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Inspection on 10/11/08 for Harry Chamberlain Court Residential Home (44)

Also see our care home review for Harry Chamberlain Court Residential Home (44) for more information

This inspection was carried out on 10th November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Harry Chamberlain Court Residential Home (44) 44 Harry Chamberlain Court Hollingsworth Road Lowestoft Suffolk NR32 4UG 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: Julie Small Date: 1 0 1 1 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 41 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 41 Information about the care home Name of care home: Address: Harry Chamberlain Court Residential Home (44) 44 Harry Chamberlain Court Hollingsworth Road Lowestoft Suffolk NR32 4UG 01502564792 01502564792 h2029@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Mrs Christine Brown Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 6 1 0 Care home 6 learning disability physical disability Additional conditions: Service Users with Physical Disability The Home may only accommodate people with a Physical Disability if they also have a Learning Disability. One named person in the category of Learning Disability over the age of 65 One named person in the category of Learning Disability over the age of 65 made known to the Commission for Social Care Inspection on 20 April 2005 (as named in the application) Date of last inspection 0 5 0 3 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 41 A bit about the care home 44 Harry Chamberlain Court is a residential care home providing care and accommodation for up to six adults with a learning disability, who may also have some level of physical disability. The home is owned by the Royal Mencap Society and is situated in a mixed housing complex on the outskirts of Lowestoft. This resource was first registered in 1989. All accommodation is sited at ground floor level and there are two small garden areas accessible to service users and a large car park to the rear of the building. At the time of the inspection the manager explained that fees ranged from £65.20 to £102.90. Care Homes for Adults (18-65 years) Page 5 of 41 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 Care Homes for Adults (18-65 years) Page 6 of 41 How we did our inspection: This is what the inspector did when they were at the care home The inspection was undertaken Monday 10th November 2008 from 13:00 to 17:20. The inspection was a key inspection that focused on the core standards relating to adults and was undertaken by regulation inspector Julie Small. The report has been written using accumulated evidence gained prior to and during the inspection. The manager was present for part of the inspection and they provided the information that we requested promptly and in an open manner. We spoke with three people who lived in the home. Care Homes for Adults (18-65 years) Page 7 of 41 We spoke with two staff members who worked at the home. We looked at four care plans of people that lived at the home. We viewed records that were kept in the home, which included health and safety records. Other records that were viewed are identified in this report. Care Homes for Adults (18-65 years) Page 8 of 41 Prior to the inspection we sent an AQAA (annual quality assurance assessment) and surveys to the home. We received the AQAA and two relative, five service user and five staff surveys. What the care home does well The staff treated the people that lived with respect. Care Homes for Adults (18-65 years) Page 9 of 41 The staff knew about how the people lived at the home communicated. Staff were aware of how people were to be supported to meet with their needs and choices. People were supported to make choices about what they wanted to do, such as with activities. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 10 of 41 The staff recruitment records were available and held the information that was needed to show that the homes recruitment procedures were followed and that checks had been made before they started working at the home to make sure that they were suitable for the job. There were paper towels in the bathrooms for people to use, which minimised the risk of cross infection. There was good guidance regarding the PRN (as required) medication to make sure that staff knew when it should be given. The care plans were updated regularly to show peoples changing needs and choices. Care Homes for Adults (18-65 years) Page 11 of 41 Staff had been provided with up to date training to make sure that they knew how to protect people from abuse. What the care home could do better There should be regular Regulation 26 visits made by the providers and the reports should be available in the home for inspection, to ensure that the home is monitored. Care Homes for Adults (18-65 years) Page 12 of 41 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Julie Small CSCI Capital Park Fulbourn Cambridge CB1 5XE 01223771300 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 13 of 41 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 14 of 41 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 can expect to have their needs assessed and met. Evidence: The group of people that lived at the home had done so for some years. There had been no people admitted to the home since the last key inspection. Care Homes for Adults (18-65 years) Page 15 of 41 Evidence: The records of four people that lived at the home were viewed and each held a detailed needs assessment, which identified the support that they needed and required. The assessments were regularly updated to ensure that peoples changing needs and preferences were identified. The AQAA stated we have an assessment process that involves gathering information from the person we are supporting, people who are important to them and any other professionals involved in their support (including