Inspection on 10/10/08 for Gloucester House

This inspection was carried out on 10th October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Gloucester House 21 Cheltenham Rd Evesham Worcestershire WR11 1LA     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: Emily White     Date: 1 0 1 0 2 0 0 8 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 31 Information about the care home Name of care home: Address: Gloucester House 21 Cheltenham Rd Evesham Worcestershire WR11 1LA 07817688225 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Charlotte Rose Davis Type of registration: Number of places registered: Noble Care 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 to 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 categories: Learning Disability (LD) 5 Date of last inspection Brief description of the care home Gloucester House is a newly developed house run by Noble Care in the centre of Evesham. The service provides care for five people with with moderate and severe learning disability, as well as people who have additional mental health needs or other specialist needs such as autism or challenging behaviours. The aim of the service is to provide care and support and to assist people in leading as fulfilling lives as possible, which includes community based services and personalised care. The house is a period building in a residential area furnished to create a comfortable and homely environment. It offers safe surroundings and has en-suite bathrooms for all five Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 5 Brief description of the care home bedrooms, a modern kitchen, two lounges, a dining room and a large garden. The house is within easy access of Evesham town centre which provides shops and a range of community leisure facilities. Evesham is a small market town in Worcestershire near to Worcester, Birmingham and the Cotswolds. Care Homes for Adults (18-65 years) Page 5 of 31 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 manager sent us information about the house before we visited. We visited on a week day, and the manager was on duty and helped us. We met two people who use the service. We also met some staff who work there. Care Homes for Adults (18-65 years) Page 6 of 31 We looked at some records such as care plans and medication and looked at how the house is run. Information about fees can be obtained from the service. What the care home does well: What has improved since the last inspection? 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. 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 8 of 31 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 9 of 31 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 are confident the service can support them. They have information and are able to visit before they move, and they have a full assessment to make sure the service can meet their needs. Evidence: The service has a statement of purpose that is standard across Noble Care homes. We looked at the care management files of two people using the service, which contains all their information relating to their care needs. Each file contains a service guide which is comprehensive. For example, the guide includes a summary of the purpose of the service, what a person can expect from care plans and reviews, satisfaction and complaints, and fee information. The guides are very detailed and the manager tells us they are read out to people before they move, but alternative formats would be considered. We spent time talking to people using the service and they told us that they had a lot of information before they moved and that they knew enough before they moved in. Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: People have a detailed assessment carried out by the manager before they move. For example this includes their personal details, brief biographical background, medical information, communication needs, daily living skills, ability for self directed choice, likes and dislikes, identified challenging behaviour, risks to self and others, and future wishes and worries. Peoples files also contain their social services needs assessment, discharge record from previous residence, and a recent psychiatric report. The information from these documents links together and feeds into their care plans. Both people we spoke to are able to participate fully in their own assessment so they had limited involvement from family, however the manager tells us that family and other representatives could be included as needed. The Annual Quality Assurance Assessment tells us that staff meetings are held before new people move in to discuss peoples needs, particularly regarding behaviours and maintaining a safe environment. We spoke to the manager and staff who told us this happened before the current residents moved in. Peoples care files also show us that staff use two admission checklists, one for staff and one for the person. This shows that the person has been given all the required information and had opportunity to discuss needs and visit the house before they move. The checklist is signed by the resident and includes dates of next meeting with social worker and manager. This is good practice and shows that the service has thought about how it can meet peoples needs right from the beginning of their time there. Peoples files also have records of their transition meeting reports. These show that four meetings took place either at the service or at previous place of residence, who was involved and all issues that were raised, before people moved to the service. People did not have an overnight stay but they were offered a meal and spent some time with staff. The Annual Quality Assurance Assessment tells us that the meetings are a chance for people to meet with staff and other residents and that people already living at the home would also have their say as to someones suitability. Care files contain a contract which has similar information to the service guide and are signed and dated by the resident. Care Homes for Adults (18-65 years) Page 11 of 31 