Inspection on 11/01/07 for Hazelwood

This inspection was carried out on 11th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hazelwood 10/01/08

Hazelwood 27/01/06

Hazelwood 18/08/05

Hazelwood 28/10/04

Hazelwood 04/08/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hazelwood 9 Church Road St Leonards-on-sea East Sussex TN37 6EF Lead Inspector Jason Denny Key Unannounced Inspection 11th January 2007 3:30 Hazelwood DS0000021359.V325633.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 Hazelwood DS0000021359.V325633.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. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelwood Address 9 Church Road St Leonards-on-sea East Sussex TN37 6EF 01424 423755 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) Graham Robert Jack Graham Robert Jack Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is three (3) Service users must be aged between eighteen (18) and thirty (30) years on admission Service users with a learning disability only to be accommodated Date of last inspection 27th January 2006 Brief Description of the Service: Hazelwood is a privately owned establishment offering a safe environment for 3 young adults with a learning disability. The home offers 24-hour care in a homely environment. The home does not provide nursing or disabled access. The home is located in St Leonards-on-Sea within easy walking distance of both shops and the seafront. The home has its own vehicle with local transport facilities nearby. All bedrooms are decorated to individuals choice and needs, with all having en-suite bath and toilet facilities. The rooms are of good size and are personalised by the Service Users. Some rooms have sea views. The communal areas are adequate in size. The home benefits from a large back garden, which service users partly use for growing vegetables and developing horticulture projects. An annual holiday outside of the home environment is offered to Service Users [service users] who choose both the destination and who to travel with. Information on the range of fees charged is within the homes current statement of purpose/service user guide and ranges from £482 to £945 per week. Charge’s for extras includes personal items such as toiletries and clothes, part of the basic cost of annual holidays, and hairdressing.. Inspection reports are not routinely sent out to families and advocates after each publication although a copy is kept on display in the reception area of the home and can be obtained via the manager. A service user guide containing the most recent inspection report is sent to any interested person [or their representatives] looking to move into the home. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced key Inspection, which included a visit to the home which took place between 3.30pm and 7.10 pm on January 11, 2007. This inspection focused on the key areas such as care, Activities, lifestyles, environment, staffing, management of the home, and how concerns are dealt with. During this inspection process, which covers the period since the last inspection January 27, 2006 and the week of the home visit, a number of relatives along with social services all verbally indicated satisfaction with the home. All of the 3 Service users returned survey cards and indicated good levels of satisfaction during discussions during the inspection visit. The staff member on duty[deputy manager] was spoken with and observed. The focus of the inspection was looking at staffing levels in light of concerns, which, have been highlighted over the last year. Some diversity and equality areas were explored in relation to lifestyles. Care records for all 3 Service users along with health and medication needs were looked at. Discussions with management looked at progress since the last inspection. All communal areas of the home were toured. Meal arrangements were examined. A record of complaints was inspected. Staffing was looked at in detail along with measures in place to ensure quality for Service users. One outcome area is assessed as Excellent [1], six as Good[6], and the other one[1] areas is assessed as Adequate and in need of improvement. What the service does well: Relatives and advocates of all Service users indicated satisfaction in phone conversations, or during the visit, with comments such as “fantastic home”, “care is excellent”, “ Pretty satisfied”. All agreed that each service user was happy and settled. The home is well established with all Service Users having successfully lived there together for a number of years [6]. The home benefits from stable staff team and deputy manager, which continues to be largely unchanged. The staff team is exceptionally well trained, highly experienced and skilled at meeting the needs of learning disabled young people. The owner/manager of the home has a positive active involvement. All Service Users spoken with indicated that they liked living at Hazelwood and that they all enjoyed active lifestyles based on their preferences and choice and had opportunities to learn life skills and make choices. Service Users have developed trusting relationship with supportive staff and have their own routines. The home continues to be clean and homely. A range of measures is in place to protect Service User’s welfare and interests. The administration of the home is good especially the care records which are exceptional showing a range of highly useful information of how Service Users needs are being met with health needs receiving close and effective attention The owner of the home has improved all aspects of the environment over the last 2 years Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 6 including bedrooms and most communal areas with some outstanding work such as carpeting expected to be complete later this year. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 7 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 Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Service users benefit from user friendly and full information and are carefully and regularly assessed to ensure their needs are met. EVIDENCE: The home has a fully completed service user guide incorporating the statement of purpose. Although each service user has a service user guide in their room. Parents and social workers are also sent copies of inspection reports. The service user guide has colour photographs on each aspect of the home and also includes staffing details. The range of fees is referred too and, is in each individual contract, of which each service user has their own copy. The home has now introduced its own form for recording assessment information. In the event of a referral the home has a clear policy and procedure, which includes obtaining the social services care assessment and visiting the service user before setting up trial visits .No emergency admissions are taken. The home is committed to long-term care only. All Service Users and their families and advocates indicated how this continues to be the right home to meet their needs and how they have progressed. There have been no admissions into the home for over 5 years and previous assessment information on all 3-service users has previously been looked at. Care –plans show how each person receives regular ongoing assessment. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, & 9. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Care plans are exceptional with all needs clearly met and closely reviewed. Service users are carefully risk assessed and given regular opportunities to access the local community. EVIDENCE: Useful and sufficiently detailed care-plans, which are followed in practice, have been developed for all Service Users, supporting them to develop skills, maintain independence and promote choice. All 3 care-plans were examined. The home has introduced a wide-ranging and easily accessible care-plan for each individual covering all aspects of this standard. The plan includes likes, dislikes, goal setting, behaviour support strategies, protocols, risk assessments, weekly activity schedules, leisure interests, along with Hygiene protocols. The goals are reviewed on six monthly- basis, and a report is submitted to a social services review, which is intended to be held held six Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 10 monthly. Records showed that this has not occurred for 2 years and was confirmed by the deputy manager. It was part of the action plan following an Adult protection investigation in August 2006 involving 2 service users that a review was to take place with Social Services to primarily look at staffing and possible funding increases to provide more staff. Following the inspection social services confirmed to the inspector that they will prioritise a review of two Service Users The inspector found that the plans continue to be reviewed every six months, with all reviewed since the last inspection with a typed report, which involves all aspects including risk assessments. Risk assessments are comprehensive and well presented and involve independence tasks such as making drinks. Each care plans contains clear assessment information back up by medical reports which indicates how each Service Users has autism and a severe learning disability thereby indicting some compatibility of needs with each person having their own differences. Service Users have a copy of their plan and are encouraged to take part in its review with views recorded. The home constantly reviews activity provision. Each plan is logically laid out and well–presented with an updated photograph of the Service User. Two of the plans were found to have recently been retyped and reviewed by staff in November 2006. Service Users are able to make a range of choices about their lives with significant consideration given to their views and feelings. Each Service User is encouraged to have an advocate. Families for 2 Service Users and an independent advocate for the other all indicated how well the home involves them in care planning in the best interests of the individual Service User. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16, & 17. Quality in this outcome area is Good, This judgement has been made using available evidence including a visit to this service. The home provides a good range of activities based on Service User preferences, abilities, and diverse needs. Service users benefit from both healthy and tasty meals at flexible times EVIDENCE: Service Users are able to make a range of choices about their lives with significant consideration given to their views and feelings. The level of Service User involvement in the home is good. The home was found to have good links with the local community. All Service Users have active lifestyles, which meet there needs, and aspirations and, which provide opportunity to develop independent living skills. All three Service Users attend distinct day centres, which according to records and discussions are meeting needs. Extended discussions took place with Service Users around their activity interests. Each Service User has an active week, which affords opportunities for skill development. Each Service User has an active social schedule based on Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 12 individual choice. A particular Service User indicated to the inspector, ongoing improvements in his communication and sentence construction over successive inspections. Service Users have opportunities to participate in the local community. According to individual interests Service Users visit music concerts, pubs, restaurants, local leisure centre, cinema and other areas. This was again confirmed in discussions with service users and in records examined. Two Service Users have active family involvement. The other Service User sees his advocate on a fortnightly basis. The advocate again commented positively to the inspector on the service. The home ensures that each Service Users has at least 3 hours per week dedicated 1:1 supported outings. The service has identified that Service Users would be benefit from having more attention especially when they return from their day centres when 3 days of the week Monday to Friday there is just one staff member who also has to cook the meal. Staff and relatives indicated that more staff would improve choice None of the Service Users were described as having regular friends although their regular attendance at social events affords this opportunity. One Service User went to Cornwall last summer with peers from the day centre he attends. All service users choose their own summer holiday each year The inspector saw a range of evidence, which indicated that all Service Users have their rights