assessments completed by care management). Each persons records included a detailed care plan, which identified how their assessed needs were to be met and they were regularly updated to show how their changing needs and preferences were to be met. The AQAA stated that they recognise the importance of carefully reviewing that someones needs can be met by the service and once we are providing a service to someone we have regular planned reviews to address any issues or changes that have been identified. Care Homes for Adults (18-65 years) Page 16 of 41 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 can expect to have their assessed needs set out in an individual care plan, to be supported in making decisions about their lives and to have the risks in their lives assessed and minimised. Evidence: Care Homes for Adults (18-65 years) Page 17 of 41 Evidence: The care plans of four people that lived at the home were viewed and each identified the step by step support that they required to meet their assessed needs and preferences, such as with personal care and their night time routines. The care plans of two people included detailed behaviour plans, which had been drawn up with the support of a health professional, and they identified the support that people required to ensure that they were supported appropriately at times of distress. The care plans clearly identified the communication methods that people used. During the inspection staff were observed to communicate effectively with the people that lived at the home. The staff were patient and clearly knew about and understood the ways that people communicated. Each care plan that was viewed identified peoples skills, strengths, the support that they required and the areas of their care that they could attend to independently, such as with personal care, household chores and with their finances. The care plans cross referenced to detailed risk assessments, which identified the risks that had been identified and methods of minimising the risks. The risk assessments included working in the kitchen, ironing and the arrangements for their finances, such as if the people managed their own finances, holding their own bank card and for their visits to the bank. Two people that were spoken with stated that they managed their own finances and they explained that they were supported by the staff if they asked for assistance. Their care plans clearly reflected the arrangements for their financial management and the methods of minimising risks. The AQAA stated risk assessments are done for the benefit of individuals, to ensure their safety and others. Two relative surveys stated that their relatives needs were always met and that they were always provided with the support that they expected or agreed. Comments included I have nothing but pure admiration for the loving care always given to my Care Homes for Adults (18-65 years) Page 18 of 41 Evidence: (the person) and it exceeds what could be expected or agreed. Five staff surveys stated that they were always provided with up to date information about the people that they supported. The staff survey asked if the ways that they passed over information worked well. Two answered always and three answered usually. The staff surveys stated how they did well, which included gives individuals choice respect and opportunity, provide good quality support and care for each of the residents. Keep the place running to the standard required. Keep records updated and stored correctly. Maintain a clean environment, treat residents as individuals, work well with other professionals and provide a warm and clean accommodation, good food, choices i.e. the daily menu where they want to go, a locked private room for them, support from staff, daily activities of their choice. The care plans and risk assessments were updated regularly to reflect peoples changing needs and preferences. One risk assessment included a temporary change in the personal care support that a person was provided with due to their condition. Records of care reviews were viewed and the person that was provided with the service and their representatives had attended, which showed that their views were listened to regarding the support that they were provided with. The AQAA stated (people) are asked who they would like to assist them with baths etc, they choose what they want to do in the evenings and at weekends. (People) are aware of their support plans and were involved producing them, these are also reviewed regularly by doing so we can monitor any changes and provide the support at the agreed level. One to one key worker days also help to support the above. During the inspection people made choices in areas such as what they wanted to drink and eat and the activities which they had chosen to participate in. People that were spoken with reported that they made choices in their lives and that staff listened to them. A person told us that they took it in turns to choose the evening meal and that they had chosen the meal for the evening of the inspection. Three people stated that they had chosen the decor and furnishings in their bedrooms and that they had helped Care Homes for Adults (18-65 years) Page 19 of 41 Evidence: to choose the decor and furnishings in the communal areas of the home. Two relative surveys stated that people were always supported to live the lives that they chose. The service user survey asked if they made decisions about what they wanted to do. One answered always, three answered sometimes and one did not answer. Four surveys stated that they could choose what they wanted to do during the day, during the evening and at the weekend and one did not answer. The service user survey asked if the staff listened and acted upon what they said. Three answered always, one answered sometimes and one did not answer. The daily records that were viewed detailed peoples well being, staff observations, choices