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. Peoples needs and goals are met through a detailed care plan. People are supported to make decisions and take risks in their daily lives. Evidence: We looked at the care files of two people using the service. Each have a care management plan, an essential lifestyle plan and a health action plan. People have more involvement in their essential lifestyle plan and health action plan whereas the care management plan provides more detailed information for staff. All three plans are based on the assessment information gathered before people moved in and are being built as they settle in. The people living at Gloucester House have been there a few weeks so their essential lifestyle plans are developing. These are set out in the way they prefer. They cover for example peoples positive reputation, what is essential to them, personal relationships, what they like, things they can do, what is working, daily routines and food likes and dislikes. The two plans we looked at already had photographs in them of recent activities and also have a poster called Its Ok To Talk Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: which explains to people what to do if they are not happy about something. The care management plans give details about how to provide personal support including management of challenging behaviour and restrictions on choice and freedom. Some individual support guidelines have have been set out as agreements with people using the service however they have not been signed by them. It is important for the service to make sure all plans and agreements agreed with people using the service are signed by them where possible. The manager tells us that everyone who moves to the service will have their own key worker and it is planned that all the care plans will be reviewed every two months. People using the service tell us that they have booked meetings with their social worker to take place in the next few weeks. They told us that they had been involved in the making of their care plans and were happy to talk about what is in their care plans. They also told us they were in the middle of choosing their key workers now they had some time to get to know the staff. The Annual Quality Assurance Assessment tells us that people help plan the menu and take part in shopping. Peoples weekly activity timetable is up on a notice board in the hall. This shows leisure activities and chores as well as shopping. During our visit we observed people talking to staff about what they were doing that day. People using the service tell us that they meet every week to discuss their plans for the week ahead. The manager tells us that the weekly meeting on a Sunday is a mini review and an opportunity for people to talk about what they want and make decisions. There will be plans for a regular residents meeting when people have settled in and there are more residents. People also have a daily debrief with staff which records whether someone has had a good or bad day, why, whether they have been sad or angry, what has made them sad or angry, and if they have anything they need to discuss. This is signed by the person and gives them a chance to make supported decisions based on the events of the day. People using the service are supported to take risks based on their own decisions, the assessment information from outside professionals and the assessments done by the service. The risk assessments are kept separately from the care planning file but all areas identified through the care plans are followed up in the risk assessments. The service understands the importance of individual risk assessments relating to a persons particular needs, for example where there are risks of harm to people using the service. The risk assessments are useful to staff because they tell them the identified risk, the potential harm, steps to reduce the risk and action to take in the event of a concern. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Peoples care files are kept in the office the manager keeps the door open when she is there and people have free access to their own files but not others. People using the service tell us that staff do not talk about their business in front of others unless they have given permission. Staff handover takes place in private where others are not able to listen which shows that staff understand the need to keep confidentiality. Care Homes for Adults (18-65 years) Page 14 of 31 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 are treated as individuals and are able to take part in meaningful occupation as they wish. People are supported to be actively involved in the community, to build relationships and manage their daily routines, including meal times. Evidence: Peoples care plans record their interests such as going to college, gardening and cooking. People using the service tell us they take turns to cook and there is going to be a vegetable patch dug for them. One person showed us his reading exercises that a member of staff has been helping him with. The manager tells us that people have expressed interest in college and enquiries have been made to enrol. Although the service is new this shows that opportunity for education and occupation will be supported. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: At the start of our visit people using the service were out with family or with staff. When they came back they told us they regularly go into the local town for shopping and to the pub or for walks. Towards the end of our visit people went out bowling with members of staff. The rota shows that the current ratio of staff is one to one which enables people to be supported in separate activities and to access the local community. Peoples activity sheets tell us that they spend time going to the local gym and making use of local facilities separately from each other as well as together. Staffing may need to be reviewed as more people move in. Peoples interests, relationships and ways they can link in with the local community are covered through care planning and in their essential lifestyle plans. People also have regular contact with their family and other personal contacts. Some people have risk assessments set up to make sure they can have full access to life outside the service but within the guidance of their care plan. One person using the service also told us that he can have quiet time alone in the quiet lounge upstairs if he wants it, which he uses to play computer games. People have CDs and DVDs which they can watch together in the lounge or privately in their rooms. Daily records and speaking to staff shows us that people using the service are being supported to maintain personal relationships in ways that follow their care plans. The rota of daily chores in the kitchen and the daily activity records show that routines for managing the house are included in peoples daily lives. Staff tell us that one large task for example cleaning the lounge is done by one person every day. People also have responsibility for keeping up their own personal spaces. People using the service showed us their personal rooms and said they have to look after them and keep their bathrooms clean. One person says that he likes to help with the cooking and housekeeping tasks. During the day we observed people helping with lunch. We observe that mealtimes are relaxed and informal, and people using the service help to cook the meals and choose what they have that day. Peoples food preferences are recorded in their care files and essential lifestyle plans. Menus are up on the notice boards and show choices that fit with peoples preferences as well as healthy options. Activity records show people have been helping with the shopping and to prepare a meal. There is a rota for meal preparation in the kitchen. The manager tells us that she plans to use pictures to help with planning the food menus and to help with meal preparation. It would be good practice for the daily tasks planning to be set out in alternative formats, to help people with their communication skills, particularly for those learning to read and write. Care Homes for Adults (18-65 years) Page 16 of 31 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. People receive their personal support in the way they prefer and want. The service has good procedures in place that staff can follow. People are supported to take their medications in a safe way. Evidence: People using the service have Essential Lifestyle Plans, Care Plans and Health Action Plans which cover all their personal support, medical and healthcare needs. The Annual Quality Assurance Assessment tells us that care plan reviews will be recorded by key workers (named staff to work with an individual) using a key worker report. These reviews will be attended by key workers, the home manager or deputy and proprietor. Other people may also be invited to attend such as social workers or other professionals. The reviews will involve looking at well being and happiness, personal comfort, menu issues, relationships with others and financial matters, and changes can be requested by people using the service. We looked at peoples care plan which shows that very little support is provided for personal care, with the majority of support provided for emotional and daily living Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: skills. Noble Care have a registered mental health nurse who has been working full time in a senior carer position with new residents and staff and to help set up the care plans. The care plans cover many areas of support such as maintaining a safe environment, behaviour, communication, personal hygiene, medication, physical health and relationships. Under each of these areas there is a summary of the persons needs, aims for the person, and a description of the staff interaction needed. There are additional guidelines for particular areas of risk which link in to the risk assessments described above. We spoke to people using the service who say that staff support them in the way they want and they have agreed to the things in their care plans. One person told us that he likes the staff and that they help him a lot. They tell us they are being helped to be healthy and eat more healthily, one person said he is being supported to go to the gym regularly. We observed staff talking with one person about an event the previous day which showed us that staff have a good knowledge of the person and are able to respond well to their needs. Records such as the daily debrief, daily diary notes, daily observation and incident reports are used. These records show personal support being provided according to peoples care plans. Peoples health action plans show that all health needs and health appointment records are being recorded. The health action plan is written in an easy to read style with pictures which supports people to manage their own health needs. Letters and communication from doctors and other health professionals are filed in the care file. People are being supported to manage weight loss and have monthly weight charts in their file. Records in the health action plan and daily notes show that there is good communication with healthcare professionals such as doctors, and concerns about health are being followed up. The key worker system, up to date records and good contact with outside professionals will make sure peoples needs continue to be met. Medications are stored in a secure locked cabinet. There is a policy for management of medications. We saw that people had the correct medications that were written in their care plans. Recording sheets are kept separately and record all medications administered correctly. The manager will be carrying out a medication audit. One temporary medication is being kept in the fridge in a secure box. The manager is aware that if long tem medications need to be refrigerated a suitable storage needs to purchased. The manager also brought to our attention that people using the service need to sign to give consent for their medication to be given. People using the service said to us that they had asked the staff to help them