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisation provides comprehensive information to enable prospective residents and their family to make an informed decision as to whether they want to live in the home. A pre admission assessment is undertaken, involving the resident and their family, thereby ensuring the assessed health, personal and social care needs can be met. Contracts are clear and fair and protect the people living in the home. Evidence: The organisation has a Statement of Purpose giving details of the aims and objectives of the service; this is complemented by the Service User Guide. The Statement of Purpose gives information relating to the organisation; a description of the service, facilities and support provided; the admissions and discharge policy; the complaints policy and procedure; individual contracts and the license agreement The service User Guide, a copy of which is given to each resident contains a summary of the Statement of Purpose; the aims, objectives and principles of the service provision; the rights of the resident; terms, conditions and fees; complaints and Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: compliments; quality assurance, key policies and procedures; useful addresses; how to contact the organisation; details of insurance cover and the reviews of the document. The organisation follows an in depth admission policy and procedure this ensures all parties have the relevant information prior to making a decision to move into the home. The pre admission assessment process ensures that the orgainsation is able to meet the health, personal and social care needs of the individual There is a thorough referral process and a moving in checklist is in place to make sure all concerns and issues are addressed prior to the individual moving into the home. New residents are given an individual guide which is clearly written using an appropriate format, for example large print, and time is spent going through this with the new resident to ensure that it is understood by the individual. This was evidenced when a new resident moved into the home. The staff from Finland Street went to visit him to find out how he liked to be cared for and how best to meet his health, personal and social care needs; visits were then arranged to Finland Street so he could become accustomed to his new surroundings and the new people with whom he would be living. This process took time and once all parties were comfortable, the new person moved in, the move has been successful and he has settled down really well, fitting in well with the current residents and seems to be enjoying living in the home. Compliments have been received from the new residents family and from his social worker relating to how the move was handled, how well he has settled and the high standard of care he receives. Four personal files were seen and all showed that pre admission assessments had been carried out; there was also documentary evidence of assessments and referrals from the local social services. These assessment documents formed the basis of the person centered plan of care for the four individuals currently living in the home. It was evident from the interaction between the residents and the staff and residents, that they appeared to be happy in their home and that the staff had a good empathy with them and understood their sometimes very complex needs. The four residents in this home have profound disabilities and needed a high level of good care to met their needs. From observing the manager, residents and staff it was evident that the assessed health, personal and social needs were being met. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans were person centered, they were personalised and individual to each resident who uses the service; thereby promoting their independence and enabling them to make choices about how they want to live their lives in the home and in the wider community. The service enables them to take appropriate risks to enable them to achieve their own aspirations, and thereby achieve their goals. Evidence: The organisation uses a person centered care planning process; working in partnership with social service commissioners, health professionals and the social work team in assessing the personal, health and social care needs, encouraging and supporting them to achieve a lifestyle incorporating their choices, wishes and preferences. The staff provide the encouragement and support to enable the people who use the service to take risks and understand the implications of those risks thereby involving them in all aspects of their daily lives. Through the introduction of person centered care Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: planning, the people who use the service have the opportunity to be involved in the day to day running of their home; attending the key worker meetings where decisions are made relating to what they want to do in the next six weeks; at the end of the six week slot the goals that were set are reviewed to ascertain whether they have been met; if not discussions are held as to why the goals were not achievable and systems are put in place to see how they can be met. There are clear support plans in place to identify how the people who use the service want their support delivered; each person has a service user guide and a detailed support plan that determines their individual requirements relating to personal, health and social care needs. The staff team supports the people who use the service to maintain family and friendship links by creating access to the community and making sure that the home itself cultivates links with the local community by using leisure, social, educational and shopping facilities within the local area. Key worker meetings are held every 6-8 weeks and the information is passed on to other staff via team meetings and staff supervision; this is done in a sensitive way ensuring confidentiality and promoting consistency in the care for the individual. Service delivery plan meetings are held 6 monthly and Care Management reviews are held annually. The people who use the service are supported to take risks as part of an independent lifestyle, risk assessment strategies are in place and are reviewed at 6-8 weekly intervals; risk assessments cover