Inspection on 22/01/09 for Gledhow Wood Road

This inspection was carried out on 22nd January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gledhow Wood Road 02/02/07

Gledhow Wood Road 17/01/06

Gledhow Wood Road 03/10/05

Gledhow Wood Road 08/02/05

Gledhow Wood Road 29/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Gledhow Wood Road 68 Gledhow Wood Road Leeds West Yorkshire LS8 4DH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Dawn Navesey     Date: 2 2 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 34 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 34 Information about the care home Name of care home: Address: Gledhow Wood Road 68 Gledhow Wood Road Leeds West Yorkshire LS8 4DH 01132179500 F/P01132179500 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Patrick Cassidy Type of registration: Number of places registered: TACT UK Ltd care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 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 category: Learning disability Code LD Date of last inspection Brief description of the care home The home is located in a residential area of Oakwood, north of Leeds. It is a detached building and does not look any different to the other houses within the road. People who use the service have bedrooms that are on the ground and first floor, with office space and the staff bedroom on the top floor. There are large attractive gardens to the rear of the building. Personal care is provided for five people who all have a learning disability. The local healthcare team offer good support to them. The home is within walking distance of a supermarket, shops, bank and a post office and people are able to make use of these facilities. There is a car at the home to make sure the people are Care Homes for Adults (18-65 years) Page 4 of 34 Over 65 0 5 Brief description of the care home able to attend any appointments they have and to take them on trips out. A regular bus service to the city centre is available. The current scale of charges at the home is one thousand, one hundred and sixty pounds per week. Additional charges are made for hairdressing, toiletries, and holidays. Care Homes for Adults (18-65 years) Page 5 of 34 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Commission for Social Care Inspection (CSCI) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk This visit was unannounced and was carried out by one inspector who was at the home from 9am - 2.45pm and 4pm - 5.10pm on the 22 January 2009. For some part of the Care Homes for Adults (18-65 years) Page 6 of 34 visit, the inspector was joined by an expert by experience. An expert by experience is someone who has expert knowledge of care services through their own experience of using services. They join the inspector to help them get a good picture of the service from the viewpoint of the people who use it. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people living there. And also to monitor progress on the requirements and recommendations made at the last inspection. Before the inspection evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the visit. An AQAA (Annual Quality Assurance Assessment) was completed by the home manager before the visit to provide additional information. Survey forms were sent out to people living at the home, staff and health care professionals. Four of these have been returned and this information has also been used in the preparation of this report. During the visit a number of documents and records were looked at and some areas of the home used by the people living there were visited. Some time was spent with the people who live at the home, talking to them and interacting with them. Time was also spent talking to staff and the manager. Feedback at the end of the visit was given to the manager. The last inspection of this home was on 2 February 2007. What the care home does well: What has improved since the last inspection? A new statement of purpose has been drawn up that gives information on the home and what it has to offer people. Although there is still more work to be done, peoples care plans and risk management plans are clearer and more detailed. This makes sure peoples needs are identified and met well. Staff have undertaken training on the mental capacity act. They said this would help them to protect peoples rights. Care Homes for Adults (18-65 years) Page 8 of 34 In the AQAA, the manager told us of improvements made to the environment. These included, Shower room reconfigured and redecorated to a high standard and now consists of shower cubicle bath wash and basin and W.C. Outhouse in garden secured. All communal areas re-floored and decorated. This has made the home more comfortable for people. Food hygiene is now managed better. Staff label foods when they are opened so that the manufacturers instructions on keeping food stuffs can be followed. Over half of the staff team have now achieved an NVQ (National Vocational Qualification)in care at level 2 or above. This means they are qualified to carry out their job. Staff are receiving regular supervision and feel well supported in their roles. Records relating the management of health and safety are now better. This means it is clear when accidents or incidents have been reported and how they have been managed. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 9 of 34 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 34 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 34 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service and their representatives have the information needed to choose a home that will meet their needs. Evidence: There have been no new admissions since our last inspection of the home. In the AQAA, the manager said, Person centred planning is used to ensure that the people we support are as involved in the structure and nature of the service they receive. He also said they are currently undertaking a, Comprehensive review of placements to include people supported and all relevant stakeholders. This means they are checking the service to see if it is right for people. In order to do this a set of planning meetings have been arranged to assess peoples current wants and needs. These meetings include the people who live at the home, their relatives and other people who know them well. They will serve as a good person centred assessment from which care and Care Homes for Adults (18-65 years) Page 12 of 34 Evidence: support plans can be developed. A new statement of purpose has been drawn up that gives information about the home. This is kept on display for people to access. People said they were happy living at the home. Their comments included: I like it here I am very happy here. The expert by experience spoke to people who live at the home. One person told them, he would not change anything about the home and said, I do like living here. Care Homes for Adults (18-65 years) Page 13 