with their medications. One person had been prescribed a new temporary medication on the day of our visit. This had not been updated in the health action plan. It would be good practice for people using the service or staff to take their health action plan to appointments with them so Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: they can be updated. Care Homes for Adults (18-65 years) Page 19 of 31 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 are able to complain and can feel confident that their concerns will be dealt with promptly. People are safeguarded from abuse, harm or neglect by the services policies and procedures. Evidence: The Annual Quality Assurance Assessment tells us that all new people moving to the service will be made aware of the complaint form which will be held in their essential lifestyle plans. People will also be able to bring up their concerns or a complaint during regular reviews. It also says that all staff will have the criminal records check before being employed and policies and procedures for safeguarding are up to date. During our visit we looked at records which support the ways people are kept safe. We looked at records which show that there have not been any concerns or complaints. The service has a copy of Worcestershire local safeguarding policy and it has its own complaints, protection and whistle blowing policy. The details of the local safeguarding offices and CSCI are correct and available to people using the service. People have on their notice board and within their care files a copy of Its Ok To Talk which encourages people using the service to speak about their concerns and how to complain in a formal way. It is written with pictures and easy to read language. The daily debrief with staff is an opportunity for people to talk about how they have felt during the day and what has happened. These are recorded by staff and put in the Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: care files. Staff also record in the daily diaries three times a day. The training matrix in the managers office shows that safeguarding is part of their mandatory training and dates have been set up for staff who have not had training yet. We also spoke to staff and people using the service. Staff all had a good understanding of what they should do if there was an incident which concerned them. We observed a staff handover which was carried out in a confidential way and where events were discussed in detail. People using the service said they know who to go to if they are not happy. They also said they feel safe and happy at the service. Care Homes for Adults (18-65 years) Page 21 of 31 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 service provides a homely, relaxed, safe and welcoming house for people to live in. Evidence: The manager of the house and people using the service showed us around the house. The house has been refurbished in a modern style and has a large communal dining and kitchen area, a lounge and a quiet lounge upstairs, the garden is large and every bedroom has an ensuite bathroom. There are no major maintenance works to be carried out but the house has a maintenance person to carry out minor jobs. People who are using the service showed us their rooms which are personalised and kept in the way they like. As more people move to the service it is expected that the communal areas will become more personalised. The manager is aware that it would be good practice to have photos up in the hall of staff and people who use service with their permission. Records and our observations show that the kitchen and bathrooms are clean and hygienic. Health and safety checks are currently being carried out by the manager who keeps a file with all the checks recorded. There is a laundry which is separate from the Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: kitchen. People using the service tell us they do their own laundry and help to keep the house clean. There is a rota in the kitchen which shows the cleaning tasks to be done. Window restrictors have been placed on windows as suggested in the registration report. Care Homes for Adults (18-65 years) Page 23 of 31 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. People are supported by a full competent staff team. People can have confidence in the staff supporting them because staff are checked before they start and have regular training, supervision and support. Evidence: We looked at two staff files and spoke to four staff during our visit. We also spoke to people using the service about the staff and observed a staff handover. It is clear from this that staff have job descriptions, they understand their role and are able to interact well with people using the service. The Annual Quality Assurance Assessment tells us that staff will be supported with NVQ training or working towards NVQ. Staff files show they have relevant background experience, and have received training and an induction. Staff tell us they feel well qualified to do their jobs and some have specialist skills such as experience of working with people with challenging behaviour. Staff tell us they have had a good induction which involved mandatory training and some shadowing. They also have a workbook to complete based on the Skills for Care Induction Standards. Staff have also had inhouse training relating to the specific needs of the people using the service. It is expected that this will continue as new people move in. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: We looked at the rota and discussed the staff team with the manager. There are three staff on during day time hours, which at present includes the manager who works part of her time on the rota and part off for management tasks. This offers one to one support for people using the service at present. Half the staff team are male which is appropriate for the needs of the men who use the service. Currently there is one waking night staff and one sleeping night staff member. The manager is aware of the importance of reviewing the rota when more people have moved to the service, for example she says that there may be two waking night staff on if necessary. Noble Care have a registered mental health nurse who works across the services but is currently working full time at this house as new people move in. The staff files show that there is a good recruitment policy and all staff have had the proper safety checks before they start work. The manager has a training chart which shows all mandatory training and safeguarding adults training has either been undertaken by staff or they are booked to take the training. This includes moving and handling training, fire safety, medications, food hygiene and infection control. Staff tell us that they have also attended training on managing challenging behaviour. The manager tells us there will be training on guardianship and the Mental Capacity Act. It would be good practice for the training matrix to cover all in house and specialist training as well as mandatory training to allow the manager to monitor the development of the staff. Staff tell us they all have supervision booked in with the manager for the next few weeks. All the staff tell us that the manager is very supportive. The manager plans to hold supervision every four to six weeks initially, and to hold supervision records in staff individual files. Care Homes for Adults (18-65 years) Page 25 of 31 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. People can have confidence in the service because it is managed well and there are good health and safety practices. The service uses the opinions of the people who live there to develop the service. Evidence: The Annual Quality Assurance Assessment was completed and sent to us on time. It had limited detail as there were no people using the service at the time. We talked to the manager during our visit. She understands the importance of using the Annual Quality Assurance Assessment to tell us about how well the service is doing. She has completed the Registered Managers Award and NVQ level 4 and has relevant experience as deputy manager at another home. She has set up all the relevant policies and procedures. Policies and procedures are available to all staff and the manager intends to review them annually or following changes in legislation. Observations during the day, speaking to staff and people using the service show that the service has been set up well and is being run in an open, positive and inclusive Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: way. Records being kept by staff are up to date and support the well being of people using the service. Individual records and home records are secure, up to date and in good order. Noble Care have recently employed an operations manager who will oversee the services that they run. We met the operations manager during our visit. She will be supervising the manager, carrying out monitoring visits with the provider, and carrying out audits as part of the quality monitoring of the service. The audits cover topics such as health and safety, medication, infection control, food safety, and an overview of the service. The service has many ways of seeking the opinions of people using the service, such as the daily debrief, weekly meetings for activity planning, and the key worker reviews of care plans. Peoples opinions will also be sought formally through surveys, and the service will also be sending surveys to family and health care professionals as appropriate. Training records and speaking to staff shows that training in safe working practices has happened or has been booked. This includes moving and handling, fire safety, first aid, food hygiene and infection control. Records show that environmental risk assessments have been carried out and the manager is carrying out the required health and safety checks. There is a method for recording of accidents and incidents which staff are aware of. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 of 31 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 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 1 It would be good practice for the service to consider alternative methods to communicate the guide to the service, according to the communication needs of individuals, for example audio guides. It would be good practice for the service to provide, in an an easily accessible communal area, the visitors book and information about the service, for example the statement of purpose, guide, CSCI inspection reports and complaints procedure. The service should make sure that where agreements have been made with people using the service, for example in care plans, risk assessments and where there are restrictions on choice or freedom, that there is somewhere for the person to clearly sign to show their agreement. It would be good practice for the service to develop, with people using the service, alternative methods for planning daily routines and meal times, for example using pictures or simple words. This would help people to use and develop their communication skills. It would be good practice for people using the service or staff to take the health action plan with them when they have appointments, so that information can be updated immediately or so that health professionals can write in Page 29 of 31 2 3 3 6 4 16 5 19 Care Homes for Adults (18-65 years) them if appropriate. 6 20 People using the service or a representative should sign to show that they have given consent for the service to manage medications for them. It would be good practice for photographs of staff to be placed in the hall and for people using the service to put pictures up of themselves if they wish. This will help with personalising the house. It would be good practice for the training matrix to cover all in house and specialist training as well as mandatory training to allow the manager to monitor the development of the staff 7 24 8 35 Care Homes for Adults (18-65 years) Page 30 of 31 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 © (2008) 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. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!