behavior and activities within the home and in the wider community; staff understand the need for the people who use the service to take risks; but these risks need to be minimised enabling them to grow and develop as individuals. The home has purchased a cordless phone so that the residents can receive and make telephone calls in private. The residents are now able to receive and make calls whenever they wish without going to the office. The manager and staff of the home are looking towards providing new and meaningful activities for the residents such as sailing, swimming, fishing, going to football matches, one resident has a season ticket for a local team; the residents had enjoyed a trip to the local ten pin bowling venue and on the evening of the inspection day were going to see the latest James Bond film at the shopping centre cinema, which is within walking distance of the home however the home does have adapted transport for the residents to use.The organisation has now implemented the Reach Standards Its my Life; the action plans are in place and the staff are engaged in encouraging and supporting the people who use the service to achieve their goals. Evidence of these initiatives were to be found document in the residents personal files and details of activities undertaken by the residents were given by the manager and staff at the time of the inspection; questionnaires received also confirmed the good Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: standard of care and that the assessed health, personal and social care needs of the individual were being met. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are supported and encouraged to participate in activities to enable them to live fulfilling lives in the home and also in the wider community. Evidence: The manager and staff at the home offer the people who use the service a whole range of activities in the home and in the wider community. The main purpose of the home is to offer the people who live there with more profound and severe disabilities, opportunities to learn to be involved in all activities and to improve their basic skills; the manager and staff seek to empower their residents to retain any skills they may have already have or have subsequently learnt. The service is able to meet the cultural needs of all the people who use the service and they are supported to maintain their family and friends networks. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The meals provided are nutritious, tasty, they promote healthy eating and also reflect the cultural needs and individual preferences of the individual. The people who use the service are supported to undertake a range of activities suited to their capabilities, wishes and preferences; they can chose to attend the local college for a range of courses; go swimming at the local leisure centre, have lunch out in pubs and restaurants; attend church services and activities organised by the local church, attending the Octopus Club, taking walks in the local area, going shopping, cooking, gardening, going to football matches, going to the local cinema, ten pin bowling, fishing and trampolining. One of the residents goes to the local church every Sunday and is well known and is involved in related activities; two of the other residents attend less frequently. All the staff have completed the person centre care plan training making; the plans are developed to ensure that the goals set by the individual are achievable and that they are able to access new activities such as sailing which some of the residents have expressed a wish to undertake; the manager is looking into how this can be accessed. The manager ensures that the people who use the service, their family and advocates are given every opportunity to participate in the decision making processes if the person who uses the service wishes. The people who use the service have a regular plan of activities and these are tailored to the individual and changes are made as and when needed this ensures that the person is able to make choices and to promote the individuals freedom to do what they want when they want. The people who use the service are consulted and supported to create a menu for the coming week; this ensures that the menu reflects their likes and dislikes; but the staff also try to ensure that the menu reflects the need for healthy eating. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager and staff of the home have a good understanding of the needs of the people who live in the home, ensuring that the personal and health care support given complies with their wishes and preferences. The home has good policies and procedures relating to the safe administration of medication ensuring that they comply with the guidelines issued by the Royal Pharmaceutical Society. Evidence: The manager and staff of the service support the people living in the home who have complex health needs ans severe to profound learning disabilities. They make sure that all the staff are familiar with the care needs of the residents and show sensitivity in the approach to the residents individual needs. This is clearly shown by the support given to the very different health issues posed by all the people who live in the home. It was evident from observing the interaction between the people who live in the home and the staff who support them that the staff respect their right to privacy and independence, support and encouragement was given in a compassionate manner and the residents wishes and preferences were considered. The people who live in the Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: home have very good relationships with the health care professionals who visit the home in various capacities for example the GP, district nurse, psychiatrist, occupational health and physiotherapists; these professionals are familiar to the residents and have insight into their complex health needs. All the people who live in the home have problems around mobility; all of them are wheelchair users and two of them cannot weight bear and these two need to be transferred by using standing/ceiling hoists; a third person is able to move around the house on his knees; this means that there are many issues relating to moving and handling requiring the staff to have the