to independence and flexible routines respected within reasonable agreed limits. All restrictions are agreed via risk assessments. All service users spoken with [3] indicated satisfaction with their current programme of activities and their individual day centres which reflect their diverse tastes and interests. One service user was found to be improving the range of the activities he undertakes as evidenced in a report by his day centre manager. The home’s vehicle described as not working at the last inspection has been destroyed with no planned replacement or budget until the house building works are completed. Some Staff who have car use their own, or taxis. Occasionally this can cause difficulties as evidenced in staff meeting minutes when a particular service user needs collecting from a day centre when he has an epileptic seizure or is unwell. All service users are picked up for their respective day centres by Social Services and the Main town of St Leonardson-Sea is within easy walking distance. Relatives indicated how they are encouraged to be as fully involved as necessary as advocates in the lives of Service Users and how they received a warm welcome at the home and kept well informed. Records of meals served along with food stocks were examined. All 3-service users were observed to have full access to all parts of the home including the kitchen when staff are present. All Service Users indicated pleasure with the flexible menu and the choices they have based on their preferences. Records of meals served showed that a balanced diet is maintained. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, & 20. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having recorded routines and guidelines, which help staff to know how best to support them based on their preferences. Service users have minimal medication in their best interests, which is carefully reviewed, but not always securely stored. EVIDENCE: Discussions with the deputy manager and a review of one service user’s records showed the close way that a epilepsy condition was being monitored with a range of support to help the service user have a better quality of life which is affected by the condition. Records showed continuous review of medication and follow up medical appointments. The service user was found to be well during the inspection. His relatives indicated satisfaction with the close way the home manages health needs. The person’s day centre report indicated how some improvement was seen in motivation and overall health following epilepsy treatments. Medication reviews are also discussed in monthly team meetings as evidenced in minutes. It was evident in the notes of the other 2 service users that number of medication reviews and changes had taken place Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 14 based on their best interests on clear information and on the basis of reducing medication dependency. Staff were seen to treat service users with respect and dignity with all encouraged to become as independent as possible within a sensible risk assessed framework. It was concerning to find medication for one Service User on the office desk along with the office door wedged open before the inspector arrived in this part of the home. During the inspectors visit to the office 2 Service Users came in at intervals. The deputy manager made this situation safe as soon as the issue was raised. It was noted at the last Inspection that staff had been reminded to ensure that the cabinet and office are locked at all times when the room is empty following an incident with a visitor gaining access. The home was therefore advised as priority to ensure that medication is stored and secured correctly at all times. Medication Stocks and records were shown to be in order. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, & 23. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home operates in an open and inclusive way in the best interests of service users. There have been no upheld complaints made against the home since it opened with one concern since the last inspection with appropriate measures taken. Staff are aware of how to both identify and report suspected abuse in conjunction with a clear policy and procedure. EVIDENCE: The home has not received any formal complaints since records began in the home. There is a clear complaints procedure, which includes details of the Commission. Each Service User has a complaints procedure in a suitable format, in their room. All complaints would be responded to within 28 days. Service User views are regularly sought and encouraged, as evidenced in care planning and other written records. Comments from visitors and all those involved in the home continue to be positive as evidenced in comment cards sent to the Commission and phone conversations and discussions with visitors on the inspection visit. A concern since the last inspection were expressed to the Commission by another organisation on two occasions, and to the home manager who investigated them and took appropriate action with no evidence that Service Users were affected. The concerns related to a member of staff no longer employed who whilst working on his own had a repeated emergency situation Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 16 brought to the home, which was spotted by a visitor whilst the situation was being sorted out. The staff member subsequently agreed to leave the homes employment. The situation would have been more effectively dealt with if 2 staff had been on duty. The home has a full adult protection policy based on preventing abuse of vulnerable people, which is signed by all staff. 3 of the 6 Staff have also received training in this area via the National vocational Qualifications they have achieved. Staff interviewed was again found to be knowledgeable in these respects. 