Inspection on 07/06/07 for Gladstone Road, 29

This inspection was carried out on 7th June 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gladstone Road, 29 09/05/06

Gladstone Road, 29 02/02/06

Gladstone Road, 29 24/10/05

Gladstone Road, 29 14/12/04

Gladstone Road, 29 08/07/04

Gladstone Road, 29 01/03/04

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

CARE HOME ADULTS 18-65 Gladstone Road, 29 29 Gladstone Road Seaforth Liverpool Merseyside L21 1DG Lead Inspector Mrs Janet Marshall Key Unannounced Inspection 7 & 11th June 2007 10:00 Gladstone Road, 29 DS0000005237.V332886.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 Gladstone Road, 29 DS0000005237.V332886.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. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gladstone Road, 29 Address 29 Gladstone Road Seaforth Liverpool Merseyside L21 1DG 0151 949 0966 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) www.peterhouseschool.org Autism Initiatives Miss Colette Heyes Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 3 LD. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 9th May 2006 Date of last inspection Brief Description of the Service: 29 Gladstone Road is a mid-terraced house in a residential area of Seaforth. Parking is outside the property in the street. The home is managed by Autism Initiatives. The home is registered as a care home to provide care and support for 3 adults who have a learning disability. There are currently three men living at the home. The staff group appears committed in providing a high level of support. Relationships with neighbours are reported being good and the service users continue to benefit from an active involvement in the community. The overall philosophy of care is to promote independence and to maximise ordinary living for all the service users. It costs between 1073.31 – 1418.47 per week to live at the home. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection. The Commission considers 22 standards for Care Homes Adults as Key Standards, which have to be inspected during a Key Inspection. The report has been put together using information gathered from a number of sources including information that the commission have received about the service since the last inspection and details provided in the pre-inspection questionnaire. “Have your say” Surveys were sent out by the Commission to people before the inspection, however none of them were returned. A site visit to the home was also carried out as part of the inspection. Records examined, people’s comments and observations made during the visit have also been used as evidence for the report. People spoken with during the visit, included a resident, the manager and a number of staff. It was not possible to obtain the views of other residents because of the nature of their disability however case tracking and observations made during the inspection visit enabled the inspector to get an idea of what is like for the people to live at the home and how their needs are being met. What the service does well: Available at the home were a number of policies and procedures, which aim to ensure that people make a positive choice about living there. The manager showed a good understanding of the companies needs assessment document and was able to describe in good detail the areas it covers. A practice support team is which made up of professional health and social care workers including a speech therapist visit the home on a regular basis to provide the manager and staff with ongoing training around the use of support plans. These have recently been introduced to the home and will gradually replace care plans previously used. Support plans are developed on the basis of a full and comprehensive assessment of needs carried out by the practice support team with the involvement of the resident, their family/representative, and the home manager and support staff. They are then used to plan, monitor, review and evaluate each persons care needs. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 6 Residents with communication difficulties are supported to make decisions and choices by use of other methods for example photographs, pictures and symbols. Residents make choices about such things as what to eat and what they want to do. It is important for one resident to know which staff are on duty each day to help him with this staff have provided him with a board his room displaying the staff rota in the form of pictures symbols and photographs. During the inspection visit staff were observed treating residents with respect and carrying out personal care in a flexible and sensitive way. One service user said that staff are always polite and treat them well they made the following comments to support this: “I like the staff the are nice to me” “They do knock on my door” The home has in place appropriate procedures for responding to concerns and complaints and for ensuring that residents are safe from abuse, harm or neglect. The commission have not received any complaints about the home since the last inspection. Everybody spoken with during the inspection said that they have access to information about how to make a complaint if they needed to. People were confident that their complaints would be listened to and dealt with in the correct way. More than half of the staff team have achieved or are working towards a National Vocational Qualification in Care level 2 and above. Staff are involved in an ongoing programme of training, which is relevant to the work that they carry out. The manager showed great enthusiasm for ensuring high standards of care, she also showed a commitment to the training and development that is required of her to maintain and update her knowledge, skills and competence while managing the home. What has improved since the last inspection? Since the last inspection Care plans have been reviewed and updated at regular intervals to ensure that resident’s needs are identified and fully met. A number of new staff have started work at the home since the last inspection this has increased opportunities for residents who are now are able to participate in activities that they prefer both at home and in the community. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 7 New support plans involved in cleaning routines, care routines, cooking and laundry decisions on a day-to-day basis to ensure that daily routines promote their independence, choice and freedom of movement. Each resident has their own bank account in their own name however access to their accounts is limited due to arrangements for withdrawals the manager is aware of the difficulties and is in discussions with relevant people with a view to change the current arrangements so that residents have more choice and control of their personal finances. 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. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 8 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 Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 9 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service had available policies and procedures, which aim to ensure that prospective residents needs are fully assessed so that they can be sure of meeting the person’s needs. EVIDENCE: No new residents have been admitted to the home since the last inspection. The home is occupied by the same three men that have lived there lived there for a number of years. Available at the home were a number of policies and procedures, which clearly describe the processes, involved for assessing and admitting new residents. Completion of a full care needs assessment, introductory visits and a trail period are processes followed to ensure that people make the right decision about living at the home. During the last key inspection there were no initial assessments available for the men that live at the home. The manager explained that this is due to the Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 10 length of time that they have been living at there. However regular care needs reviews take place with the involvement of the care management team. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 11 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. The new support plans provide staff with the information that they need to support residents to live independent and safe lifestyles. EVIDENCE: Viewed at the home for each of the residents was a working file, which contained all the relevant information that staff need to support residents in all aspects of their lives. The companies practice support team have developed a new care-planning format, which they have called, support plans. Support plans, which are gradually being introduced to residential services across the company, will replace care plans previously used. The practice support team is made up of professional health and social care workers including a speech therapist and are experts in the field of Autism and Aspergers syndrome. The team provide Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 12 managers and staff with ongoing training around the use of the support plans and associated documentation. A member of the practice support team who visited the home during the inspection visit explained the new support plans and how they are used to support residents. Support plans are developed on the basis of a full and comprehensive assessment of needs carried out by the practice support team with the involvement of the resident, their family/representative, and the home manager and support staff. They are then used to plan, monitor, review and evaluate each persons care needs. A support plan is put in place for each particular area of need or goal. The plans aim to support residents to achieve independent lifestyles. Daily records, which are linked to support plans, are completed by staff during each shift. Support plans and associated records, which have been completed for one resident, were looked at in detail as part of the case tracking process. The plans covered areas of need such as communication, behaviour, personal, healthcare and social support. Recordings made for one resident were detailed and clearly linked to his support plans and showed that since the last inspection residents are encouraged to be more involved in daily routines around the home such as cleaning, cooking and laundry. Residents that have limited verbal communication skills are supported to communicate choices using a number of different ways for example by use of pictures, signs, photographs and symbols. Support plans, which were looked at described residents, preferred methods of communication and the help and assistance that they need to make choices and decisions. Pictures, photograph and symbols are used to assist resident in making choices and decisions with regard to things such as what to eat and where to go. One resident was seen communicating by use of pictures and photographs. The practice support team provide staff at the home with training, advice and guidance on how to communicate effectively with people with special needs. During the last inspection there was evidence to show that that each resident has their own bankbook showing transactions made, however they are part of a single account managed by Autism Initiatives. The current system does not allow residents to access their money directly. Withdrawal request forms have to be completed and forwarded onto head office for authorisation by a senior manager who then withdraws money from the bank on behalf of the resident. There is a risk that residents are left short of money because this process can Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 13 take several days. The manager was advised to look at ways of changing this so that residents can access their money more easily. During this inspection visit the manager said that she is in on going discussions with relevant people with a view to change the current arrangements so that residents have more choice and control of their personal finances. Residents’ money and records, which were kept at the home, were examined as during this visit. All money and records were in good order. A member of staff explained that residents’ money is checked at the end of shift. Records to show this were seen. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 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 and supported to live active and healthy lifestyles although some records do not always show this. EVIDENCE: The pre-inspection questionnaire detailed the range of activities available for residents at the home they included arts/crafts, painting listening to music and household tasks also detailed were other activities in the community which included swimming, cinema, bowling, walks and photography. On the morning of the inspection visit a resident was observed leaving the home to attend a day centre. A member of staff said that he attends the centre each weekday as part of daily routine. Another resident who attends Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 15 day care on a part time basis spoke about how much he enjoys it he also gave examples of a range of activities that takes part in both at home and in the community which included swimming, meals out, shopping, household tasks and trips to the theatre. On the morning of the inspection visit the resident was observed vacuuming communal parts after completing this a number of other domestic tasks he left the home with a member of staff to go swimming. Discussion with the resident and viewing of records showed that these activities are consistent with his assessed needs and wishes which were recorded in his plan. Another resident does not regular attend day care or any other arranged, however a member of staff said that he is encouraged and supported by staff to take part in various tasks and activities in and outside the home. Discussion with staff and observation of records showed that this is particularly important for this individual as without the appropriate encouragement and support will spend a lot of time isolated in his room. The residents care plan and other care records such as daily notes were viewed as part of case tracking. Recent assessments including a social work review clearly stated that the person should be offered a range of activities and opportunities for personal development to encourage his independence and prevent isolation. Daily monitoring records which were viewed for this person showed little evidence that they have been given appropriate opportunities. However during discussion staff gave examples of a range of activities, which they had offered the resident. They included photography, cooking and trips to the local shops. Staff were advised to record this to show that the person is offered appropriate opportunities for personal development, which are clearly set out in his plan of care. Gladstone Road, 29 DS0000005237.V332886.