skills, experience and training required to meet these specific needs of each individual. The district nurses attached to the GP surgery are available on a regular basis to come into the home to advise on continence issues and pressure area prevention and care if necessary. One of the people living in the home requires a pureed diet and advice has been sought from the dietitian at the GP surgery; two of the other residents have swallowing and eating difficulties and require input form the speech and language therapist. Where it is identified that the people who live in the home have a lack of capacity to consent; best interest meetings are held and their family and an independent advocate are fully involved. All the residents have a six monthly medication review; other health reviews include dentistry, podiatry, psychiatry, epilepsy, audiology and optometry. Systems are in place for the safe administration of medication; MARS were checked as was the medication file, all documentation relating to the safe administration of medication was found to be in order, correctly recorded on all levels; medication is reviewed on a regular basis by the community pharmacist. All those living in the home have a health action plan in place, that is created in conjunction with the GP surgery that is reviewed on a regular basis. All the staff undertake yearly medication refresher training and have their competency to administer medication tested annually. The manager intends to implement a new checklist around health appointment to ensure consistency of care and clarity of information. There will also be training courses for staff relating to pressure area prevention and care. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are protected by the organisations policies and procedures relating to complaints and Safeguarding Vulnerable Adults; thereby ensuring people who use the service feel safe and secure in their home environment. Evidence: The organisation has sound policies and procedures relating to complaints; these are identified in the homes Statement of Purpose and Service User Guide and displayed on the homes notice board. The home has a Safeguarding policy and procedure that has been developed in conjunction with the governments No secrets legislation and the local authoritys safeguarding vulnerable adults policy and procedure. It was evident from looking at the training plan that staff received appropriate training relating to Safeguarding Vulnerable Adults. The policies and procedures are summarised in the staff handbook as is a code of conduct. It was evident from speaking to the staff that they are aware of the organisations policy and procedure relating to whistle-blowing and that they are aware of the need to report any suspicions they have relating to safeguarding thereby ensuring transparency. Staff confirmed that they are able to access Safeguarding Vulnerable adults training and that this is updated annually. The home has recently sent all the relatives of the people who use the service a copy Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: of their complaint policy and procedure so they are aware of how to make a complaint or voice a concern about any issues they have relating to the home. There have been no complaints or safeguarding issues since the last key inspection 12 months ago. The home manager conducts weekly finance checks; finances are audited every three months and a monitored on a monthly basis. Property lists, securities books for all residents are maintained and staff are clear about their responsibility for residents valuables. The home manager has added the Safeguarding of Vulnerable Adults as a fixed agenda item at all team meetings and supervisions. The home manager is currently working with Respond who will re-interview the people who use the service to see if they feel safer and know about the policies and procedures following training delivered to the homes staff by Voice UK. The home manager is looking to create a DVD to enable the people who use the service to fully comprehend the complaints policy and procedure and to deal with issues relating to Safeguarding. The manager is currently implementing the Reach Standards to support the people who use the service and train the homes staff to become Quality Checkers; the standards will be used to conduct individual service reviews; a whole service review and quality checks. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensures that the home enables the people who live there to maintain their chosen lifestyle by providing accommodation and facilities to meet their assessed individual needs. Evidence: The home is situated in a residential street and has good access to local transport and local amenities. The shopping centre is within walking distance and the home is within easy reach of local parks, Surrey Quays with access to a wide range of shops, cinemas, bowling alley and restaurants; there is also access to a leisure centre. The home is a purpose built bungalow and is fully adapted for people with severe mobility problems, it is wheelchair friendly with wide hallways and spacious toilets and bathrooms; the bedrooms are individually furnished, decorated and personalise to the persons tastes reflecting their interests and hobbies; this was evidenced whilst walking around the home and visiting the bedrooms of the people living in the home The house is well maintained and cleaned to a good standard, the house has a homely feel and from observing the residents it was evident that they could move around easily and that they felt at home and comfortable in the house. A housing association own the building and the home manager has a good working relationship with the association and has an assigned housing officer who is Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: responsible for the homes development plan. The orangisation has policies and procedures in place relating to health and safety including infection control. The home manager makes sure that the people who live in the home are consulted about re-decorating and refurbishing the home; their opinions are sought and listened to and incorporated into the plans. The house has been decorated since the last key inspection; there has been a new bath installed and the bathroom and toilets have been