3 senior and long serving staff have recently done a Protection of Vulnerable Persons course in light of a previous recommendation. The home have previously acted promptly and sensibly whenever any Service Users has been at the risk of harm. The home has needed since the last inspection to improve incident reporting in light of scratches spotted on one Service User by Day centre staff, which was reported to both the Commission and Social Services before the home reported this. Staff had recorded the incident in the home but had not reported it as the grabbing attacks on the Service User arms are quite frequent and that it was difficult to pinpoint exactly when, as there is not always a witness due to staffing levels. The injuries were not serious the concern was delay in reporting. .The information had not been immediately passed on during shift handovers and occurs when one Service User does not give another space with the other grabbing especially when staff are not in the same room. Since the Adult Protection Meeting the home has reported all incidents and also ensured that there is report from the staff person who was on shift at the time of the incident. All Service Users have clear behavioural management guidelines with staff having done the relevant training. Service user finances are managed by the home and when previously inspected in detail, contained full-itemised records and receipts with all aspects in order. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, & 30. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The ongoing modernisation and renewal of the home is near completion creating a good impression on visitors and benefiting service users. EVIDENCE: The inspector toured the communal parts of the home. The home has sufficient space for the 3 Service Users with sufficient communal areas to entertain guests in privacy. The lounge and dining room were found to be completely refurbished and redecorated to Service User’s satisfaction as confirmed in discussions and previous inspections. All bedrooms are en-suite bathrooms/toilets. The usable space in the lounge had been extended, with new wooden flooring and redecorating, along with new furniture. The dining room has been renewed to a similar standard. The garden was found to be well-maintained and used by all Service Users. Since the last inspection the kitchen has been refitted. The staircase carpet previously reported upon has now been striped off and is awaiting replacement. The owner has written to the Commission to confirm that this will Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 18 be replaced once all building work is competed, which is now expected before the Summer of 2007. Plastering on the top floor has been completed after the recent fixing of a damp problem. One Service User bedroom window, which rattles, is being replaced. Two bedroom carpets have been replaced. The home have identified that this is causing the fire doors to not completely auto- close but was found to be in the process of sorting this. Other communal areas such as hallways were found to have been decorated. The front entrance stairs were found to be in the process of being improved. The home were aware of repairing the front doorbell as some visitors were observed to have difficulty initially making staff aware they were waiting outside. The home was found to clean, warm and fresh smelling. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33, 34, 35, & 36. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Service Users benefit from having good committed staff that are carefully selected, experienced, and well qualified, most of which have worked in the home for a long time. Service Users will be better protected and have better outcomes if staffing levels met their needs. EVIDENCE: Relatives and advocates were fulsome in their praise of staff and how their skills and length of service continues to be important to Service Users in helping them feel understood and secure. The only concern expressed was about staffing numbers which they felt sometimes affected choice and led to the issues sometimes occurring between two Service Users who provoke each other on the alleged basis of getting attention when there is just one member of staff on duty which is 4 days a week. Numbers of staff available to supervise Service Users was a key issue agreed at the last Adult Protection meeting August 2006.At the current time the service are still awaiting Social Services answer on their request for more funding to provide staffing and for these 2 people to be reviewed by Social Services. The Inspector found on looking at Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 20 their current level of funding that this did not clearly show how it could meet their high assessed needs or provide the necessary staffing which is supported by the homes owner/manager working 7 hours on shift per week. The owner has indicated that it is not financially viable to provide more staff based on current income. The inspector observed during his visit that when the 3 Service Users arrived home from their various activities at 4pm how they competed for the one staff member of attention who also had housework and cooking to organise. One particular Service User attempted to dominate staff attention leading to frustration in others. The Inspector observed one of these Service Users continually grabbing this person’s arm as the Service User continued to approach him or in the lounge. The impact on staff morale caused by not having a second person to divide between the 3 Service User to actively engage them and prevent incidents of assault was evidenced in staff discussion, minutes of team meetings and staff supervision records. The service is therefore issued with a requirement requesting them to organise a review with Social Services in order to formally agree what the funding levels and staffing levels should be in the home based on assessed need. That written evidence is sent to the Commission within 4 months of the inspection visit to confirm this agreement. On a positive note social services following the inspection visit informed the inspector that will organise reviews as a matter of priority, to look at assessed needs to determine whether funding is matched to these needs and risks. On 3 days of the week second staff person works 3 hours which enables the group of Service Users when they are not at their individual day centres to attend a 1:1 community activity. The frequency by which one Service Users goes home at the weekend to see his family also helps reduce the difficulties. Recruitment practices continue to be tight and thorough as evidenced in the staffing file of the one person employed since the last inspection. This person also had a range of relevant training and is committed to starting a National Vocational