Inspection on 07/02/07 for Forest Grange

This inspection was carried out on 7th February 2007.

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

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

Other inspections for this house

Forest Grange 10/03/06

Forest Grange 19/08/05

Forest Grange 08/03/05

Forest Grange 27/09/04

Forest Grange 16/02/04

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 08/07/2008.

CARE HOME ADULTS 18-65 Forest Grange 15 Forest Road Moseley Birmingham West Midlands B13 9DL Lead Inspector Sarah Bennett Key Unannounced Inspection 7th February 2007 10:05 Forest Grange DS0000039321.V323970.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 Forest Grange DS0000039321.V323970.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. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forest Grange Address 15 Forest Road Moseley Birmingham West Midlands B13 9DL 0121 449 2040 0121 449 4704 lado@strenshamhill.com 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) Ms Itrat Batool Mrs Mandy Josephine Callaghan Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That the 2nd floor bedroom may only be occupied by a designated service user, agreed with the NCSC, currently Mr PG At such time he vacates this room, the agreement of the CSCI must be obtained prior to it being occupied by another person. That all residents must be aged under 65 years Date of last inspection 10th March 2006 Brief Description of the Service: Forest Grange is a three - storey property situated in the Moseley area of Birmingham. The home provides care and accommodation to up to seven adults with a learning disability some of who have complex needs. There is one ground floor bedroom and one bedroom on the second floor; all other bedrooms are on the first floor. Some bedrooms have en suite facilities and there are bathroom and toilets on each floor. Communal space consists of a large lounge, which leads onto a dining room, and a separate smaller lounge. There is a spacious rear garden, which has ramped access. The home is within close proximity to local amenities. The current service user group are all male. The fees charged as stated in the pre-inspection questionnaire are £1,800 per week based on the assessed needs of individuals. The fees do not include chiropody, barbers, toiletries, magazines/papers, transport and holidays. The CSCI inspection report is available in the home for those who wish to read it. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home, a pre-inspection questionnaire completed by the Manager, completed CSCI comment cards from relatives and health and social care professionals and reports from the provider. The home has recently been awarded the ‘Investors in People’ standard. A copy of the assessors report was forwarded to the CSCI. One inspector carried out the unannounced fieldwork visit over one day. This was the homes key inspection for the inspection year 2006 to 2007. The Owner, the Manager and the staff on duty were spoken to. Conversations with some service users were limited due to their complex needs and limited verbal communication. The inspector met with service users and time was spent observing care practices, interactions and support from staff. A tour of the premises took place. Care, staff and health and safety records were looked at. What the service does well: A professional said, “ The care provided is exemplary. The service users have excellent facilities and are treated at the highest standard.” The home is clean, well decorated and maintained so that is a comfortable place to live in. The garden is large and paved so that service users can play football, which they enjoy but also to keep some people safe. Each service user has a member of staff working with them during the day and evening. A professional said, “ An excellent home with good staffing levels as required.” A relative said, “There are always enough staff on duty.” Staff know what each person likes or dislikes and how they need to support them to have a good quality of life. Staff have the training and support they need so that they can meet the needs of the people living in the home and do their job well. A relative said that they are aware of the home’s complaints procedure but have never had to make a complaint. Some service users have special diets because of their cultural background or their health needs. Staff make sure that they have the right diet so that these needs are respected. Service users said that they like the food and choose what they eat. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 6 Service users said that they chose the colours that their bedrooms were painted. Their bedrooms were very personalised and included their personal belongings and photos and pictures of people important to them. Service users go to the places they like going to and do the courses that interest them. Each day is planned around what each person enjoys doing and will help them to develop as an individual. This helps to reduce any anxieties the person may have so that they have good health. A professional said, “ The needs of the people who live there are always at the forefront of the care.” Service users are supported to go to health appointments and the advice of health professionals is followed to ensure that individual’s health needs are met. Individual’s medication is regularly reviewed and changed if needed. This makes sure that people are not taking medication that they no longer need and may have bad side effects that make them feel ill. Regular checks of equipment used in the home are done to make sure they are working properly and that the home is safe to live in. What has improved since the last inspection? One requirement was made at the last inspection to tell the CSCI of any events that happen that affect the people living in the home. This has been met and detailed reports of any incidents and accidents are sent to the CSCI. The home has achieved the ‘Investors in People’ award. The assessor said, “ For only the second time in 12 years as an assessor, there were no areas identified for improvement. I have no hesitation in recommending that Forest Grange Care Home be recognised as an Investor in People organisation”. The first formal service users meeting was held in January 2007. Minutes showed that individual’s who wanted to be involved talked about activities and also their key workers so giving them a chance to have more say in what goes on in the home. 