of 34 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to make decisions about their lives and are involved in planning their care and support. Evidence: In the AQAA, the manager said, Choice and the ability to take decisions of their own are central to the philosophy of the service at Gledhow. We involve people supported in as much choice and responsibility as they are capable and comfortable to deal with. We treat all the people we support as unique individuals with differing needs, capabilities, aspirations and difficulties. Care Plans are in place to illustrate individual needs and promote independence whilst respecting privacy and dignity. Risk Assessments are in place and are reviewed regularly or as circumstances change. Staff receive training in diversity and the concept of individual choice is central to the organisations aspirations. We looked at care plan and risk assessment records for some people who live at the Care Homes for Adults (18-65 years) Page 14 of 34 Evidence: home. We found them, in the main, to be person centred and individual to each person. Some plans had clear and detailed instruction on how the needs of people who use the service are to be met. They had some good information about how people should be supported with personal care, communication, social and health needs. There is also a clear emphasis on furthering peoples independence and involving them in the daily life of the home. People are given support to be as involved as they can be. There were however, some shortfalls with the care plans and risk assessments. Some plans did not give the detail of how care needs are carried out. Terms such as prompt do not tell staff how much support a person needs and could lead to needs being overlooked. Some risks had been identified for people but were not supported by risk management plans that were individual to that person. For example, risk assessments for people who were at risk from choking. This does not tell staff how to meet the individual needs of people. The manager said that the planning meetings that were taking place for people would mean that new support plans would be drawn up. He said they would be in more detail on peoples support needs and would also focus on peoples likes, dislikes and future goals and aspirations. Staff were familiar with what was written in peoples care plans and could talk confidently about the support they give. They had very good knowledge of peoples individual support needs and could describe peoples routines well. Care plans are reviewed and evaluated regularly to make sure they are still relevant for people. Key workers do this on a monthly basis with people who live at the home; this makes sure they are still meeting peoples needs properly. People are encouraged to make choices and decisions about what they do. Staff said they encourage people to choose what to do, where to go out, what to eat and what to be involved in around the house. We saw people were supported to make choices, using a variety of communication methods such as pointing, touch and facial expression. Staff showed they had a good understanding of how people communicate. The expert by experience said, The resident told me that he goes to Tescos with staff support and chooses the food that goes in the shopping. He also added that he chooses what he would like to eat at meal times and that staff cook his meals and he likes to help out with the washing up. Care Homes for Adults (18-65 years) Page 15 of 34 Care Homes for Adults (18-65 years) Page 16 of 34 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle. Social, educational, cultural and recreational activities meet peoples expectations. They also benefit from a good, healthy and varied diet. Evidence: In the AQAA, the manager said, People supported continue to lead varied lifestyles, social and leisure activities are supported as much as possible by staff of their own choosing. Exposure to different cultures through leisure activities, from local carnivals to themed curry nights. He also said, Choices are actively encouraged around the provisions of food and drink with alternatives offered at mealtimes and people supported encouraged to make their own drinks and help themselves to snacks. Care Homes for Adults (18-65 years) Page 17 of 34 Evidence: The manager said improvements had been made to the service by offerring people more one to one activity. He also said in the AQAA that he was planning to further examine how the people we support make choices and how best we can make them a reality. The expert by experience spoke to people who live at the home about what they liked to do. One person said that he sometimes likes to go to the pub and the cafe. The staff member added that people like to do their own things individually so they dont have set activities. He also said that one person told him that he goes out with one to one or two to one staff support and that he enjoys rides out in the countryside. Also adding that he does not like to go on holiday but that the other people go on holiday once a year. There is a variety of activity on offer to people. This includes, drives out to the countryside and parks, walking, shopping, going to the pub and meals out. Some people also attend day centres or use a local opportunities service for one to one activity. Staff also make sure there is plenty for people to do at the home such as gettng involved in household activity, cooking, watching television and listening to favourite music. One person has pet fish and is encouraged to care for these. People are also supported to keep in contact with family and friends. Staff said they support people to make and receive telephone calls from family and arrange regular visits to their family home. Staff said that, in the main, they felt they had enough staff to support people with their activities. They said that when short staffed it can sometimes be more difficult to get people out, especially if there was no member of staff on duty who could drive. On the day of the visit, we saw that taxis were arranged to take people out for drives to local parks as there was no driver on duty. There was plenty of social interaction between the staff and people who use the service. It was clear that staff and people who use the service get on well. We looked at menus at the home. These are planned around peoples likes and dislikes. Choices are made on a daily basis, menus are not fixed. Staff said there is always an alternative to what is being cooked as the main meal and snacks are readily available. Staff record what is eaten and comment on whether people liked it or not. Staff said they know peoples likes and dislikes well. People who live at the home said they enjoy the food, one person said, Its lovely and we are having pork chops for tea Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: tonight. Staff said they try to encourage people to have a variety of foods but