redecorated. A new hob and large freezer have been purchased, a new washing machine and some curtains have been replaced. The people who use the service have a large communal lounge where activities take place; the lounge is comfortably furnished with plenty of space for wheelchairs and there is also overhead tracking for hoists so that residents can be moved safely and comfortably. The kitchen/diner is spacious with a large communal dining table where all the residents can sit comfortably to have their meals; there is plenty of space for staff to sit to help those who need support and encouragement to eat. There are small gardens to the rear and front of the property. The house is well equipped with specialist aids to assist the people who use the service ensuring that they are able to maximise their independence; the beds are of nursing quality; adjustable with overhead tracking for hoists and overhead poles to assist with mobility and thereby meeting the assessed needs of the people who live in the home. The home manager ensures that there is a maintenance plan that ensures that all equipment is kept in good order with regular safety checks and that the house is maintained to a good standard. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manger and staff team are skilled, competent and experienced in caring for the people living in the home; this has been achieved by effective and efficient recruitment, selection, supervision, appraisal and training Evidence: This service has an established, skilled, competent and experienced staff team; this is evidenced by the robust recruitment and selection policy and procedures.They have access to mandatory and specialized training; they have regular supervision with the home manager and also have an annual appraisal. From speaking to the staff it was evident that they were interested, motivated and committed to providing a good standard of care and that they had a good knowledge of their residents complex care needs. The staff also have the skills to create positive working relationships with other relevant healthcare professionals and this has reinforced the network of support that the people who use the service. There is a training and development plan for the service and each member of staff has their own training and development plan that is compiled and agreed at annual appraisal. Each member of staff has supervision with the home manager, every six to eight weeks, where the objectives set at the annual appraisal are reviewed. Team meetings are held on a regular basis and are documented. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Ten staff members have attained NVQ level 2 and one member of staff is working towards NVQ level 3. This service has good retention of staff and many of them have been working at the home for a number of years; this ensures that there is continuity of care and that the people who live in the home have empathy with the staff; this was evident from observing the resident/staff interaction during the visit to the home. The home manager is to make sure all the staff and residents attend training in implementing the Reach Standards. Staff are to receive specialist training relating to pressure area care and prevention. The staff team is to hold two team days over the year where staff will receive training relating to specific areas of the care of the people who use the service particularly if they have a complex learning disability or medical problem. One staff member who has good management potential has been given the opportunity to develop by being allocated specific tasks; all the processes put in place by the manager and the organisation have resulted in the service maintaining a stable staff team. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service benefit from efficient and effective leadership from a skilled, competent and experienced manager; ensuring that they are can feel safe and protected within the home. Evidence: The service is run well by a committed home manager and a dedicated team of staff who are skilled and experienced with their client group. There are regular monitoring visits by the organisations service manager who completes a Regulation 26 report on a monthly basis. The service has also adopted the Reach Standards enabling residents and staff to become quality checkers and the manager will use the standards to conduct reviews of the people who live in the home, the standard of care in the home and the standard of the environment, thereby ensuring there are regular, documented quality checks. The service has a stringent policies and procedures relating to health and safety in place; this ensures that they met current health and safety legislation, for example the Health and safety at work Act 1974 and the Management of Health and Safety at Work Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Regulations 1999. The Health and Safety committee meet quarterly to discuss issues and respond to any concerns raised, there are appropriate risk assessments in place ensuring that the people who live in the home and the staff who work there remain safe and risks are minimised. The organisation runs a Service User Advocacy group called Surprise that represents the views of the people who live in the home. The organisation has an external health and safety adviser and the home manager is responsible for implementing the organizations policies and procedures and is able to call on the adviser for help and advice. Weekly health and safety checks are carried out in the home and they are all documented these include fire alarm checks, lighting checks, fire drill, water temperature checks, fridge and freezer temperature checks. There was evidence to support that the staff had attendee mandatory training, first aid, moving and handling, food safety and health and safety. A copy of the Choice Support business plan is available at the service and the home manager has made the staff aware of the goals that relate to the service. The organisations mission statement demonstrates that there is clear evidence of the service values. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 34 Sch 2 The registered person must 31/07/2009 ensure that recruitment documentation is available at the home. Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!