Inspection on 17/07/06 for Harleith

This inspection was carried out on 17th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harleith 18/03/06

Harleith 25/07/05

Harleith 22/02/05

Harleith 05/10/04

Harleith 15/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Harleith 42 Grand Avenue Southbourne Bournemouth Dorset BH6 3TA Lead Inspector Stephanie Omosevwerha Key Unannounced Inspection 17th July 2006 & 18th July 2006 15:00 Harleith DS0000003945.V304053.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 Harleith DS0000003945.V304053.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. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harleith Address 42 Grand Avenue Southbourne Bournemouth Dorset BH6 3TA 01202 426544 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) The Stable Family Home Trust Mrs Samantha Irene Habgood Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The manager must complete NVQ Level 4 in care by 31st December 2005. 18th March 2006 Date of last inspection Brief Description of the Service: The registered service provider is the Stables Family Home Trust [S.F.H.T] a charity that provides residential care, a day service and related services for adults with learning disabilities. The day and residential services are interdependent with support from specialist staff at the day service being available to the staff and service users in residential care. The day service staff provide training, guidance and help with among other things matters such as employment, risk assessments and personal relationships. The home is located in a residential street in the Southbourne area of Bournemouth, within easy walking distance of local amenities that include, cliff top walks, a beach, shops, cafes, restaurants, post office and places of worship. Public transport is readily available and Bournemouth town centre a ten-minute bus ride away. The accommodation provides for up to eight people in a large detached three-story house converted for use as a residential care home. Service users bedrooms are located on the first and second floors of the premises. The home is centrally heated and all residents have single rooms, and the use of a shared lounge, dining room, kitchen and laundry facilities. To the rear of the property there is a garden with a paved patio area, a brick built barbeque and garden seats. At the front there is a large parking area. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection of the home and took place over approximately 6 1/2 hours. It was carried out as part of the planned inspection programme for care homes undertaken by CSCI and to address the requirements and recommendations made at the previous inspection. This inspection was a key inspection and therefore, assessed all identified key national minimum standards for care homes for adults (18-65). The inspector initially spent time with the manager of the home and examined various records and documentation including care plans, risk assessments, staffing records and health and safety records. The inspector conducted a tour of the premises viewing all communal areas of the home and a sample of 4 service users’ bedrooms. The inspector had the opportunity to speak with six residents who spoke positively about their experiences of living in the home including their rooms, their weekly activities, the staff and the food. The inspector also spoke with two members of staff who said they enjoyed working in the home. Additional information received by the inspector prior to the inspection was also taken into account. This included monthly monitoring visit reports from the responsible individual of the home, previous inspection reports and any incident reported to the Commission under Regulation 37 of the Care Homes Regulations 2001. Surveys were received from 3 relatives who said “we are satisfied with the care our son receives at Harleith” and “they all do a wonderful job and the standard of care provided at Harleith is excellent and of the highest standard”. What the service does well: Harleith is a home that will benefit service users who want to become more independent. The care planning and risk management strategies focus on the need to promote choices and independence. Support is provided in a flexible way giving service users many opportunities to participate in independent living skills. Examples include service users self-medicating, service users choosing and preparing their own evening meals, and 2 service users having their own food budget. The home has a management style that is empowering so that service users are able to fully participate in the running of the home such as choosing the décor and deciding to turn the dining room into a new games room as well as undertaking domestic duties. Service users benefit from an ethos that is open and inclusive and feel confident about raising issues and that these will be listened to and acted upon. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 6 There are excellent opportunities for social and educational opportunities and good links with the local community with service users regularly accessing the local shops and amenities. The home has a welcoming atmosphere and friends are encouraged to visit and personal relationships supported. Staff interact positively with service users giving them support in a way that promotes independence. The home demonstrates a commitment to providing good quality training and all staff have the opportunity to complete a number of courses that reflect the homes aims and meet service users needs. What has improved since the last inspection? What they could do better: The organisation still needs to develop a policy on quality assurance and an annual development plan incorporating feedback from service users needs to be produced for the home to provide action points/targets to further improve the quality of service in the home. The registered person needs to ensure that prior to agreeing any placement they obtain a copy of an assessment of the service users needs by a suitably qualified professional. A further minor recommendation is that care plans are signed and dated to evidence when reviews have been carried out. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 7 Some aspects of the environment need improving particularly the bathroom facilities that have had some work carried out but still need to be finished off. At the last inspection the inspector noted there were no lampshades on the communal landing and this was still the case. The manager said this was being fixed in the next week when an electrician was coming to the home to complete any outstanding work. The inspector recommended that the procedure for missing a medication dosage be clarified with the resident who self medicates to ensure he is fully aware of the correct action to take. There needs to be an agreed procedure with the Commission about where the recruitment information is to be stored for employees to ensure this can be accessed during the course of an inspection. 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. Harleith DS0000003945.V304053.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 Harleith DS0000003945.V304053.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a clear admission procedure and thorough assessments are made of prospective service users’ needs to ensure they will be suitably placed in the home. However, the home must ensure they have the required documentation from placing professionals prior to accepting a new service user into the home. Contracts have been improved to ensure residents are fully informed of their terms and conditions of occupancy in the home. EVIDENCE: The home has a clear admission policy and procedure. There had been one new resident admitted to the home since the previous inspection. Records showed the manager had carried out a thorough assessment of the service user’s needs prior to admission. Discussion with the service user confirmed they had been given opportunities to visit the home prior to admission. They said they liked living in the home and observation during the inspection indicated they had settled in well in the home. The inspector could find no evidence on the service user’s file of an assessment or plan carried out by a care manager, although there was evidence that the Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 10 home had been liaising with the care manager prior to the placement. For example, there was an email from the care manager confirming her agreement of the assessment the manager had carried out. The registered person needs to ensure that prior to agreeing any placement they obtain a copy of an assessment of the service users needs by a suitably qualified professional. There was a recommendation made at the previous inspection that service users’ contracts contain information about their contributions towards their residential fees. A sample of contracts was examined and this had now been implemented. Harleith DS0000003945.V304053.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are detailed, person-centred and informative ensuring service users and staff are fully aware of how needs and goals are to be met. Service users are encouraged to make a whole range of decisions giving them a real sense of control and choice over their daily lives. The home has clear risk assessment and management strategies enabling service users to take responsible risks rather than preventing them from doing so. EVIDENCE: A sample of 2 service users’ files was case tracked as part of the inspection. These showed each service user has a care plan, which covers a range of needs including personal care, health needs, social, education and leisure activities and independent living skills. The plans included service user own Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 12 personal goals for the forthcoming year such as “to do more cycling” or “to travel independently”. There were also detailed support plans that described the action needed by staff on a daily basis to ensure service needs were met. The manager told the inspector that these plans were new and she had just completed them for all residents. The inspector recommended these were signed and dated to provide evidence of when reviews were carried out. Observation throughout the evening evidenced many good examples of how service users are supported to make their own decisions e.g. they could choose their own meals, be supported to prepare them and choose when and where to eat them, and service users could choose to go out during the evening to the shops. All service users are supported to manage their own finances and have their own bank accounts. Service users confirmed they were enabled to manage their own finances and 2 service users had their own budgets for food further promoting their independence by enabling them to purchase and prepare their own meals. Evidence at the previous inspection confirmed good risk management strategies were in place. Assessments had been completed for a number of tasks and the inspector saw examples of these such as service users managing their own finances and managing their own medication. The emphasis was on promoting service users independence by giving them support and training to carry out tasks where possible while reducing/minimising any risks. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Provision of daytime activities and links with the local community are good and support and enrich service users’ social, leisure and educational opportunities. The home has good links with family and friends and service users are given excellent support to maintain their personal relationships. Routines in the home offer choice and flexibility promoting service user’s individuality and independence. A whole range of individual dietary choices are offered and service users are fully involved in the planning and preparation of menus. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 14 EVIDENCE: All service users were engaged in daytime activities and these were recorded on their individual files. The SFHT has its own integrated day service that provides a variety of courses such as art & craft, pottery, woodwork, personal relationships, current affairs and horticulture. Discussion with the service users during the inspection showed they also attended a range of different services during the day including college courses and work placements. All service users said they were satisfied with their weekly activities. There was evidence that service users accessed the community on a regular basis. Service users confirmed they utilised a whole range of amenities including shops, banks, post offices and leisure facilities. Some residents were assessed as being able to access the local community independently and could use public transport. Observation during the inspection confirmed residents could access the community as residents went out during the evening to the shops, they also told the inspector they were looking forward to going for a walk to the beach later during the evening. The home welcomes visitors and family and friends can stay overnight if appropriate. Service users confirmed they could have visitors and see them in the privacy of their rooms. One service user told the inspector he had recently invited his girlfriend around for a meal that he had prepared himself. Service users can access the house phone to make personal calls to family and friends and residents were observed using the phone during the inspection. The organisation has a policy on Personal Relationships and service users are given support and advice on this subject. Observation during the evening showed routines in the home were flexible. For example service users chose whether to spend time in the communal areas or opting to be alone in the privacy of their rooms; meal times were flexible and service users could choose where to eat their meals. Service users confirmed they have keys to their bedrooms and staff respect their privacy not entering their rooms without permission. Staff were seen fully interacting with service users and giving appropriate support during the evening. Service users attending the SFHT day service are provided with a cooked lunch. Arrangements during the evening for food preparation are flexible with all residents being encouraged to make their own meals or snacks independently or with staff support according to individual need. This means that service users are able to choose exactly what they want to eat. For example on the evening of the inspection a variety of different meals were observed including couscous and salad, sausage and chips and fish pie. Two service users have their own food budgets, and plan and prepare their own menus including purchasing their own food. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of service users’ personal care needs and support is offered in a way that promotes independence and respects personal preferences. Improvements have been made to the way health issues are recorded ensuring staff have good guidance as to how to meet the healthcare needs of all service users. The systems for administration of medication are satisfactory with clear and comprehensive arrangements in place to ensure service users medication needs are met including promoting service users’ abilities to self medicate. EVIDENCE: Service users’ care plans clearly documented their personal care needs and the support they require. The majority of service users at Harleith can manage their personal care independently with staff providing advice and prompting when necessary. Discussion with service users confirmed their personal care Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 16 needs were met and they were comfortable asking for assistance from staff who treated them with respect. Discussion with staff demonstrated they had a good understanding of service users’ individual needs and their likes and preferences. All service users had their own personal health records where all information was recorded about service users physical and emotional health, as well as details of their current medication. Visits to healthcare professionals were recorded such as dentists, opticians and hearing tests and there was evidence these were being carried out on a regular basis. There was also evidence of liaison with other professionals such as the community nurse who had written comments in the service users healthcare record. Since the previous inspection general guidance had been written about certain medical conditions such as epilepsy, there was also specific guidance relating to individual service users where this was necessary so staff could be confident about what action to take. Staff had also undergone training for certain conditions such as epilepsy. A comprehensive policy and procedure is in place that gives detailed advice to members of staff about the administration of medication. The home uses a NOMAD system of medication and records were checked and these were found to be generally up-to-date and accurate apart from one omission on one record, which the manager agreed to follow up with the member of staff. All service users current medication is listed as well as information about the medication including any contraindications so staff have easy reference to this. Staff complete external courses in Medicine Management that are arranged through the SFHT. The manager had complied a list of agreed homely remedies for each service user, which was signed by their G.P. to confirm his agreement to them being taken if necessary. One resident is currently administering their own medication and appropriate risk assessments for this were seen. The resident showed the inspection a locked medicine cupboard in his room and was able to explain how he takes his medication to the inspector. The inspector noted he had missed a dose on one occasion and checked the procedure with him, whilst he was clear that the medication should be left in place, he didn’t mention that he should alert staff immediately. The inspector checked this out with the manager who said he had in fact informed staff immediately on this occasion. It is recommended that the procedure be clarified with the resident to ensure he is fully aware of the correct action to take. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home promotes an open atmosphere where service users are encouraged to raise any issues/concerns and feel confident that their views will be listened to and acted on. Staff have a good understanding of adult protection issues, which helps to safeguard service users from abuse. EVIDENCE: The home has a detailed complaints procedure that meets good practice recommendations and regulations. Service users have easy access to complaints forms that have been designed in a user-friendly format. Evidence from previous inspections demonstrates complaints are taken seriously and acted on quickly and thoroughly ensuring the best outcomes for service users. The home has clear and detailed policy and procedures in place for protecting vulnerable adults. Staff receive training in this area. Evidence from previous inspections demonstrates adult protection investigations have been dealt with appropriately by the home. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home offers a comfortable and homely environment, although some improvements need to be made to ensure facilities are consistently maintained in the home. The standard of cleanliness is adequate with staff and service users being aware of procedures to prevent the spread of infection in the home. EVIDENCE: A tour of the premises was carried out as part of the inspection, including all the communal areas of the home and a sample of 4 service users’ bedrooms. The premises were generally well maintained and decorated in a homely way that was suitable for its stated purpose, i.e. providing care and support to adults with learning disabilities. Communal areas were found to be light, bright and comfortably furnished. The home is in the process of converting the dining room into a games room at the residents’ request. Service users Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 19 bedrooms were observed to be personalised to each individuals taste with plenty of space for personal possessions. There is still outstanding work needed in the communal bathrooms to ensure they meet the appropriate standards and the inspector noted one bathroom was not very clean. The manager said that some work had been completed in the bathrooms and they would be fully refurbished by September 2006. At the last inspection the inspector noted there were no lampshades on the communal landing and this was still the case. The manager said this was being fixed in the next week when an electrician was coming to the home to complete any outstanding work. The premises were observed to be generally clean and hygienic apart from one of the bathrooms. The manager said that service users were expected to take responsibility for keeping this clean and she would check this out with them. Procedures were in place to prevent the spread of infection, e.g. fridge and freezers are maintained satisfactorily and safe procedures followed for food preparation and storage. There was evidence that service users were aware of these procedures. For example service users were observed washing their hands before preparing food and were able to tell the inspector what the different colour chopping boards were for. There is a separate laundry room with impermeable walls and flooring that is away from food preparation areas. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team have a good mix of experience and skills, which has enabled them to develop a good understanding of service users needs. The registered provider is able to demonstrate robust procedures have been followed for vetting and recruiting staff ensuring the protection of service users living in the home. However, there needs to be an agreed procedure with the Commission about where the recruitment information is to be stored for employees. The home demonstrates a commitment to providing good quality training and all staff have the opportunity to complete a number of courses that reflect the homes aims and meet service users needs. EVIDENCE: There are currently six members of staff working in the home and two vacant posts. These are covered by regular bank workers who are employed by the SFHT. There is a mix of male and female staff and most staff had previous experience of working with adults with learning disabilities. Analysis of the Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 21 rota showed that one member of staff was provided from 7.00 – 9.00 am and two members of staff from 5.00 – 10.00 pm (Mondays to Fridays) and two members of staff throughout the day at weekends. Historically the home has not provided staff support during the hours of 9.00 am and 5.00 pm. This is because the service users attended day care outside of the home. However, service users needs and wishes have changed and service users are requesting more flexible day opportunities. Staffing support is now offered during the day in the home so service users have greater choice about daytime activities. Although the staffing hours provided are less than those recommended by the Department of Health guidance, observation during the inspection demonstrated that sufficient staff were available to meet service users’ needs. Two members of the staff team currently hold an NVQ or equivalent qualification and further two members of staff are working towards NVQ qualification meaning the home is well on track to meeting the target of 50 qualified staff. All staff have completed LDAF induction and foundation training. The inspector had the opportunity to speak to two members of staff who demonstrated a good knowledge and understanding of the residents’ individual and collective needs. They told the inspector they enjoyed working in the home. Observation of practice showed there was a high level of interaction between staff and service users and it was clear positive relationships had been formed. Service users told the inspector they liked the staff, found them approachable and were able to discuss any problems or concerns with them. A sample of 3 staffing records was viewed as part of the inspection. Most staffing records are kept at the SFHT Head Office and copies kept in the home. A couple of gaps in the required documentation were noted including a reference for a member of staff and a work permit. The manager said she was certain this information would be available at the SFHT Head Office and this information was subsequently sent to the inspector. There needs to be an agreed procedure with the Commission about where the recruitment information is to be stored for employees to ensure this can be accessed during the course of an inspection. All staff received terms and conditions and an employee handbook is also available, which contains amongst other things information on the SFHT’s grievance and disciplinary procedures. Staff are employed subject to a six month probationary period and a form completed to record the outcome of this was observed during the inspection. Service users are included on the interview panels for staff recruitment and service users are given training in how to carry out interviews. The home has an annual training plan identifying training needs for the whole staff team. Individual members of staff have a personal development record. These showed staff had attended a number of training courses including first aid, health and safety, food hygiene, fire training, prevention of abuse, medication, manual handling and infection control. It was noted that as well Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 22 as the required courses ensuring safe working practices the home promotes additional courses that reflect the home’s aims and service users needs such as epilepsy, autism, Makaton, oral health, risk assessment and challenging behaviour. Staff confirmed the training was “very good”. The manager showed the inspector a new in-house induction package that had been devised which linked to the Skills for Care guidance and LDAF. A newer member of staff confirmed they had received a thorough induction when commencing work in the home. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s manager is experienced and qualified and is competently meeting the home’s stated purpose, aims and objectives. There has been some attempt to gain feedback about the quality of service from service users but this needs to be included in a formal plan setting out aims and objectives for future service development. Improvements had been made to a number of health and safety systems ensuring service users are appropriately protected in the home. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 24 EVIDENCE: The registered manager of the home is Samantha Habgood. She is appropriately qualified having achieved the Registered Managers Award and NVQ 4 in care. She also has a degree in psychology. She has worked for a number of years with adults with learning disabilities. Staff commented during the inspection that the manager is very approachable and supportive. Observation throughout the inspection showed the management style empowered service users to make decisions and contribute to the running and development of the service. There was some evidence that progress had been made towards developing a quality assurance system. For example the home had introduced “Its my life” books to look at quality standards such as areas concerning home life and access to the community, based on individual needs identified in care plans. The organisation still needs to develop a policy on quality assurance and an annual development plan incorporating feedback from service users needs to be produced for the home to provide action points/targets to further improve the quality of service in the home. The responsible individual makes regular monthly monitoring visits to the home and a report of these is made available to CSCI. Progress has been made towards updating all the written policies and procedures for all the topics set out in Appendix 2 to the National Minimum Standards (2nd Edition). The Director of the organisation is producing these so a corporate identity can be achieved in all SFHT homes. The inspector examined records that showed that the home was meeting the requirements of other agencies such as Dorset Fire and Rescue Service and Environmental Health Department. Certificates were in place demonstrating that equipment and facilities were regularly serviced and maintained. Records of fridge, freezer and food temperatures were kept as well as water temperatures, which now included the outcome of any fault that needed rectifying as required at the previous inspection. A fire risk assessment was in place and staff carry out weekly visual checks on equipment. A record of fire drills is kept and these showed the times of these had now been varied as recommended at the previous inspection. Fire training records had also been improved to give information about the content of training. The home had clear policies and procedures relating to health and safety practices. The manager confirmed her awareness of relevant legislation and certificates were in place showing staff had attended various training courses in safe working practices. Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 4 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 X 12 3 13 3 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 1 2 X 3 X Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes 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 YA2 Regulation 14 Requirement The registered provider needs to ensure that prior to agreeing any placement they obtain a copy of an assessment of the service users needs by a suitably qualified professional. The registered provider needs to achieve the target of at least 50 of care staff achieving a NVQ 2 qualification in care. Timescale for action 01/09/06 2. YA32 18 01/12/06 3. YA39 24 The registered provider must 01/09/06 develop an annual plan for the home in order that the success in achieving the aims and objectives set out in the Statement of Purpose can be measured. (This requirement is repeated from the previous inspection dated 18/03/06.) Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 27 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 YA6 YA20 Good Practice Recommendations It is recommended care plans are signed and dated to provide evidence of when reviews were carried out. It is recommended that the procedure for missing a medication dosage be clarified with the resident who self medicates to ensure he is fully aware of the correct action to take. The fixtures and decoration within the home should be maintained at an appropriate standard. There needs to be an agreed procedure with the Commission about where the recruitment information is to be stored for employees. The corporate policy on quality assurance and review needs to be developed further to include how feedback is to be sought from other interested parties, including service users. It is recommended that the registered provider should produce written policies and procedures for all the topics set out in Appendix 2 to the National Minimum Standards (2nd Edition) and these should be produced in relevant formats for service users where appropriate. 3. 4. YA24 YA34 5. YA39 6. YA40 Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 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 Harleith DS0000003945.V304053.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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