to also respect peoples choices. One said, We introduce new things and see how they go down with people. Food hygiene is now managed better. Staff label foods when they are opened so that the manufacturers instructions on keeping food stuffs can be followed. Care Homes for Adults (18-65 years) Page 19 of 34 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, peoples general healthcare needs are well met and based upon their individual needs. Evidence: In the AQAA, the manager said they, Always strive to support people in a manner appropriate to their wishes and mindful of their needs. Staff had good knowledge of peoples personal support needs. Staff were thoughtful, discreet and respectful of peoples dignity when attending to any needs. People who live at the home looked well cared for, well dressed and groomed. A person who lives at the home, told the expert by experience that he felt that staff respected his privacy and added, They always knock on my door. Good records are kept of health appointments and their outcomes. Staff make sure that people are given support to attend appointments to meet their health needs. People are referred to health professionals when needed. Staff have identified and monitored health needs well. In the AQAA, the manager told us that people who live at Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: the home had attended well man clinics to monitor their health. Staff said they had received some training on meeting the specialist health needs of people who use the service such as epilepsy and behaviour management. Staff said they would benefit from further training on peoples mental health needs. One person said they responded to peoples needs and how their illness affected them as an individual but said they felt a more general overview of the persons condition would help them provide better support. The home uses a monitored dosage pre-packed system for medicines. There are good ordering and checking systems in place. We checked some medication administration records (MAR) sheets. These were found to be in reasonable order. However, some people were prescribed creams and ointments and the records for these did not at times give directions for their use or show they had been administered. The manager was advised that a seperate MAR sheet could be used and kept with the creams in the persons room to make sure they are properly administered and recorded. We also noticed that some entries on the MAR sheets had been handwritten. It is good practice to make sure these entries are checked and countersigned by a second person to make sure the information is correct and people receive the right medication. Care Homes for Adults (18-65 years) Page 21 of 34 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and are protected from abuse. Evidence: In the AQAA, the manager said, We have a complaints procedure that all people supported and their families are aware of and it is available in an easy to read format and React appropriately to any concerns expressed by the people we support, their families friends or any relevant stakeholder. The expert by experience said, The resident said that he would speak to the manager or the senior if he had a problem or a complaint and would speak to staff if he did not feel safe. Staff have received training in safeguarding adults. They were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. They were familiar with the whistle blowing procedure and said they would have no hesitation in using it if they thought they needed to raise concerns outside of the home or organisation. Staff have also undertaken training on the mental capacity act. They said this would help them to protect peoples rights. Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: Records are kept of the finances of people who live at the home and their monies are kept safe. However, there seems to be an ad hoc approach to the paying for taxis for people who use the service. As mentioned in the Lifestyle section of this report, people go out for drives using taxis. Staff said that people who live at the home sometimes pay for the taxi themselves and at other times the homes budget is used. This must be reviewed to make sure it is fair for all people who use the service. Care Homes for Adults (18-65 years) Page 23 of 34 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is homely, comfortable and in the main, safe for people who live at the home. Evidence: In the AQAA the manager said, We provide a homely, friendly, relaxed and safe environment for the people we support to live and flourish. Bedrooms are decorated to match the personalities and preferences of the individuals. Gardens are well maintained with a summer house and good quality garden furniture, people supported continue to enjoy B.B.Q.s in the summer months. A tour of the home was carried out. Communal areas, bathrooms and bedrooms were visited. The home looked clean, homely and well maintained. The living room furniture however, is looking tired and worn. The manager has already identified this and is looking into how it can be replaced. The expert by experience thought the home was nicely decorated and kept clean and tidy. He also said, One of the residents showed me his bedroom. I found the bedroom very spacious and it was decorated to a high standard. The resident told me that he liked the way the home and his bedroom was decorated. The bedroom was full Care Homes for Adults (18-65 years) Page 24 of 34 Evidence: of the residents own personal belongings and was decorated to his taste. In the AQAA, the manager told us of improvements made to the environment. These included, Shower room reconfigured and redecorated to a high standard and now consists of shower cubicle bath wash and basin and W.C. Outhouse in garden secured. All communal areas re-floored and decorated. This has made the home more comfortable for people. Clinical waste is properly managed. Staff have received training in infection control as part of their induction and were able to say what other infection control measures are in place. Hand washing and hand drying facilities were available in all areas of the home. Liquid soap or paper towels were available. This ensures good hygiene practice. Care Homes for Adults (18-65 years) Page 25 of 34 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are, in the main, trained, skilled and in sufficient numbers to support people who use the service. Evidence: In the AQAA, the manager identified that there had been recent problems with recruitment and staff sickness in the service but has put plans in place to try to reduce the effects of this. For example, the use of regular bank staff rather than agency staff. He said in the AQAA, We do not use agency staff but we have a small core of Bank staff who have known the people we support for many years and will usually fill any staff shortages. People who live at the home said they liked