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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health and personal care is well monitored and supported enabling them to live healthy lifestyles. EVIDENCE: Care plans recorded individuals preferred routines, likes or dislikes with regard to personal care. Details of how staff need to support each person with personal care were available in good detail. The information, which following a requirement as part of the last inspection report has been reviewed and updated and now show that resident’s health and personal care needs are being met. A member of staff assisted a resident with personal care this was done in a way that ensured the privacy and dignity. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 17 One resident said, “I get up and go to bed when I choose” “I choose the clothes I wear each day” “I make my own bed with some help from the staff” Records showed that specialist advice and support is accessed for residents who need it i.e. speech therapists and physiotherapists. During interviews staff demonstrated a good awareness of the main principles of care, including privacy, dignity and respect. Records showed that residents are offered minimum annual health care checks and that these needs are well met, monitored and supported. Records that were viewed showed that residents are supported to attend GP appointments, dentists, chiropodists, hospital appointments and opticians. Details provided in the pre-inspection questionnaire, discussion with a resident and a member of staff showed that residents access health care services, which are located in the local community. Records showed that support and monitoring is consistent for one resident who has epilepsy. Staff showed good knowledge and understanding of his condition and how to manage it. Daily records that were viewed also showed that residents health care is monitored and that complications and problems have been identified and dealt with appropriately. Medication and Medication Administration Record Sheets were examined, they were all in good order. Medication was stored in a locked cabinet that was fixed to the wall in the office. Records showed that medication is administered by staff that have undertaken the required training. Staff interviewed confirmed that they have undertaken medication training. During the previous inspection the manager confirmed none of the residents administer their own medication and it is unlikely they will ever be able to. The necessary risk assessments have been carried out to show this and the reasons why. A policy for the receipt, recording, storage, handling administration and disposal of medication was available at the home. A record of medication received and leaving the home was seen. Gladstone Road, 29 DS0000005237.V332886.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): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be sure that any complaints they make are listened to taken seriously and acted upon. EVIDENCE: No complaints have made about the service to the home or to CSCI since the last inspection. A copy of the services complaints procedure was displayed in the hallway of the home. This was written in plain English and was supported by pictures to explain the process. A discussion with one resident confirmed that he was aware of the complaints procedure and he said that he would tell somebody if he was unhappy about something. A copy of the services own abuse awareness and whistle blowing policy was viewed. They were available in the homes policy and procedure file as well as being displayed on a notice board in the office. A copy of the local authorities complaints procedure was also available at the home. Through discussion two members of staff spoken with showed a good understanding of what they would do if they suspected or evidenced abuse of a resident. One member of staff explained that the service has their own Adult Protection officer who provides support and advice regarding adult protection issues. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 19 Discussion with staff, staff training records that were looked and details provided in the pre-inspection questionnaire at showed that all staff has received training in the protection of vulnerable adults. Gladstone Road, 29 DS0000005237.V332886.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): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is homely, comfortable and free from hazards. EVIDENCE: A partial tour of the home was carried out. The home is of domestic style and in keeping with others in the Road. The home has several shared spaces, which include a lounge, a sitting room and a large kitchen/dining room. Residents were seen using these rooms during the visit. The home has a bathroom and a separate shower room on the first floor and a toilet on the ground floor. Since the last inspection locks on all bathrooms and Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 21 toilets have been repaired and are now in full working order ensuring residents privacy. There is a staff sleep-in room on the first floor and an office on the ground floor. All parts of the house are accessible to all residents. None of the residents are wheelchair users. There were no hazards identified at the time of the visit. Policies and procedures relating the health and safety of the environment were available in the homes health and safety manual, which was in the office and easily accessible to staff and residents. A planned maintenance and renewal programme for the fabric and decoration of the home was seen. The outside of the home was checked. Both the front and the back gardens were generally well maintained. The exterior decoration was in satisfactory condition. All resident’s bedrooms were viewed; they were clean, tidy and furnished to a satisfactory standard. The decoration in one residents bedroom showed signs of wear and tear. This was discussed with a member of staff. It is recommended as part of this report that the room be redecorated to enhance the comfort and dignity of the resident. It was recommended as part of the last inspection report that the sofas in the lounge be replaced this was because they were worn and stained in parts. Since the last inspection sofas have been replaced with new ones. A member of staff confirmed that the sofas were purchased without the involvement of the residents and staff at the home. Were possible residents and/or their representatives should be involved in selecting new furniture for their home to show that they are consulted on and participate in all aspects of the home. All other furnishings, fittings and equipment in the home were of good quality and condition. Details provided in the pre inspection questionnaire and examination of a selection of records showed that the required safety testing of systems and equipment has taken place as the required intervals. All parts of the home were clean and tidy. During the visit one resident was seen helping with cleaning parts of the home. He said he helps with vacuuming, polishing and cleaning his own room. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 22 Policies for the control of infection were available at the home. The kitchen was equipped with domestic style appliances including a washing machine and dryer. Staff spoken with showed a good understanding of procedures remaining to hygiene and control of infection. Gladstone Road, 29 DS0000005237.V332886.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): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by a staff group that understand their roles and responsibilities, however is no guarantee that all staff are fit to work at the home which has the potential to put residents at risk. EVIDENCE: The pre-inspection questionaire provided details of the current staff group. This shows that six support staff and the manager work at the home. the preinspection questionaire shows that a CRB check has not been obtained for two support workers. Staff records were not available for inspection as they were locked away by the manager who was not on duty on the day of the inspection visit. A further visit to the home was arranged with the manager to view staff personell files. the manager confirmed that a number of new staff have started work at the home since the last inspection. personnell files for these people were not avialble at the home for inspection. the manager explained that they were in head office being updated and that she was intending to collect them that day. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 24 The companies personell department have since provided written confirmation showing that all the appropriate checks have been carried out and obtained for all staff that work at the home. The manager was advised that all the required information about staff should be kept at the home to show that they were recruited appropriatley and they are fit to work at the home. This was a requirement as part of the last inspection. The home employs people of various age, gender and of different ethnic and minority groups. An Equal opportunities policy was available at the home. this was discussed with a member of staff who felt that it deals with all the relevant issues which relate to equality such as employment, training and attitude. There were two members of staff on duty on the morning of the visit and two residents at home. One to one support was given to a resident enabling him to take part in an arranged outdoor activity. The resident and member of staff left the home in the morning to go swimming. The other member of staff provided support for a resident who chose to stay at home for the day. The staff rota for a four week period was examined it showed a minimum of two staff on duty throughout the day and a sleep-in staff at night. It is important for one resident to know in advance which staff are on duty each day to help him with this staff have provided him with a board his room displaying the staff rota in the form of pictures symbols and photographs. During interview staff confirmed that they have received manatory training including epilepsy awareness, diabetes, administration of medication and disability awareness. All staff interviewed have completed or are undertaking a National Vocational Qualification in Care Level 2 or above. The the preinspection questionaire gave details of future training planned which includes moving and handling, first aid, food hygiene and health and safety. Gladstone Road, 29 DS0000005237.V332886.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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed to the benefit of the residents and staff. EVIDENCE: Since the last inspection the appointed manager Mrs Colette Heyes has been approved by the commission as registered manager of the home. The homes registration certificate issued by the Commission, which includes details of the manager, was clearly displayed at the home. The previous inspection evidenced that the manager has commenced a National Vocational Qualification level 4 in management at this inspection visit she confirmed that she is near to completing the award. Discussion with the manager evidenced that she continues to undertake periodic training to Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 26 maintain and update her knowledge and skills records, which were viewed, also evidenced this. During discussion the manager showed a good understanding of her role and a commitment to ensuring high standards of care. Information provided in the pre-inspection questionnaire and examination of a selection of records during the inspection showed that those required by regulation are available, up to date and accurate. Staff spoken with was complimentary of the manager and the way she runs the home, the following comments made by staff supported this: “The manager is flexible, supportive and very approachable” “No faults, the manager is brilliant very supportive” “The manager is a very good listener, supportive and professional” Also As part of the homes quality assurance process and in accordance with Regulation 26 of the Care Homes Regulations a representative for the home visits the premises monthly. They talk to residents and staff, check records and inspect the environment. This is done to check the standard of care in the home. Following the visit a report detailing the visit is written. Records show that the visits and reports are being carried out each month as required. The health safety and welfare of residents are well protected this was supported by a comprehensive set of policies and procedures, which were detailed in the pre-inspection questionnaire and available at the home. Information provided in the pre-inspection questionnaire and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. A member of staff who was on duty at the time of the inspection confirmed that he is responsible for ensuring that the alarm system and fire equipment is regularly tested he showed a good knowledge and a clear understanding of fire safety policies and procedures. Gladstone Road, 29 DS0000005237.V332886.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 X 2 3 3 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 2 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 3 X 3 X X 3 X Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 28 Yes 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 YA41 Regulation 17(2)(b) Requirement The manager must ensure that staff files are kept at the home and include all the required information. (This is a previous inspection requirement) Timescale for action 30/06/07 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. 2. Refer to Standard YA11 YA8 Good Practice Recommendations Opportunities should be better recorded for one resident to show that staff are appropriately supporting his personal development. Were possible residents and/or their representatives should be involved in selecting new furniture for their home to show that they are consulted on and participate in all aspects of the home. Gladstone Road, 29 DS0000005237.V332886.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Merseyside Area Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Gladstone Road, 29 DS0000005237.V332886.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. 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