that people had made about their daily lives and the activities that each person had participated in. Two peoples records that were viewed included letters from a local advocacy service, which they had been supported to contact. The letters stated that they were attempting to locate an advocate for them in the local area. Care Homes for Adults (18-65 years) Page 20 of 41 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect to be supported to participate in activities, to be treated with respect and to be provided with a nutritious diet. Care Homes for Adults (18-65 years) Page 21 of 41 Evidence: The records of four people who lived at the home were viewed and each clearly identified the arrangements for their attendance to daily support services, which included their transport arrangements and if they required a packed lunch. Each person attended a day centre which met with their preferences. The records included minutes of reviews which had been undertaken at the peoples day centres, which showed that their choices were listened to and their progress was identified. Two people that were spoken with confirmed that they were supported to attend a day service which was of interest to them. They stated that they attended their day centres by public transport. Three people were observed to return to the home by their regular arranged transportation, the driver explained to a staff member that they had also given a lift to a person, who usually used public transport, due to the bad weather. When people arrived home, they were observed to make themselves and each other drinks in the kitchen area. Staff were observed to support two people to get ready to go out to bingo. They stated that they regularly attended the activities that were organised by a local club in the community. Another person said that they did not like bingo and chose not to attend. A person was observed making a giant pom pom and a staff member that was spoken with stated that they enjoyed making pom poms, that they purchased the wool from a local shop and that they gave them to people for gifts. A person explained that they had lots to do, and said that they often visited their relatives and went to the beach. They said that they had been to Great Yarmouth the week before the inspection by public transport. The person also stated that they enjoyed going on holiday and had been to Benidorm, which they were hoping to do again next year. A person was spoken with and showed us the Christmas gifts and wrapping paper that they had bought for their relatives, they stated that they had been shopping in Lowestoft town centre to buy the gifts. The person showed us photographs of activities Care Homes for Adults (18-65 years) Page 22 of 41 Evidence: that they had participated in, which included holidays. The person told us that they cleaned their pet bird, which was in a cage in the lounge, and they cleaned the filter for the fish tank, which was in the dining area. Another person that lived at the home showed us the bird and said that they liked it. Peoples records that were viewed identified when people had participated in activities, such as shopping, eating out, going to church, going to the sea side and watching fireworks. Peoples records clearly identified the contacts that they maintained with their relatives and friends, which included telephone calls, visits to their relatives homes and visits to the home by friends and relatives. A person reported that their relative visited the home often and that they were always made welcome. Two relative surveys stated that their relative was supported to maintain contact with them and one commented if my (the person) wants to speak to me at any time they dial the number for (the person). Two surveys stated that they were kept informed of important issues that affected their relative and one commented I am always contacted immediately on all such issues. The AQAA stated our families charter encourages and guides our staff in supporting people to maintain and strengthen family connections that are important to them and (peoples) families are made welcome and sometimes are invited to tea. Peoples care plans identified the areas of their care that they could attend to themselves and people that were spoken with said that if they could do things for themselves that they were supported to do so. They stated that their independence was respected by the staff that worked at the home. People reported that the staff always knocked on their bedroom doors before entering, that they always received their mail unopened and that they chose their own clothing. One person reported that they ironed their own clothing and we viewed a risk assessment which confirmed that the risks identified in them using the iron were minimised. Two people stated that they kept their own bedrooms clean and tidy and that they helped to keep the communal Care Homes for Adults (18-65 years) Page 23 of 41 Evidence: areas clean. Peoples daily records that were viewed showed where people had participated in the household chores in their home, such as laying the dining tables and washing the floors. Staff were observed to include the people that lived at the home in their discussions. The record of meals that people had eaten was viewed and it was noted that they were provided with a balanced and nutritious diet and that they were provided with a choice of meal. For example, where people had eaten fish for their evening meal, two people had chosen cod and three people had chosen salmon. A person that lived at the home told us that they took it in turns to choose the evening meal and that they helped to prepare the meals. They reported that they had chosen the meal for the evening of the inspection, which was pizza, waffles and vegetables. The person was observed to put the pizza and waffles in the oven and prepare the vegetables for the meal. The AQAA stated we have a menu plan on the fridge which (people) each have a day to choose what they would like for the main meal, (people) choose a variety of foods and with staff support meals are prepared and freshly made. If (people) do not like what is on offer for main meal an alternative is available to them. Care Homes for Adults (18-65 years) Page 24 of 41 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 can expect to have their health care needs met and to be protected by the homes medication procedures. Evidence: People were supported in the ways that they preferred and required to meet their assessed needs. Four care plans were viewed and each detailed the step by step Care Homes for Adults (18-65 years) Page 25 of 41 Evidence: support that people required and preferred in their personal care. The areas of their care that they could attend to independently were identified. A person that was spoken with stated that they bathed independently and that they were supported to do so. Peoples risk assessments which were viewed identified areas of risk in peoples personal care and the methods of minimising the risks. There was a short term addition to the risk assessment and care plan of one person which identified the increased staff support that they would require when attending to their personal care due to their condition. People that were spoken with stated that they felt that their privacy was respected. A person reported that they shopped for their own clothing and always chose what they were going to wear each day. Peoples health care needs were met. Peoples records that were viewed identified the health care support that they were provided with, such as doctor, dentist and optician appointments. The records also identified the ongoing specific individual support that people were provided with, such as with continence care, epilepsy, minimising falls and psychiatric support. The AQAA stated as part of person centred planning we aim to support people in being more aware of their health needs and use health action plans to support people in doing this. This is not just about physical needs, it also means helping people to feel good about themselves. People were safeguarded by the homes medication procedures and practices. Peoples records that were viewed each held a medication profile, which identified their prescribed medication, the reasons for them taking the medication and the possible side effects. The arrangements for the administration of peoples medication was clearly identified in their care plan. The medication was stored securely in a cabinet in the office. The MAR (medication administration record) charts were viewed and it was noted that they had been completed appropriately when people had taken their Care Homes for Adults (18-65 years) Page 26 of 41 Evidence: medication and there were no unexplained gaps. There were clear guidelines for the PRN (as required) medication for one person, which identified at what points of their behaviour the medication should be considered and alternative methods of diverting their behaviours. Risk assessments were present for people who self medicated and they provided details which identified how the risks should be minimised. Risks were minimised by the provision of medication to those who self medicated on a weekly basis, occasional prompting by staff and random observations of people taking their medication by staff. The MAR (medication administration record) charts that were viewed clearly identified when people had been provided with their medication and when staff had observed them taking their medication. Two people were spoken with and confirmed that they independently administered their medication, they stated that they kept their medication in a locked drawer in their bedrooms and stated that sometimes the staff watched them take their medication, they said that they did not mind this. The medication procedures clearly identified how people should be safeguarded by the safe handling, storage and administration of medicines. The AQAA stated our policies and processes around medication actively encourage our staff to demonstrate safe working practices and to fully involve the person in taking as much control as possible over their medication. Staff training records were viewed and it was noted that staff were provided with medication training which ensured that staff were advised about the methods of the safe handling, administration and storage of medication. Care Homes for Adults (18-65 years) Page 27 of 41 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 can expect to have their complaints listened to and acted upon and to be protected from abuse. Evidence: People that were spoken with reported that they knew who to speak to if they were not happy about the support that they were provided with. Two people stated that they felt that the staff listened to them and acted upon what they said. Four service user surveys stated that they knew how to make a complaint and one did not answer. Five surveys stated that they knew who to speak to if they were not happy. Comments included Im always happy and tell someone. Care Homes for Adults (18-65 years) Page 28 of 41 Evidence: Two relative surveys stated that they knew how to make a complaint and one stated that they have never had the need to complain. Five staff surveys stated that they knew what to do if a person wanted to make a complaint. The complaints procedure was viewed and clearly detailed how people could complain and what happens after a complaint has been received. The AQAA stated that there had been no complaints since the last inspection and this was confirmed by the complaints log which was viewed. The manager reported that a complaint had recently been made to the head office, regarding a person who had recently left the home. The AQAA stated it is our belief that those who use our services, or are clients of ours, should be able to comment or complain if any aspect of our services or