staff and got on well with them. One person told the expert by experience, They are all nice, I like all the staff. Records showed that, in the main, there are two staff on duty throughout the day. Occasionally there are three staff. The manager said he aims to have more staff on duty at weekends and evenings when the majority of the people who use the service are at home. Staff said that ideally having three staff on was good as it meant people could get out more. All staff we spoke to said they made sure the needs of people who Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: use the service were met well no matter whether there were two or three staff on duty. Staffs comments included: Been a bit short lately due to sickness and maternity leave, we just work harder, dont let it afffect the service users, make sure they dont miss out Service can be impaired but not significantly We make sure the clients get what they need, paperwork and cleaning may be affected but not the people. A person who lives at the home said, They are struggling a bit at the moment with staff numbers but usually there was enough staff. Staffing levels should be kept under review to make sure the service is fully meeting the needs of people who live there. We looked at recruitment records. These showed that recruitment is properly managed by the home; interviews are held, references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. Induction training is based on the Skills for Care common induction standards. Staff said their induction had been good and prepared them well for their job. We also looked at training records and these showed that most staffs training was up to date or if updates were needed, they were planned. Since the last inspection of the home, the manager has updated some of his essential training such as fire safety and food hygiene. However, he is aware that some further updates are needed, for example moving and handling. Some records had not been kept up to date and it appeared the staff had not received training in some areas such as safeguarding adults and moving and handling when in fact they had. The manager agreed to update the records. There is a commitment from the organisation for staff to complete their NVQ (National Vocational Qualification) in level 2 or above. Over half of the staff team have now achieved an NVQ in level 2 or above. This means they are qualified to carry out their job. Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: Staff spoke highly of their training. Comments included: Provides good training Keen to make sure that staff are trained before they do specific tasks e.g. medication Encourage personal development via NVQ and distance learning courses. We looked at staffs supervision records and saw that regular one to one sessions are now being provided for staff to discuss their roles. Most staff said they were happy with the support they get. One member of staff said they thought the service could do better by providing more supervision. Care Homes for Adults (18-65 years) Page 28 of 34 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, the interests of the people who use the service are seen as important to the manager and staff and are properly safeguarded. Evidence: The manager of the service is a registered nurse and has many years experience of managing the home. He has not yet achieved the registered managers award. He said he had started this since our last inspection and is aware of the need to complete it. He provides good leadership and support to staff, working alongside them and leading by example. Staff and people who use the service spoke highly of the manager. Their comments included: One of the best I have ever worked with Feel appreciated I like (name of manager) He encourages openness and honesty He never belittles you. Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: In the AQAA, the manager said the service, Promote a relaxed and friendly environment for both the people we support and the workforce. Involve the people we support in all aspects of decision making. A person centred approach is adopted to ensure that all people supported are as involved in the structure and nature of the service they receive. A staff member said, The service is a homely and comfortable place to live, the staff do everything possible to offer open and honest communication between staff and the people we support Records we looked at showed that regular health and safety checks are carried out. In the AQAA the manager said relevant health and safety policies and procedures were in place, and reviewed. He also said equipment has been serviced or tested as recommended by the manufacturer or regulatory body. Records showed that certificates on gas and electrical safety were up to date. The organisation provides a comprehensive manual of policies and procedures for staff to refer to. We looked at accident reporting and spoke to staff about this. Staff were clear on their responsibilites and how to report and record accidents or incidents. The organisations operations manager conducts monthly provider reports with detailed requirements for improvement. The manager receives regular supervision from the operations manager to support him in his role. Care Homes for Adults (18-65 years) Page 30 of 34 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 31 of 34 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The administration of creams and ointments must be recorded and clear directions for their use must also be recorded. This will make sure administration is safe. The system of payment for taxis must be reviewed and a policy put in place. This will make sure peoples financial interests are protected and the system is fair for all people who live at the home. 28/02/2009 2 23 13 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 People who use the service should have detailed care plans and risk management plans, clearly outlining all their support needs. This should include likes/dislikes and future aspirations and goals. This will ensure that they receive person centred support Care Homes for Adults (18-65 years) Page 32 of 34 that meets their needs fully. 2 19 Some consideration should be given to providing staff with more training on specific conditions that people who live at the home may have. This will make sure they can meet peoples needs more fully. Handwritten entries on MAR sheets should be checked and countersigned by a second person to make sure the information is correct and people receive the right medication. Staffing levels should be kept under review to make sure the service is fully meeting the needs of people who live there. The manager should continue to work towards completion of the registered managers award to make sure he is qualified to carry out his role. 3 20 4 33 5 37 Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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