Inspection on 16/07/08 for Gaywood Street 24

This inspection was carried out on 16th July 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gaywood Street 24 27/07/07

Gaywood Street 24 14/07/06

Gaywood Street 24 19/01/06

Gaywood Street 24 23/09/05

Gaywood Street 24 04/01/05

Gaywood Street 24 05/10/04

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

CARE HOME ADULTS 18-65 Gaywood Street, 24 London SE1 6HG Lead Inspector Lynne Field Key Unannounced Inspection 16th & 24th July 2008 09:30 Gaywood Street, 24 DS0000007090.V363949.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 Gaywood Street, 24 DS0000007090.V363949.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. Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gaywood Street, 24 Address London SE1 6HG 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) 020 7261 9210 020 7261 9210 esterj@plus-services.org PLUS (Providence & Linc United Services) Ester Janko Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home 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: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 27th July 2007 Date of last inspection Brief Description of the Service: Gaywood Street is care home providing personal care and accommodation for up to 5 people with a learning disability some of whom may be over 65 years of age. Hyde Housing Association Limited owns the building but Choice Support manages this. The service is staffed and managed by PLUS support (Provident and Linc United Services), a voluntary organisation. The home is located in Elephant and Castle, close to shops, pubs, the post Office, underground and buses. The home consists of a two-storey building, and is designed to be wheelchair accessible, with passenger lift, and access to a patio area. All the home’s bedrooms are single. They are decorated to individual residents tastes and needs. The range of fees is charged from £277-60p per week. Additional charges are made for things such as hairdressing and toiletries. Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection was unannounced and was carried out over two days in July 2008. The registered manager was unable to be present on either days of the inspection, which was facilitated by a senior care worker on the first day and the deputy manager on the second day. We spent time at the organisations head office checking staff files and found the ones relating to the home had all the information relating to good recruitment practices. As part of the inspection we contacted the training department and they were able to confirm the all the training staff in the home had undertaken in the past two years. On the first day a senior support worker who facilitated the inspection spoke about how the residents money was managed by the home to save the residents from any financial abuse. We sat in on a staff handover and spoke to staff about the systems the home has in place to ensure there is good continuity and communication in the home to meet the residents needs at all times. We met four residents and five support staff. Three residents and three staff files were viewed and two residents were case tracked. On the second day we met the deputy manager. We checked records on care plans, medication records and the complaints book and was able to access confidential documents the senior carer did not have access to on the first day of the inspection. The deputy manager told me about the recent developments in the home and how the service was being developed. The staff and managers have continued to ask for increased staffing levels at nigh to ensued the resident’s comfort and dignity is not compromised. This is still and ongoing issue to be resolved. Some parts of the communal areas and there are plans to redecorate and recarpet bedrooms. They hope to refurbish the kitchen within this financial year. What the service does well: Prospective residents are given the information they need to enable them to decide whether the home is suitable. The home strives to achieve its aims by providing a service tailored to meet individual needs. It gives good individualised care to all residents and supports Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 6 residents right to make choices for themselves by having key worker meetings, residents meetings and service reviews. Care planning records held at the home have been updated, are securely kept, and reflect the changing needs of each resident. These reflect the residents’ health and social care needs and give information about how the resident likes their care to be given. Staff know what food residents like and support residents to eat a balanced healthy diet. 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. Gaywood Street, 24 DS0000007090.V363949.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 Gaywood Street, 24 DS0000007090.V363949.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): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides important information to prospective residents, families and health professional so that they are informed on services available. No resident is admitted to the home unless they have had their needs fully assessed first and the home is confident that they can meet their needs. Prospective residents and their relatives can come and look around the home and meet staff before they decide to move there. EVIDENCE: The home up dated the statement of purpose and service user guide to include all the information relating to the new organisation who took over the home 2006. The information in the Statement of Purpose and Service User Guide that is given to prospective residents and their families explains what the service offers. We were told at the last inspection by the manager they planned to re write these in a format that is more acceptable to the residents who live in the home and they are now planning to improve this again by the use of video and audio tapes that prospective residents can view rather than read. There are no vacancies at the present time. Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 9 We met the last resident to move to the home at the last inspection in August 2007. We were told as part of the assessment process, they were invited to visit the home and made several visits to see if they liked it. The manager assessed them before they were accepted into the home. The manager said the home had made sure all adaptations were in place, such as handrails and a profiling bed, before the resident came to live at the home and they would do this for all prospective residents. We checked three resident’s files and noted there are licence agreements and contracts in place. Gaywood Street, 24 DS0000007090.V363949.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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are consulted and supported to make decisions about their lives by staff and appropriate independent professionals. Potential risks are identified and residents are supported to take risks within a risk management framework. EVIDENCE: We checked three residents’ files. The files are more organised and have continued to be developed since the previous inspection. The support plans we saw give a description of residents’ individual behaviours, reactions and preferences and how the resident likes to be treated. This included their strengths and needs and how these could be met. The home encourages residents make decisions for themselves by involving them in the development of their support plans. This is done with the help of their key worker and other staff support. Support plans and risk assessments are reviewed with residents Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 11 and their families every six months or sooner if necessary. There are copies of risk assessments that have been carried out. Details of any changes to the risks are recorded in the support plans along with details of how to manage the risk. There were resident’s wheelchair guidelines and wheelchair risk assessments on file. Although there were copies of the risk assessments for bedrails and wheel chair straps there were no formal records of the relatives other professionals being informed these are being used for the residents safety. We discussed this with the deputy manager who said they would discuss and record this in each resident’s file at the next review, so there could be no misunderstanding about why they are being used. We were told the home has internal reviews even if there is not a social worker involved and there were copies of best interest meetings on file. These are planning meetings for individual needs and then they review the plan after six months. Every resident has had a first facilitation meeting within Person Centred Planning. There have been a variety of approaches used and variety of communicational tools has been incorporated. Many of the documents are being done in “Picture Format”. Objects of reference have been developed in relation to some residents in order to improve communication and support their needs and aspirations better. The deputy manager said they were continuing to develop Person Centred Plans for each resident. This will help identify a number of goals and plans for the future. The deputy manager told us that one resident choose to go to lunch at the War Museum for their PCP meeting but when they arrived there they did not like it so went somewhere else. One family had asked for a written report every two weeks, which the home have agreed to do. Gaywood Street, 24 DS0000007090.V363949.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): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to access the community with the support of staff and engage in appropriate, enjoyable and fulfilling activities. Families and friends are encouraged to keep in touch with the residents and participate in social activities. Mealtimes are relaxed and residents enjoy a healthy, varied diet. EVIDENCE: There is a timetable of weekly activities for each resident kept in their file with the daily task sheets so that those activities do not get missed. Residents go to different activities depending on their needs. One goes to the day centre two times a week. All residents have aromatherapy once a week, which they enjoy. All residents are encouraged to go out as much as possible during the day and Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 13 at weekends. They have regular access to the community and activities programmes are developed to meet each resident’s individual needs. In this way residents are supported and encouraged to take part in activities that are enjoyable, beneficial to their mental and physical health. One residents’ family continue to visit them five days a week. Another resident visits their friends in Lewisham with staff support when he wishes to do this. We were told that there is enough staff on any one shift to provide support to at least one resident to go out into the local community. We looked at the rota and his was generally the case. The deputy manager said if it is planned that more than one resident wants to go out, extra staff will be rotated on for that shift. On the day of the inspection on member of staff was feeling ill and had to go home so the deputy manager authorised for another member of staff to come to cover the shift so there was no shortfall in staffing levels. Two residents share a car that is adapted to take their wheelchair and only they are able use it. Staff said the other residents used public transport or Dial a Ride to access the community activities. The home records of all community based activities on sheets over a period of month. This gives the home an over view of what activities are happening and what is not happening and why is it not happening. We were told there is a trip to Brighton planned and they also hope to go to France soon. The organisation that runs the home, plan a number of outings for the residents of the homes they run. Details of these are published in a booklet that is distributed to the homes. Staff said they discuss with the residents which outings they would like to go on and book them up. Extra staff would be on duty to cover the outings because all residents do not always want to go on the same outing. The home plans other regular outings apart from visiting the local community. Recently two residents went to Blackpool on holiday to a hotel that had all the facilities, such as easy access and hoists The staff said they encouraged the resident’s to eat a healthy diet. The resident’s are asked about what food they would like on the menu. Meals have been devised from those preferences. The staff said most of the residents had lived at the home for a number of years and they are able to tell by their reaction whether they like the food they are given. There was a good range of different food with healthy options, such as low fat food and fresh fruit recorded on the menu. A record of what resident’s have eaten is kept in the daily records. The sensory room was moved to a bigger room and refurbished to include different sensory experiences. Staff said in the past residents enjoyed going in there and it could be a calming or stimulating experience depending on how the resident was feeling. And we were told this continues to be the case. One resident who dose not like the sensory room for some reason has a one to one sensory session in their room. Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support, in the way they prefer and their physical and emotional needs are met during the day. Staffing levels at nigh mean residents dignity and comfort is compromised and staff health and safety is put at risk. Residents are not able to take control of their medication and need assistance to take it. Medication handling and procures have improved since the previous inspection and staff are following the homes procedure for the administration of medication. EVIDENCE: As the residents have aged the staff are finding they need more help with personal care. Profiles have been reviewed. We were told all support plans and risk assessments these were to be redone Staff spoke to residents with respect and addressed residents by the name they preferred to be called by. Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 15 The three residents files contained all the information staff need to support the residents in their preferred personal care routines. There were updated details of how much help an individual requires with different personal care tasks. There are records of health appointments attended. This indicates each resident is supported by care staff to attend an appropriate range of healthcare appointments in line with their individual healthcare needs. These included the outcome of the appointment. One resident has had a number of assessments by the Speech and Language Therapist, for example there was an “Eating and Drinking” assessment. The out come of these are kept in the residents file. Another resident has a Health Action Plan and these have been up dated The home has waking night staff to ensure that residents receive adequate support during the night. All residents are checked on hourly basis through the night to try to ensure no one is left with their needs not being met. We were told three of residents have risk assessments in place requiring them to have 2:1 support to move and change them when they are in bed. Staff said “none are receiving this due to lack of funding to have two waking staff on duty during the night”. We were told “residents are having to be left in urine saturated / soiled pads for sometimes up to ten hours”. The management and staff said, “Residents beds are very wet in the morning (soaking actually)”. We were told this has been discussed at resident’s reviews but funding is not forthcoming. During the inspection we notified of an incident that occurred during the waking night shift. We were told, “A member of staff observed resident in discomfort due to opening their bowels over three to four times during the night. The weather was very hot, humid. Staff member felt that it would be inappropriate to leave the resident as the incontinence pad totally saturated with watery stool. The room was becoming smelly and it was early in the night shift. The change of pad normally requires two members of staff. On this occasion, to remedy the resident’s discomfort, the staff member attempted to change the resident by herself and in doing this, she injured her wrist. The member of staff was off sick for a period of few days until her wrist healed. The resident was subsequently transferred to hospital the next day because their condition deteriorated”. The manager felt this incident, once again, highlighted the need for extra member of staff during the night hours. The staff at the home feel an additional member of staff, would give adequate support to the residents during the night hours and not leave them in discomfort sometimes for a number of hours. Procedures must be put in place to ensure residents do not have to go through the indignity of lying in soiled pads for an unacceptable time during the night and the health and safety of staff is not compromised in doing this. None of the residents are able to take control of their medication and well as needing assistance to take it. Medication is kept in locked cabinet in the kitchen area and key is kept by staff at all times. The resident’s medication comes in the blister pack system and liquid medication is dispensed into medicine pots by the staff. We checked the MAR charts and the medication of Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 16 three residents and found it all correct. Each chart had a photo of the resident and a list of the medications prescribed for the resident. Homely remedies list was signed by the GP. The deputy manager said the home receives regular pharmacy inspection visit, which provides them with further recommendations if necessary. Staff team had also received a feedback and training from the last visit done by pharmacy. Gaywood Street, 24 DS0000007090.V363949.