activities do not meet the high standards that they have a right to expect. Our policies and processes around feedback and complaints actively encourages all our staff to be receptive and respond positively to any identified shortfalls. Staff training records that were viewed showed that they had been provided with safeguarding training, which was updated in 2007. The local authority safeguarding guidelines were available in the office for staff reference and the guidelines included a document which staff had signed and dated to show that they had read them. Staff spoken with reported that they had been provided with safeguarding training and they were knowledgeable about actions that they should take if they had concerns about a person that lived at the home. There had been six safeguarding referrals made and we had been notified of the incidents. The manager clearly explained why the safeguarding referrals had been made, which included the protection of people that lived at the home from people in the community and from a former resident of the home, who had since moved out. The AQAA stated we recognise that in supporting people who can be vulnerable and Care Homes for Adults (18-65 years) Page 29 of 41 Evidence: who may also have difficulty in expressing their feelings and fears, that the awareness and vigilance of staff is key to protecting people from harm. Our policies and processes require staff to actively engage with local vulnerable adult processes and ensure that any threat to people with a learning disability is identified and reported promptly and appropriately within our organisation, so that appropriate action can be taken. It was noted that peoples finances were safeguarded and their records, which were viewed, clearly identified the arrangements for their finances. The records included clear risk assessments regarding peoples finances and for those who required support there were records which identified their spending and incoming finances. Care Homes for Adults (18-65 years) Page 30 of 41 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. People can expect to be provided with a clean, comfortable and hygienic environment to live in. Evidence: The home was clean, comfortable and well maintained and it was noted that there were no unpleasant odours. The service user survey asked if the home was fresh and clean and four answered always and one answered sometimes. People that were spoken with stated that they liked their home and that they had helped to choose the Care Homes for Adults (18-65 years) Page 31 of 41 Evidence: decor and furnishings in the communal areas and that they had chosen the furnishings and decor in their bedrooms. Three people showed us their bedrooms and it was noted that they reflected their individuality and choice. Each bedroom contained peoples personal memorabilia. The AQAA stated all (peoples) rooms are of their own chosen colour schemes and furniture. The communal areas of the home included a comfortable and homely lounge, which provided comfortable seating which was sufficient for the number of people that lived at the home. The dining and kitchen area included sufficient tables and seating for people to enjoy their meals. There were two bathrooms, one which provided a shower and another provided an assisted bath. Each provided a toilet and hand wash basin and there was a further toilet, which was sufficient for the number of people that lived at the home. Each communal bathroom provided hand wash gel and disposable paper towels, which minimised the risks of cross infection. The laundry was viewed and held sufficient washing and drying machines. Care Homes for Adults (18-65 years) Page 32 of 41 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 can expect to be supported by staff that are trained to meet their needs and to be protected by the homes recruitment procedures. Evidence: Four staff recruitment records were viewed and it was noted that people were safeguarded by the checks that were undertaken prior to staff working at the home. The records included CRB (Criminal Records Bureau) checks, two written references, Care Homes for Adults (18-65 years) Page 33 of 41 Evidence: their work history identified in their application forms and identification. The staff survey asked if checks were made before they started work. Four answered yes and one answered no and commented I started working for Mencap at 44 Harry Chamberlain Court when CRBs werent applicable, they are now in place, I also have a POVA (protection of vulnerable adults) check. The AQAA stated all staff are POVA and CRB checked and references are taken up prior to employment. The staff records that were viewed showed that probation reports had been undertaken with new staff, which ensured that the staff were working in the ways that they were required to. They were advised on the requirements of their roles in an appropriate induction training course, such as the Skills for Care Common Induction Standards induction. A staff member was spoken with and confirmed that they had undertaken the Skills for Care induction when they started and that they completed a work book. The staff survey asked if their induction covered everything that they needed to know about the job when they started working at the home. Four answered very well and one answered not at all and commented not really as I started work where I am back in (the year) and we did not do any inductions then. We just did lots of training as we went along. The AQAA stated Mencap have their own training team to provide induction and ensure that staff receive the training required to maximise their skills. Staff spoken with stated that they were provided with a good training plan, which provided them with the information that they needed to meet peoples needs. Staff training records were viewed, which included training certificates that showed that staff were provided with training on fire