Inspection on 28/03/07 for Ford Road

This inspection was carried out on 28th March 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ford Road 18/11/05

Ford Road 05/07/05

Ford Road 10/03/05

Ford Road 10/06/04

Ford Road 09/10/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Ford Road 98a Ford Road Dagenham Essex RM10 9JP Lead Inspector Julie Legg Key Unannounced Inspection 28th March – 4th April 2007 10:00 Ford Road DS0000027899.V334633.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 Ford Road DS0000027899.V334633.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. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ford Road Address 98a Ford Road Dagenham Essex RM10 9JP 0208 596 9377 F/P 0208 596 9377 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) Outlook Care Mr Darren Osbourne Care Home 7 Category(ies) of Learning disability (7), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. As agreed on the 24/05/2006, two existing service users, with a dual diagnosis of learning disability and mental disorder, can be accommodated within the home. 18th November 2005 Date of last inspection Brief Description of the Service: Ford Road is a purpose built care home for 7 people with learning disabilities. The home is on a bus route and is within a 20-minute walk of the local railway station and is within easy walking distance of shops and other local community resources. The home is detached and situated in a residential are of Dagenham. Accommodation is in single rooms, with a separate lounge and dining room and a domestic style kitchen. The home is not designed for people with a physical disability, as there is no passenger lift to the first floor. The Statement of Purpose and the Service User Guide are issued to every prospective resident and these documents can also be found on the service users’ notice board. A copy of the most recent inspection report is also available. The weekly fees for the home are £949.45 a week this information was given by Caroline James (Service Manager) on 23rd April 2007. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took place over two days; this was due to the manager not being available on the first day of the inspection, which meant some staff files were not available. The first visit took place during the day and the second during the evening. The inspector was able to speak to all seven service users about their experience of living at the home. Six relatives were also contacted and gave their views of life at Ford Road. Discussions took place with the acting manager and four of the care staff; Staff were spoken to about care practices and their employment at the home. The inspector also observed interaction between the service users and staff, which was friendly but professional. A tour of the home was undertaken and a number of staff and resident’ records were examined. The acting manager has applied to the Commission to become the registered manager. The inspector had a discussion with staff and people living in the home about how they wished to be referred to in the report. They expressed a wish to be referred to as service users. This is reflected accordingly throughout the report. The inspector would like to thank the service users and staff for their assistance during the inspection, in particular the service users who showed the inspector around their home. What the service does well: The home is well managed and has a very welcoming and relaxed atmosphere. Behavioural issues are being well-managed using ‘Positive Response Techniques’. The home is run in the best interests of the service users, who are involved with the daily running of the home. All of the service users told the inspector that they were happy living in the home and did not want to live anywhere else. Relatives commented that staff are very welcoming, approachable and helpful and they are very happy with the care their relatives receive. Care plans are person centred and are in written and pictorial format. The plans showed medium and long term goals are being set to enable service users to improve their lifestyle skills and their independence. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 6 All of the records were up to date and well kept with information readily available. Healthy and safety records in particular were well documented and evidence showed that all regular checks are being undertaken, with one of the service users being responsible for the fire drill. All of the staff are NVQ trained and have received other relevant training. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2 and 3 People who the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Prospective service users and their relatives have the information they need to be able to make an informed choice about moving into the home. The assessment of needs and other information received from health and social care professionals means that staff have detailed information to enable them to determine whether or not they can meet the needs of prospective service users. Prospective service users know that the home can meet their needs. EVIDENCE: The Statement of Purpose and the Service User Guide are both in pictorial format, which enables prospective service users to know what the home is like and what services they can offer. The Statement of Purpose does need to be updated to reflect that the previous manager has left Ford Road and the current staffing levels. This is Requirement 1. The current service users have been living at the home for some considerable time; the most recent service user has been living at the home for four years. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 9 It is the procedure of the home to ensure that any new service users are appropriately assessed prior to admission. The funding authority and health professionals will provide assessments as well as the home carrying out their own assessment. Further information will also be gathered from the prospective service user and their families if appropriate. The admission process will be designed around the needs of the prospective service user. The prospective service user may make several visits to the home and possibly an overnight stay to ensure that they like the home and to meet the other service users. This transition period also allows staff to get to know the prospective service user and to know whether they can meet the prospective service users’ needs. One service user told the inspector “when I came to the home, the staff were kind”. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,8 and 9 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. All of the service users’ identified needs are reflected in up to date care plans and risk assessments. This ensures that service users’ needs are being appropriately met and that service users and others are safeguarded. The service users, some with assistance, are able to participate in all aspects of life in the home and to make decisions about their lives. EVIDENCE: The manager and staff have ensured that the service users are involved in all decisions about their lives. There is a care planning system in place that is clear and concise. Each service user has an individual person centred care plan and this information is provided in pictorial format. These care plans were Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 11 completed with the involvement of the service user and their relatives (if appropriate). The pictorial format is photographs of the home and the service user e.g. one picture is of a service user standing with his washing by the washing machine and the wording is ‘I need help putting my clothes in the washing machine’. Each service user has a ‘my life book’ and a care plan folder. These very comprehensive documents cover areas of the service users’ lives, such as, likes and dislikes, what I need help with, how I would like to be helped, things that I am good at, things that I like to be reminded of and what I want. One service user doesn’t like hot water in his bath, he does not like attending college or staying in the house. He likes going on trains, buses, shopping and going to London. To enable this service user’s needs to be met he receives 1:1 support for four hours every day. One of the service user’s wishes was to see inside an aeroplane and look at where the pilot sits. The service user was taken to Duxford aerodrome and was able to sit inside the cockpit; he said, “I loved it”. All of the service users are involved in bi-monthly meetings with their keyworkers, where their life care plan is reviewed. A Mencap advocate is involved with the service users and assists them in decision- making within the home, such as, the recent redecoration and refurbishment programme of the home. From the evidence gathered it is obvious that the manager and staff have put a lot of hard work into this aspect of the service users’ lives and a score of 4, commendable, has been given in recognition of this. Each service user has their own diary where the daily records reflect the assistance that has been given on a day-to-day basis and how service users are involved in the life of the home. They are involved in menu planning (using pictures), shopping trips, cooking, and as stated above the redecoration of the home. They are also consulted on activities in the home and in the community. All of the service users (some with assistance) are able to put their laundry in the washing machine, some of the service users keep their own bedrooms clean and undertake other tasks within the home such as, making tea, peeling the vegetables, preparing sandwiches and hovering. Other records seen, showed service users’ choice of meals, whether or not they participated in activities within the home and community. A score of 4 has also been given in recognition of staff, ensuring that the service users are involved in every aspect of life in the home. Staff were observed interacting with the service users, their relationship was easy going and friendly but in a professional manner. Staff were seen to ask service users what they wanted and the appropriate assistance was given, if required. One of the service users wanted to go to the shops and a member of staff took him to buy a magazine. Service users are encouraged to take reasonable risks. Risk assessments that were examined showed areas identified such as, behavioural, tasks and activities within the home and in the community, health risks and medication Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 12 and what action to be taken. These risks have been forwarded to the service user’s care plans. Risk assessments were seen to be updated and one risk assessment was recently updated due to a change in a resident’s behaviour. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15,16 and 17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users are able to take part in leisure activities and other activities within the local community that are appropriate to age and culture. Service users have appropriate personal and family relationships. Their rights are respected and are supported to take responsibility for their actions. Service users are offered and encouraged to eat a healthy diet. EVIDENCE: Service users’ care plans identify lifestyle choice, such as going to college, clubs, local leisure activities and visiting families and the daily logs record whether these activities have taken place. The service users have some opportunities for personal development but the acting manager has recognised Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 14 that service users’ leisure activities could be more individualised and varied. A new member of staff has been recruited and her brief is to meet with the service users and to look at their individual interests and preferences. Some of the service users enjoy going to the local pub for ‘karaoke’ nights and playing pool. This month one of the service users is off to the Cotswold and another is going on an ‘Emmerdale’ weekend with her keyworker. Three of the service users attend local authority day centres, three service users attend the local college where they attend courses on English and Arts & Crafts, two service users attend church on Sunday, three female service users attend a women’s group and one of the service users attends a men’s group. These activities are accessed in a variety of ways, some of the service users use public transport, council transport and taxis independently and a member of staff accompanies other service users. One service user receives 1:1 support four hours every day and this allows them to access facilities such as, shopping and train and bus rides. None of the service users are involved in a sexual relationship, however the acting manager was clear that any service user