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. Forest Grange DS0000039321.V323970.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 Forest Grange DS0000039321.V323970.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): 1, 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need to ensure they can make a choice about whether or not they want to live at the home. Prospective service users individual needs and aspirations are assessed before they move into the home. Each service user has a licence agreement so they know what the terms and conditions of their stay at the home are. EVIDENCE: The statement of purpose included all the relevant and required information, as did the service users guide. The service users guide was produced using pictures making it easier to understand. One service user has lived at the home since 2005, a few years after the other service users moved in. A detailed assessment was undertaken that included visits to their previous placement before introducing them to the home. The Manager and Owner said the assessment process took about 14 months. They felt it was important to get it right not just for the individual but for the established service users so as not to disrupt their lives. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 9 Each service user had their own licence agreement. A picture relevant to the individual was on the front of this so it was clear whom it belonged to. The licence agreement included all the terms and conditions of their stay at the home, what their fees pay for and what the home pay for. Forest Grange DS0000039321.V323970.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): 6, 7, 8, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff have detailed information in care plans as to how support each person. Service users are supported to make decisions about their lives. Service users are supported to take risks within a risk assessment framework ensuring they are safe. EVIDENCE: Two service users records were sampled. They included detailed individual care plans. These stated how staff are to support the individual with their physical needs (mobility, epilepsy, health & safety, elimination, vision, hearing, dexterity, personal hygiene, dressing, eating/drinking, sleep patterns), their behaviour, communication, social networks, holidays, leisure, sexuality, spiritual/cultural needs and social skills. Care plans were regularly reviewed and updated with changes. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 11 Some of the care plan was produced using pictures making it easier to understand. This was about what makes a good or bad day for the individual and what their likes and dislikes are. Care plans showed that the service user and where appropriate their representative had been involved. The first formal service users meeting was held in January 2007. Minutes showed that individual’s who wanted to be involved talked about activities and also their key workers. Staff were observed offering choices to individuals about what they drank and whether or not they wanted to show the inspector their bedroom. Records included detailed risk assessments that were specific to the individual. They had been regularly reviewed and updated. They included a detailed risk assessment of their bedroom including whether or not they would be at risk if they had an en suite. Other risk assessments included the risk of the persons relationship with others including peers, staff and in groups, community access including each familiar venue, how the person would be supported if there was a fire and how to help them prevent a fire, support in the home and in-house activities. There was a detailed assessment as to who can sit where when using the vehicle and what support each person needs. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Arrangements are in place so that people living in the home experience a meaningful lifestyle. Service users are offered a healthy diet that meets their special dietary needs. EVIDENCE: Service users records included individual activity plans and programmes. These were produced using pictures making them easier to understand. Some people attend adult education classes in woodwork, music, cookery, pottery, media studies and citizenship. The Manager said that some of the service users have achieved units within National Vocational Qualifications (NVQ’s) as part of their classes. One of the colleges is due to close in 2009. The Manager said that they are already looking at venues that individuals can go to instead so they can get used to these before the college closes. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 13 Service users participate in a range of leisure activities including swimming, bowling, cinema, parks, theatres, pubs, restaurants and shopping. All service users spent the day out with their member of staff doing their planned activities. Some care plans relating to activities stated that staff are to be prepared for the journey and not to expect the service user to wait once they are ready. The care plan detailed what staff needed to get ready before asking the individual to put on their coat to go out, as this was the time they needed to go. One service users family lives abroad. The manager said and records and photographs showed that last year their family visited and the staff supported the service user to spend a lot of time with them and go out with them during their stay. Contact with families where appropriate is kept through visits and phone calls. There were photographs around the home of some special events including a Christmas party at a local hotel and an award ceremony that some service users attended at the end of their courses. The Manager was booking a sing-along entertainer for one of the service users birthday parties. She said that another service user would not like this so they are planning for him to go bowling, as he would prefer this. The manager said that another service user may like the entertainer for their birthday but she would need to ask him first before booking. Two vehicles are provided to enable service users to access the community. In the winter months service users often use taxis and public transport during the summer months. The money for taxis is provided as part of their day care package. Each year service users are supported to go on holiday. The last few years’ service users have gone to Butlins in Minehead and they each have their own chalet with their member of staff. Service users records showed that individuals are supported to be as independent as possible. Assessments are completed as to what the individual can do e.g. cooking, cleaning and laundry. From these care plans are developed so that staff know what support the individual needs. The Owner said that the kitchen door is locked only during mealtimes as the service users could be at risk of going in there and also so they are not distracted from eating their meals. Food records showed that a variety of food is offered including fruit and vegetables. A lot of fresh vegetables were available in the home. Special diets Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 14 are catered for including diabetic and kosher. The individual who has kosher food also has their own pots and pans so it can be cooked separately as required by their religious background. Specialist food shops are used to buy Jewish food and African food where appropriate for individuals. Staff spoken to were aware of who was on a special diet and what foods this included. Ample food stocks were provided. The Owner said that most of the shopping is done from a supermarket on-line but service users go out with staff to buy fresh fruit and vegetables locally. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way they prefer and require and their health needs are well met. The management of the medication protects service users and ensures their well-being. EVIDENCE: Care plans detailed how staff are to support individuals with their personal care. They included a very detailed morning and evening routine for each person. These included visual cues so that the person knew what was going to happen next such as showing them their toiletry basket when going for a shower. They detailed which bathroom the person prefers to use and how they like to maintain their personal hygiene including self-help skills. A list of what toiletries each person uses was included in their care plan. Service users were well dressed according to their age, gender, cultural background, the weather and what activities they were doing. There were some photographs around the home showing service users dressed up for the Christmas party and to go to an award ceremony in their shirt, tie and suit. Service users had individual styles of dress and hair. Service users said they Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 16 go shopping with staff to buy their own clothes and to local barbers to get their haircut. One service user said that they have their own key for accessible toilets so that they can use when they want to when out in the community. Staff were observed communicating with service users in a way that was appropriate to the individual including using MAKATON (sign language), small phrases or single words. Records sampled included details of what things the individual may say and what that means for that person e.g. fish and chips may mean that the particular individual is hungry. Service users health records showed that they have regular check ups with the dentist and optician. Service users have regular blood tests where needed to test their medication levels in their blood and have regular medication reviews. Records showed that where appropriate under the guidance of the psychiatrist some service users have had their medication reduced and this had benefited their well-being. Service users had detailed care plans as to how the staff are to support them to meet their health needs. Health professionals are involved in service users care where appropriate. Records showed that where service users were unwell staff noticed this and sought advice from the GP when needed. A local pharmacist supplies the medication in individual blister packs for each week. The pharmacist visited in November 2006 to look at the medicine management systems. They stated in the report of their visit that staff were sufficiently trained and that discontinued and unused medication is returned to the pharmacy so that large stocks do not build up. One service user is prescribed insulin to be given by staff as an injection. The District Nurse has trained all staff to administer this and also to test the individual’s blood glucose levels. Records of the individual’s blood monitoring are kept. Detailed information is provided for staff on hyperglycaemia (high blood sugar) and hypoglycaemia (low blood sugar) and what to do if this occurs. Medication Administration Records were all signed appropriately and these crossreferenced with the blister packs indicating that medication had been given as prescribed. Where service users were prescribed PRN (as required medication a detailed protocol was in place stating what medication should be given, why and when. Homely remedy protocols detailed what each individual could take with their prescribed medication and when these should be given. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users know how to make a complaint and that their views will be listened to and acted on. Arrangements are sufficient to ensure that service users are protected from abuse, neglect and self-harm. EVIDENCE: Each service user had a copy of the complaints procedure in their service user guide. These were produced using MAKATON signs and pictures making them easier for individuals to understand. A restrictive physical intervention policy was seen that was last reviewed in December 2006. It referred to individual behaviour management plans, using distraction techniques, known triggers and the use of Studio III techniques (a recognised form of physical intervention) as a last resort. Individual very detailed behaviour management strategies were in place. One stated that it was under continual review and reassessment and was reviewed regularly. It stated the triggers and signs of the behaviours that the person displays, proactive steps to use, environmental controls and distracters. The specific requests and demands that the individual uses and how staff are to respond to each were listed which could avoid the person displaying challenging behaviour. Two service users financial records were sampled. The Pre-inspection Questionnaire stated that the Owner is the appointee for five of the service Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 18 users. Each service user has their own bank account on which they receive interest. Service users do not pay for activities they participate in during the day, as this is part of their day care package and is paid for from their fees. Financial records showed that service users spend their money on personal items only. The amount in individual’s tins cross-referenced with their records. Receipts are kept of all purchases. The Manager regularly audits the service users money and the accountant also audits them every six to eight weeks. Staff training records showed that staff had received training in adult protection and the prevention of abuse. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28. 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable, safe and clean environment that meets their individual needs EVIDENCE: On the ground floor there are three service users bedrooms, a quiet lounge, a large lounge, dining room, kitchen, separate laundry, WC and shower room. All rooms are well furnished and generally well decorated with the exception of the dining room that is looking a bit worn and the border around the wall is torn in several places. The manager said this would be redecorated in September when the service users are on holiday as it would be too disruptive to redecorate while they are at home. However, following this visit the behaviour of one of the service users changed around mealtimes. In response to this the room was redecorated and the layout of the room was changed to ensure that all service users are comfortable and free from any risks during mealtimes. The manager said that there was no disruption encountered by the service users as a day out was planned so they were not affected by the redecoration. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 20 On the first floor there are service users bedrooms, a bathroom and a small office. Three service users have an en suite facility in their bedroom. On the second floor there is an office and a separate staff room, where lockers are provided so that staff have somewhere safe to keep their belongings while they are on duty. There is also a walk-in food cupboard, which was full of tins and packets of food. One service users bedroom is located on the second floor and they have an en suite. There is also a bathroom that can be used by service users. There is a large rear garden that is accessed by a ramp so that all service users can use it. The garden is block paved and staff said service users enjoy playing football there in the warmer months. It is also safer as one service user will eat plants and shrubs. Garden chairs and tables are provided. Service users bedrooms were very personalised according to the interests and tastes of the individual. There were photographs and pictures around their bedrooms and service users said they had been involved in choosing the decoration for their bedroom. There is a large cellar that is locked to service users to keep them safe, as the stairs to access it are steep. Cleaning materials are stored there as was a chest freezer full of food. There is a large fridge/freezer in the kitchen that was also well stocked. There is a payphone that staff can use. There is a cordless phone that service users can use if they wish to. The home was clean and free from offensive odours throughout. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well trained and supported staff team that can support them to meet their individual needs and achieve their goals. Service users are protected by the home’s recruitment practices. EVIDENCE: The pre-inspection questionnaire stated that 50 of staff have achieved NVQ level 2 or above in Health & Social Care and the rest of the staff team are working towards level 2. The pre-inspection questionnaire stated that four members of staff had left since the last inspection, two of these staff left to further their career, one moved out of the area and the other did not have their contract renewed by the organisation. Staff work on a 1: 1 basis with service users and a member of staff is allocated each day to work with an individual. The Manager and staff said that when staff start working at the home they ‘shadow’ other staff for at least 6 weeks. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 22 Regular staff meetings are held and minutes of these are kept. Staff said that they have the opportunity to raise things in staff meetings and can put items on the agenda if they want to. Staff records included the required recruitment records including evidence that a Criminal Records Bureau (CRB) check had been undertaken to ensure that suitable people are employed to work with the service users. Staff records showed that they had received training in adult protection and the prevention of abuse, moving and handling, first aid, fire safety, Safe Handling of Medicines, food hygiene, health & safety, administering insulin, Studio III (a recognised form of physical intervention) and autism. Some staff are doing the accredited Infection Control Distance learning course. Staff spoken to showed knowledge of individual service users needs, likes and dislikes. Staff said that they had received regular training and this is renewed every year so they keep up to date. Records sampled showed and staff said that they have regular, formal recorded supervision sessions and an annual performance review. Staff said that they found supervision sessions helpful and felt that these directed and motivated them. They said and supervision records sampled showed that they were told what they do well and in what areas they need to improve. The Manager said that this year they did part of the performance reviews in groups and they found this more useful. They did an exercise about what each person thought was good and not so good about each person in the group. This was put in individual envelopes for each person to take home with them. The Manager said she found it very useful herself to do this as it was good to receive praise but also be aware of the areas where development was needed. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Manager communicates a clear sense of direction so that individual’s needs are well met. Service users views underpin all self-monitoring, review and development of the home. Service users health and safety is promoted and protected. EVIDENCE: The Registered Manager has several years experience of managing a care service for people who have autism. They were observed to know the individual service users well and how to meet their needs. Staff spoken to said that the Manager is very supportive and they felt at home working there and felt comfortable to voice their opinions. Staff said that the Owner is supportive and often visits the home and is available on-call if needed. Staff said that the organisation of the home is very good and they know what to do and what is Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 24 expected of them. They said that communication between the Manager and staff is good and they have no desire to work anywhere else. The Manager, with the ongoing support of the Owner has demonstrated ongoing compliance with requirements made at previous inspections. There are no outstanding requirements from the last inspection. The Owner completes monthly visits to the home as their responsibilities under Regulation 26 and writes a report of this. The reports of the visits consider the views of service users. The home has recently achieved the ‘Investors in People’ standard. The Investors in People assessor said, “ There was much good practice in evidence within this organisation. From the genuine commitment of the proprietor and manager to supporting their staff to learn to the resources committed and the benefits that have been identified from the investment.” Questionnaires about others views of the home are given to relatives and visitors. Fire records showed that regular fire drills are held so that staff and service users know what to do if there is a fire. Staff regularly test the fire equipment to make sure it is working. An engineer regularly services the fire equipment. A Corgi registered engineer completed the annual test of the gas equipment in Jan 2007 and stated that it was in a satisfactory condition. A valid certificate of employers liability insurance was displayed. An electrician completed the five yearly electrical wiring test in 2005 and stated that it was in a satisfactory condition. An electrician completed the annual test of portable electrical appliances in Jan 2007. Staff complete quarterly health and safety audits and any outstanding repairs that would affect the health and safety of service users and staff are completed. Risk assessments were available for the premises, food, staff, fire, moving and handling and hazardous substances. These were all regularly reviewed and updated where necessary. Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 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 x 26 4 27 3 28 4 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 4 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 3 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 4 3 X X 4 x Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 26 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 YA24 Regulation 23 (2) (b, d) Requirement The dining room must be redecorated. This requirement has already been met. Timescale for action 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Forest Grange DS0000039321.V323970.R01.S.doc Version 5.2 Page 28 - 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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