Qualification in Care as evidenced in his supervision notes, which showed they occur monthly with the deputy manager. The new person has covered a full induction in the other owners home he works in. In relation to this home evidence showed how he had covered a basic introductory induction and worked two shadow shifts. The home deputy has developed a useful written supervision format to give staff support and monitor performance and learning. Since the last Inspection supervisions have resumed and now occur regularly for all staff as evidenced in monthly records. Within written records looked at staff such as newest member were seen to be able to have their views and needs recorded and acted upon Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 21 Staff were found to have a range of relevant care training fully in compliance with TOPSS [now Skills for Care]. All training is linked to the aims of the home as described in its statement of purpose. 2 senior staff have recently done Crisis intervention training [SCIP] linked to particular Service Users. All 3 regular staff have worked in the home for a number of years and are popular with Service Users as confirmed in discussions. 3 of the staff have the advanced National Vocational Qualification level 3 which is higher than the Government recommended qualification that at least 50 of staff should have the basic level 2. The new member of staff who mainly works in another home is looking to has start the basic level 2 National Vocational Qualification in Care and another persons who works one shift a week and has an National Vocational Qualification level 3. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39, 41,& 42. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The way the home is managed ensures good outcomes for Service Users despite restricted resources. The completion of the necessary management course will be beneficial. Service users are protected by equipment being regularly tested and by staff being well trained in health and safety. EVIDENCE: The manager/owner has previously managed similar services. The manager was found to have now started a relevant management course [National Vocational Qualification level 4 and registered managers award]. This course is due for completion in July 2007 with the manager attending on a weekly basis. The owner became the Registered Manager following the last Inspection conditional on giving the home sufficient management time and Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 23 adequate emergency on- call arrangements involving his deputy as the manager lives outside of the county. The inspection found that the home was receiving sufficient management and administration time and that overall outcomes for Service Users are still good. The home is managed is open way as observed during the inspection. Relatives also indicated that the home is well managed in the best interests of Service Users. Regular meetings take place in the home as evidenced in monthly team minutes such as 15 October 2006, which shows Service Users at the centre of these discussions such as in respect of monitoring medication changes. The deputy manager also conducts regular quality assurance checks, which take in all aspects of the homes service delivery with high scores regularly recorded such as on November 2006, which recommended further health and safety training. Evidence was also seen of regular surveys of Service Users and their advocates views, the most recent in November 2006. Care-plans as previously stated in standard 7 are reviewed monthly and sixmonthly. The overall annual development plan for 2007 is currently being worked upon by the owner in conjunction with the deputy manager who manages the care, administration and staffing side. This plan will include the completion of the environment, [as seen during the inspection] the possibility of a new car, further staff training, and the need to ensure improved staffing levels linked to appropriate funding agreement with Social Services. The home was advised during the inspection to ensure that staffing records are correctly secured and not left visible within the office which all staff have access to, so that no one except the management can have access in keeping with Data Protection regulations The manager is currently a registered nurse in learning disability. All staff have a range of training based on protecting Service Users from harm with refresher training planned such as fist aid. Food hygiene, and health and safety All equipment such as fire, gas, and electrical, was found to be within its service schedule. Incident records showed that all necessary significant incidents are recorded and following the adult protection in August 2006 are now reported without delay to the Commission and Social Services. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 1 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X 2 3 X Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA20 Regulation 13[2] Requirement Timescale for action 11/01/07 11/05/07 YA33 3 YA41 That the Registered Person must ensure that medication is kept secure at all times 18[1] That the Registered Person must ensure that a review of staffing levels takes place with the purchasing authority- Social Services in respect of Service Users to ensure that there are sufficient staff at all necessary times to protect Service Users from harm and meet assessed needs. That the outcome of this review includes a statement from social services as to funding arrangements and agreed staffing levels and how this links to assessed needs, and is sent to the Commission by the date shown 11/05/07 17[1][a][b] That the Registered Person must ensure that records maintained in the home [staffing] is kept secure in line with Regulation 17 and the Data Protection Act 1988. 18/01/07 Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 26 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 YA13 YA24 Good Practice Recommendations That a vehicle is provided for use by Service Users That the Registered Person confirms to the Commission when remaining and scheduled renewal works such as staircase carpeting is complete. Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hazelwood DS0000021359.V325633.R01.S.doc Version 5.2 Page 28 - 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!