would be supported if they wished to have a consenting sexual relationship with another person. One of the service users stays with her parents every other weekend, goes out to lunch with them every Thursday and goes out with her sister every other Saturday. Some of the other service users visit their families at home and nearly all of the other service users receive visits from their families, some more regularly than others. There are no restrictions placed on visiting times to the home. Relatives commented “I’m always made to feel welcome when I visit”. There are no set ‘house’ rules and service users were observed to go about the home freely. At the time of the inspection one service user was just having her breakfast and another service user had just got out of bed. Service users are given the option as to whether they hold the key to their bedroom door. Some of the service users exercise this choice and keep their bedroom doors locked when unattended. One service user has the keys for the house and knows the keypad for the front door and the kitchen. Service users were observed being spoken to with respect and names that service users preferred were used. Staff have the overall responsibility for the cleaning of the home, however most of the service users are able to participate at varying levels, to keeping their bedrooms clean and tidy, assisting with their laundry and in some cases their ironing. Service users were appropriate are encouraged to make cups of tea and prepare snacks. The menu is set weekly taking into consideration service users’ likes and dislikes, as well as dietary requirements. One of the service users has a diary free diet, however he is still able to have treats like the other service users and had been bought a diary free Easter egg. Another service user sometimes goes and buys her own meals, if she feels like something different. On the day of the inspection each service user had different fillings in their sandwiches. One Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 15 of the service users was seen eating their breakfast in their bedroom at 10.30am. On the second part of the inspection one service user sat with the manager and the inspector and ate his dinner in the manager’s office, another service user was seen making a cup of tea supervised by a member of staff. Food store cupboards, the refrigerator and freezer were inspected and all foods were appropriately stored. The food in the refrigerator corresponded with the meals planned for the day; there was also fruit, cakes biscuits and crisps, if service users wanted a snack. Service users’ comments were “the food is really nice”; “I can have anything to eat”. A relative stated, “I sometimes visit the home at mealtimes and the meals look very appetising and everyone seems to enjoy the food”. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19,20 and 21 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users receive personal support in the way they prefer and their physical and emotional needs are met. Service users’ wishes regarding their death are clearly recorded; this should ensure that their final wishes are carried out. Most of the service users are unable to administer their own medication. There are policies and procedures in place to ensure that this is carried out safely. EVIDENCE: Care plans and daily records were examined and discussed with the manager. The care plans clearly identify health and personal care needs and how these needs should be met. Most of the service users require encouragement and prompting rather than physical assistance. A member of staff was observed asking a service user if he would like to go to the toilet, this was carried out in Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 17 a very discreet way, which did not appear to cause him any embarrassment or distress. Some service users prefer to bath and others prefer to shower. Service users were seen to be dressed in clothes that were appropriate for the time of year and which suited their personalities; one service user was in shorts and t-shirt, another service user was wearing jeans and t-shirt. One of the service users stated “I can have a bath whenever I want “, another stated “I can do most things for myself, and the staff would help me if I needed it”. A relative stated, “He always looks clean and he is always dressed nicely”. Records inspected showed that service users have very comprehensive personal health records and health action plans; all of have been reviewed within the past six months. All service users are supported to access dental care, opticians, chiropody, well women clinic, the community nurse and psychiatric out patient appointments. One service user stated, “I don’t like the dentist but W (staff) comes with me and I don’t feel so nervous”. There are policies and procedures for the handling and recording of medication within the home. Staff have received medication training and there is a list of staff (with their signatures) that are competent in the administration of medication. Medication Administration Records (MAR) charts and the medication cupboard were checked and found to be correct. Three of the service users’ medication was audited and the amount given and the amount remaining reconciled with the MAR charts. One of the service users is able to administer their own medication; appropriate risk assessments are in place. The manager regularly undertakes medication audits to ensure that staff are administering medication appropriately. Care plans that were examined had details of people’s preferred wishes regarding their funeral arrangements; one service user’s care plan stated that he wants to be buried in his white shirt and tie and he would like his cassette player placed in his coffin. Other care plans were as detailed. It is a difficult subject for staff to talk to service users about, however this appears to have been dealt with in a sensitive manner. It would be a recommendation that staff now discuss with service users and relatives (if appropriate) Preferred Place of Care Plan (PPC). PPC would detail the resident’s thoughts about their care and the choices they would like to make, including saying where they would want to be when they die. Information about the family can also be recorded so that care staff can read about who’s who and what matters to them. This is Recommendation 1. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 People who use the 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 service users’ views are listened to and acted upon. Service users are protected by the policies and procedures and the monitoring systems within the home. EVIDENCE: The home has a clear complaints procedure, which is available in written and pictorial format. A copy of the procedure has been made available to all of the service users. There have been two complaints recorded in the past twelve months, both of these complaints were substantiated and both complainants were satisfied with the outcome of the investigations. Service users were asked individually what they would if they were unhappy with anything at the home, responses included “I would tell Linda (the acting manager)”, “I would tell my brother”, “talk to W (keyworker)”. Relatives that were spoken to said that they would speak to Linda if they had a problem, as she was very approachable and had dealt with any concerns speedily and to their satisfaction. All of the service users told the inspector that they were happy at the home and did not want to live anywhere else. There are regular service users’ meetings, which are attended by an advocate from Mencap; this ensures residents’ views are listened to. The service users are encouraged to participate in decision making on issues and events within Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 19 the home; service users chose the colour schemes and new furniture for the home. The home has policies and procedures for the safekeeping and expenditure of service users’ money. Service users’ money, which is held in safekeeping by the home is monitored by the finance department of Outlook Care and also monitored during the monthly regulation 26 visits. At the change of each shift the ‘handover’ process also checks the money held in the home. Bank statements are provided to all the service users and to relatives (with the resident’s consent). Service users are given support where appropriate to make purchases, receipts are kept for all expenditures and records of money held. Two staff have to sign for any money taken out. One of the service users is responsible for their own finances. There are guidelines in place to safeguard her interests; these guidelines were drawn up with the resident. The home has a comprehensive adult protection policy and procedures; there was evidence that these have been read by the staff. Three staff members that were spoken to were very clear on what constituted abuse and their responsibility in reporting any potential or actual abuse. Staff files indicated that all members of staff have attended Abuse Awareness/Adult Protection training. All permanent staff working within the home have undergone Positive Response Training, which shows them how to respond appropriately to physical and verbal aggression. They fully understand that the use of physical intervention is a last resort and know what other alternatives to use. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,25,26,27,28 and 30 People who use 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. Service users live in a homely and comfortable environment. Bedrooms, living areas, toilets and bathrooms meet the residents’ needs. EVIDENCE: A tour of the home was undertaken including the service users’ bedrooms. The inspector would like to thank the service users who showed her around their home. The home is decorated and furnished in a homely fashion and all areas of the home were well-maintained, clean, tidy and odour free. All of the service users’ bedrooms are of a reasonable size and one has ensuite facilities. The bedrooms were individually decorated and personalised with their own possessions, such as, televisions, CD players, photographs, ornaments and football memorabilia. All have new armchairs and five of the service users’ bedrooms have been decorated in the last six months, with the Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 21 service users choosing their colour schemes. One of the service users experiences difficulties with pictures and photographs hanging on their walls, the acting manager with the agreement of the service user is going to stencil some artwork on the bedroom walls, this will ensure that the room has more of a homely feel. Service users had also chosen their new bed linen and one of the service users, who is an Arsenal supporter, told the inspector “I am going to the Arsenal shop with W (keyworker) to buy my bedcover and other Arsenal stuff”. Some of the service users have chosen to have keys to their bedroom doors and one service user has the key to the front door and knows the keypad number to the front door and the kitchen. Both the lounge and dining room have recently been redecorated and fitted with new net curtains and blinds. The dining room has had a new carpet laid and new dining room table. The lounge has new armchairs and new loose covers on the settee; there is also a dining table in this room, as some of the service users prefer to eat in here rather than the dining room. Again service users were involved with choosing the colour schemes and the furniture, they were very proud of their choices and made a point of telling the inspector how pleased they were with the colour of the walls matching with the curtains. Relatives that were spoken to were complimentary about the décor and cleanliness of the home. The bathroom, shower room, hallway and stairs have also been redecorated within the past three months and new curtains have been purchased for the hallway. Adaptations have taken place in the bathroom to allow a service user to bathe more independently due to a change in their needs and a second banister has been put on the stairs to assist a service user in climbing the stairs safely. The kitchen was clean and tidy and has recently been fitted with a new oven. The kitchen is suitable for residents to carry out domestic tasks, such as, washing up, making cups of tea and preparing snacks. The laundry room was clean and tidy and with clear instructions both written and pictorial format on how to use the washing machine, as some of the service users are able to use the washing machine independently. There is a garden to the rear of the home that service users make full use of during the warmer months. The home is situated back off the road and there is CCTV fitted to the outside of the home, this enhances the well being of the residents and staff. Service users are able to receive their visitors in the lounge or dining room (which has a settee), their own bedroom, which have comfortable armchairs or the garden in the warmer weather. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 22 The home is well maintained and there was evidence that all repairs are dealt with promptly. The home has a robust infection control policy and would seek advise from external specialist if and when required. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,33,34,35 and 36 People who use 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. Service users are supported by qualified and competent staff Staffing levels are satisfactory and there are sufficient staff on duty, who have the appropriate skills and training to meet the individual needs of the service users. The procedures for the recruitment of staff are robust and provide safeguards for service users living in the home. Staff receive regular supervision and annual appraisals, which is beneficial to the service users. EVIDENCE: Duty rotas were inspected and they correlated with the staff on duty, there were sufficient staff on duty to meet the needs of the service users. There are two staff on duty on each shift and one waking night staff, as well as the acting manager or deputy manager. The current staffing situation is: the acting Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 24 manager has applied to the Commission to be the registered manager, a new deputy manager commences 30th April 2007 and there are two full- time vacancies for care staff, which are currently being advertised with interviews to take place in May. Though the acting manager is using ‘bank’ staff, these staff have worked at the home for a considerable period and therefore are familiar faces to the service users. There is a clear recruitment policy and procedures. Four of the staff files were inspected and showed appropriate recruitment procedures had taken place; a completed application form, two written references, health screening questionnaire, copies of qualifications, driving licence, bank details and a current Criminal Records Bureau (CRB) check. Staff confirmed that they had a face-to-face interview and that references and checks had been carried out prior to them commencing work at the home. There was evidence on staff files that an induction programme had been undertaken as well as food & Hygiene, health & Safety, COSSH, Adult Protection/Abuse Awareness, first aid, moving & handling, infection control, administration of medication, person centred planning, autism awareness and positive restraint techniques. The most recent member of staff is undertaking NVQ 3 and all of the remaining staff have NVQ 2/3 and seven members of staff hold their first aid certificate. Staff files indicate that they are receiving supervision regularly and annual appraisals have taken place, which staff were able to confirm. Staff meetings are also held regularly. Every staff member has a training profile where training that has been undertaken is recorded and future training needs are identified. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 and 42 People who use 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 home is well managed, which means service users’ health, safety and welfare are promoted and protected. Service users can be confident that their views underpin the self-monitoring, review and development of the home. EVIDENCE: The acting manager has been in post since October 2006. She has applied to the Commission to become the registered manager. She has previous management experience and has had extensive training: budget management, supervision, managing conflict, makton, effective communication, NVQ 4 in Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 26 care and certificate in management studies. She is currently undertaking the Registered Manager Award. There was evidence that her induction programme and training log had also been completed. As stated earlier in the report service users’ meetings take place and all are encouraged to have an input into these meetings. Minutes are kept of all meetings held. An advocate from Mencap is also a regular visitor to the home. There has been a review of the home; information was gathered from professionals, residents and relatives. An annual development plan will be completed reflecting the comments and views from the surveys. The standards that relate to health and safety were also well managed and information was readily available. Fridge and freezer temperatures are taken and recorded daily. Food stored in the fridge and freezer was covered and dated. Fire drills are taking place regularly; a service user carried out the last one (March 2007). She said how much she had enjoyed doing it and was looking forward to carrying out the next one. Fire extinguishers received their annual check in November 2006, fire alarm call point is being tested and recorded weekly, fire risk assessment was carried out in August 2006 and the last fire alarm service and emergency lighting test was undertaken in March 2007. The annual Gas safety certificate is dated February 2007, the five-year Electrical safety certificate is dated January 2007 and the Legionella test for the home was carried out July 2006. The acting manager also carries out monthly health & Safety inspections, which includes: checking fire doors, extinguishers and fire blankets. The fixtures and fittings, the electrics, plumbing and heating of the home and the contents of the First Aid box. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 28 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4(1)(c) Requirement The name of the previous registered manager needs to be removed from the Statement of Purpose. Timescale for action 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA21 Good Practice Recommendations It would be good practice for staff to discuss with the service users their preferred place of care plan. This plan would detail the service users’ thoughts about their care and the choices they would like to make, including saying where they would want to be when they die. Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Ford Road DS0000027899.V334633.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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