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. Practices and training at the home ensure that residents are protected from abuse. Resident’s views are listened to and acted upon. Residents dignity and comfort is being compromised when they are left wet, soiled pads because there are insufficient night staff on duty to be able to change the residents safely. EVIDENCE: The home has a complaints policy, a copy of which is in the residents’ guide. We spoke to care staff during the inspection and said there were different types of abuse, not just physical abuse, such as verbal abuse and financial abuse. They said if they suspected abuse was happening they would reassure the resident and report what they suspected to the manager or the deputy manager. The house has a complain book in place. Any comment by a resident, family visitor or advocate is recorded in the book. Residents have a safe in their rooms for keeping valuables. We were shown the complaints book. No complaints had been made since the last inspection. The deputy manager said all complaints are taken seriously and appropriate action would be taken to Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 18 ensure a residents’ or a family members complaint was addressed immediately. Each resident has their own petty cash book, which shows all transaction being done from their account into their own money tins. Receipts are kept for all transactions and they are checked by a deputy manager each week. We checked the all resident’s money tins with a member of staff who went through the homes procedure with us and explained the money was checked at each handover. All money checked was correct. One resident is able to access their own account and all transaction details are kept in the book. Majority of staff has had a basic training in Safeguarding Adults which enables them to recognize and act on suspected case of abuse. All residents receive a financial statement of all transaction being made and this regularly checked by senior management on monthly visits. To access residents’ account two signatures should be provided for such transaction and one of those is the senior manager of the company. One of the resident is able to access his own account and all transaction details are kept in the book. Staff and the homes managers spoke to us about their concerns about residents being left wet and soiled pads which could be concidered a form of abuse. Staff said “we find it very distressing that we are not able to change a resident when they are very wet and clearly uncomfortable and in distress at times”. Gaywood Street, 24 DS0000007090.V363949.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): 24,25,26,27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A pleasant, welcoming and comfortable home is provided for the residents. Recent redecoration and adjustments have improved the facilities and further improvement work is planned. The home is bright, clean, comfortable and safe. Residents’ rooms are comfortable and are decorated to reflect their personalities. The whole home is accessible to people with mobility needs. EVIDENCE: We were shown around the home by the deputy manager and found the home was clean, smelt fresh and homely. House is spacious and is fully wheelchair accessible. Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 20 We were told the living areas have been redecorated in colours of the resident’s choice. The flooring in the kitchen was replaced about a year ago. The kitchen is dated and at the last inspection we were told they hoped the kitchen would be refurbished. The deputy manager explained there had been a change of how projects are funded but they have been successful in establishing funding for anew kitchen. They said they hoped the work would start in this financial year. We were told they already had a plan for a new kitchen. They hoped to use that because it identified what was needed in the way the kitchen units were situated in the kitchen to accommodate the needs of the residents. Everyone in the house has been very happy about this. A new kitchen table has been purchased as well as new specialist cutlery for some of the residents. The garden is sunny and secluded and is accessed from the kitchen. We saw the new garden furniture that was purchased and they have a new solar garden lights. They said they felt garden is now much nicer and easier to manage. The staff room/small office has been moved into a smaller room to enable residents to have a bigger room for their sensory use. All residents have their own bedroom that is wheelchair accessible. We saw four resident’s bedrooms. The deputy manager said they planned to redecorate and recarpeted a number of bedrooms. At the moment each bedroom is individual and reflects the residents style and preferences. We were told residents will be supported to choose the colour of the decoration and carpet of their bedrooms as well as items they want to keep. The first floor bedrooms are accessed via a lift. The lift was replaced at the beginning of 2007. They had one episode since then where the lift would not work but have had none since. The carpets on the stairs and landing were replaced after the lift was replaced and are in good condition. The home has handrails in all the comunal areas and the toilets and bathroom have grab rails and handrails fitted to give residents extra support should they feel unsteady. There are adequate bathrooms and toilets with specialist equipment for staff to use to assist the residents safely with their personal care. Gaywood Street, 24 DS0000007090.V363949.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. Recruitment arrangements are good and residents individual and joint needs are met by appropriately trained staff. There is a friendly, motivated and competent staff team and staff has regular supervision and are supported in their work. EVIDENCE: We checked the staff rota and this reflected accurately the staff members that were on duty. As we arrived to start the inspection one member of staff was going home because they were feeling unwell. Another member of staff was trying to get cover for them to ensure they had enough staff on duty to meet the needs of the residents. It was evident through observations and from the rota that there were enough staff members working in the home. The deputy manager said they always tried to keep the staffing levels consistent and extra staff would be put on the rota if more than one resident wanted to go somewhere or staff had organised an outing that needed more staff on duty. Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 22 We sat in on the staff handover. The staff went through the handover checks they said they did at each handover. This includes checking the money held on behalf of the residents. The oncoming member of staff signs a record of this. The home has a daily task sheet for each shift that is signed by the member of staff who completes the task. This is handed over during the change of shift as well as giving verbal feed back. We met four staff during the course of the inspection. One member of staff who said they had worked for the organisation for ten years and enjoyed working in the home. They said the whole staff team had done a pressure training course and medication refresher training. Throughout the inspection we observed staff interacting with residents and the qualities seen included good listening skills, a calm and confident manner, and a good grasp of the basic areas of need they needed to meet, including communication. As part of the inspection process we visited the organisations head office to check recruitment practices and staff files. We looked at three files of staff who work in the home. Of those files of staff who work in the home all had an employment contract, which includes details of their terms and conditions of employment that they had signed. The home protects residents by obtaining references, CRB Enhanced Disclosures with relevant POVA checks were present for each staff member. We were informed earlier this year that the organisation had worked with the Home Office in relation to staff whose immigration status was in question re working permits/passports. As a result a number of staff were removed from the service. We were told the organisation always has residents on the panel as part of the recruitment process. All the residents who take part have training in interviewing skills and they are paid expenses for attending interview sessions. The organisation provides a wide range of training for the staff team mandatory training including manual handling, food hygiene, infection control, first aid and other general health and safety training and this is updated as required. We contacted the organisations training department and they were able to confirm staff in the home had completed a wide range of training and that mandatory training takes place each year. We saw copies of the training file that is kept in the home. This is an up to date record of all the training undertaken by the staff in the home. Three staff members have undertaken NVQ3 and two staff members are in process of completing NVQ3. One staff member is in the process of completing NVQ2. The staff said they receive regular supervision once a month and said they felt they could talk to their manager whenever they are around. Copies of staff supervision notes, which are signed, by a manager and a staff at the end of the supervision to confirm the goals set in a meeting are kept locked in the staff office. We were shown copies of staff meeting minutes that are held every two months. Gaywood Street, 24 DS0000007090.V363949.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): 37,39,41,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager has brought continuity, leadership and good levels of communication to the work of the home and this benefits the people using the service. The manager has clear the expectations of staff and ethos and approach the staff at the home should take. Residents know the home is well managed and planned. EVIDENCE: Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 24 The manager completed her registration since the previous inspection and is now the registered manager of the home. They hold a BSc Psychology (Hons), NVQ4 in Management, Diploma in First Line Management and have many years of experience working within the organisation. The deputy manager was new in post at the last inspection and now has three years management experience in all. The deputy manager has NVQ3 in Health &Social Care and is now registered for level 4 and has undertaken a First Line Management course. We were told she will undertake RMA after completing NVQ4. Both the manager and the deputy manager have undertaken specialist training reflecting the needs of residents group they support. Copies of the policies and procedures are kept in the staff office and are available for staff to refer to on a daily basis. They said “everyone has worked very hard to improve service at Gaywood and they feel the results are obvious in many areas, such as the homes appearance, staff confidence, staff’s future aspirations with a clear vision for the future. Records indicated that all fire and electrical systems and equipment in the home are serviced and inspected appropriately and that all internal checks are conducted at appropriate intervals. We were told the lift has an effective emergency maintenance contract in place to ensure the lifts are kept working at all times and on one of the days of the inspection the lift was serviced. We saw copies of the Quarterly Monitoring Report that monitors, evaluates and sets goals in all aspects of the home and the service provided to the residents. The senior management of the organisation conducts unannounced management visits to the home every month. A record of these are kept in the home and a copy is sent to CSCI. The home has a specially designed questionnaire, which it uses to ask the residents if they are happy with the service and living at the home. The outcome was positive. Gaywood Street, 24 DS0000007090.V363949.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 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 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 2 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 3 X 3 3 X Gaywood Street, 24 DS0000007090.V363949.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 YA7 Regulation 17 Sch3 3(q) Requirement Timescale for action 13/10/08 2. YA19 YA23 The registered person must ensure that there are formal records of the relatives and other professionals being informed bedrails and chair belts are being used on residents for the resident’s safety. 12(4) The registered person must 13(1)(b)(5) ensure residents’ dignity and comfort is retained at all times and staff are not put at risk in doing this. 13/10/08 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 Gaywood Street, 24 DS0000007090.V363949.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Gaywood Street, 24 DS0000007090.V363949.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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