safety, medication, safeguarding, food hygiene, first aid, epilepsy, person centred planing, manual handling and challenging behaviour. Five staff surveys stated that they were provided with training which helped them to understand peoples individual needs, kept them up to date with new ways of working and that was relevant to their role. Comments included we have mandatory training and are able to attend other courses that may help the needs of the service users and I have regular training, if I feel any other training would benefit me in my Care Homes for Adults (18-65 years) Page 34 of 41 Evidence: job I am able to request this from my manager. The home had met the target of 50 of staff to have achieved a minimum of NVQ (National Vocational Qualification) level 2 by 2005 as identified in the National Minimum Standards relating to adults. The AQAA stated that six staff worked at the home and three had achieved a minimum of NVQ level 2. This had since increased and the four staff records that were viewed held NVQ qualification certificates. Staff spoken with stated that they were provided with regular supervisions, where they discussed the ways that they worked and any issues that they had. Five staff surveys stated that their manager met with them regularly to provide them with support and to discuss how they were working and two stated I have regular supervisions. The staff records that were viewed held records of regular supervision meetings. During the inspection staff were observed to be attentive to the needs of the people that lived in the home and they interacted with people in a friendly, respectful and professional manner. People that were spoken with reported that they liked the staff and that they treated them well. The service user survey asked if the staff treated them well. Three answered always and two answered sometimes. Care Homes for Adults (18-65 years) Page 35 of 41 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 expect to live in a home which is run in their best interests and that their health and safety is promoted and protected. Evidence: The home was managed by a registered manager who been successful in the CSCI Care Homes for Adults (18-65 years) Page 36 of 41 Evidence: (Commission for Social Care Inspection) registered manager process. The manager reported that they had achieved the NVQ registered managers award (RMA) and that they had undertaken training courses, which updated their knowledge. They said that they recently attended a training course on the process of the updated Mencap staff appraisal, which they were in the process of implementing. The manager was receptive to the inspection process and provided us with the requested information promptly and in an open manner. The people that lived at the home that were spoken with were complimentary about the manager and how they treated them. The manager and staff informed us that the home would be providing a supported living service in the future. CSCI had not yet received an application for the voluntary cancellation of the service. The home was regularly monitored by the Regulation 26 visit reports, which were viewed. However, the reports had been undertaken on a monthly basis until March 2008 and the records that were viewed at the home were available from May 2008 and November 2008. The Regulation 26 visits must be undertaken on a monthly basis. The manager stated that they had not been undertaken as often as they were, but they ensured that they monitored the running of the home to ensure that it was run in the best interests of the people the lived at the home. Records were viewed which showed that the manager undertook regular checks of the homes record keeping and the support that people were provided with. For example, the manager had made notes on the incident and accident records, which showed that they had checked the reports and identified if there was need for further input by staff. The results of annual satisfaction surveys were viewed, which were received from the people that lived at the home, their relatives and other professionals that were involved in the service. The manager stated that the results of the surveys were forwarded to their head office, where they were summarised and published. The Care Homes for Adults (18-65 years) Page 37 of 41 Evidence: manager reported that if an issue was identified on the surveys then they would contact the person that had completed the survey to discuss the issue and that they would seek ways of improving the service. Peoples health and safety was promoted and protected. During the inspection a fire drill was undertaken and the people that lived at the home explained how we should evacuate the building and they told us when it was safe to return. The fire safety records were viewed and it was noted that fire safety checks were regularly undertaken. Staff training records that were viewed showed that staff had been provided with fire safety training and this was confirmed by the staff who were spoken with. Records were viewed of regular temperature checks of water, the freezer and the refrigerator, which ensured that they maintained safe temperatures. Records were viewed which showed that regular health and safety checks of the environment were undertaken to ensure that the environment was safe. The electrical portable appliances were regularly checks to ensure that they were safe to use. Care Homes for Adults (18-65 years) Page 38 of 41 Are there any outstanding requirements from the last inspection? Yes No 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 39 of 41 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 Description 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 Description 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 Care Homes for Adults (18-65 years) Page 40 of 41 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 41 of 41 - 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!