Inspection on 19/11/08 for Heatherside House

This inspection was carried out on 19th November 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Heatherside House 23/05/08

Heatherside House 25/06/07

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

CARE HOME ADULTS 18-65 Heatherside House Dousland Yelverton Devon PL20 6NN Lead Inspector Anita Sutcliffe Unannounced Inspection 19th November 2008 11:45 Heatherside House DS0000069209.V373153.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 Heatherside House DS0000069209.V373153.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. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heatherside House Address Dousland Yelverton Devon PL20 6NN 01822 854771 01822 855972 samgomm@lineone.net 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) Sheval Limited Miss Samantha Ann Louise Gomm Care Home 25 Category(ies) of Learning disability (25) registration, with number of places Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning Disability (Code LD) The maximum number of service users who can be accommodated is 25. 23rd May 2008 Date of last inspection Brief Description of the Service: Heatherside House is a care home providing personal care and accommodation for a maximum of twenty-five people with learning disabilities aged 18 and over, some of whom have been in care for decades and are at or approaching older age. The current ownership commenced October 2006. There is a manager and 24 hour staffing. Health care is provided through community health care services, as the home is not registered to provide nursing. This home is located at the end of a private driveway in the village of Dousland on the edge of Dartmoor. There are local amenities such as shops, pubs and post offices in the local village of Dousland and in the nearby towns of Yelverton and Tavistock. The home is a detached, two storey property, with a single storey extension and large gardens that are well maintained and accessible. The home has been going through a major, phased refurbishment for over a year and will soon be restored to three units within the home itself, each with its own laundry and kitchen facilities. Many bedrooms have been refurbished and now have en suite facilities. The Statement of Purpose and Service User Guide are available in the office of the home and the last inspection report displayed at the entrance. We were told that the current fees received are between £275 and £580 but the basic fee will now be £650. There is an additional charge for personal purchases, clothing, toiletries, trips Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 5 out, hairdressing and chiropody. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use the service experience adequate quality outcomes. We have collected information about the home since the previous key inspection May 2008. Since then we made Random Inspections on 28th August and 2nd September. This was to check compliance with the requirements made in May and included an audit, by the Regional Lead Pharmacist for the South West, of how the home handles medication. The Random Inspection report is not published but is available on request from the Commission. Reference to the findings of the Random Inspection is made within this report. For this key inspection we did two unannounced visits to the home. A representative of the organisation People First accompanied us on the second visit. He, and his support worker, work as ‘Experts by Experience’. They also visited during the May inspection. Again they spent three hours meeting people and talking to them about living at Heatherside House. Those findings are found within this report. We looked in detail at the care and support people receive. We spoke with people at the home, key workers/support staff and the manager about their care. We also spoke and met with five health and social care professionals who support people at the home. They provided factual information and opinion about the service. As part of the visit to the home we looked at all communal areas, some bedrooms, the kitchen and laundry. We were updated regarding the planned changes. Throughout the inspection the manager and all staff at the home were helpful and provided assistance. People who use the service may be described within this report as people, residents, clients or service users. What the service does well: People who use the service show confidence and affection to the manager Samantha Gomm. There are also some good relationships between them and some staff, some who have known each other for a long time. People are helped to present themselves as they wish and keep themselves clean. They are also helped to maintain their physical health. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 7 People’s rooms are pleasant, clean, well furnished and individually decorated. Where a person is not well able to express their choices staff have interpreted what they would like from their experience of knowing them. No new staff start to work at the home unless all the checks, necessary to ensure they are safe to work with vulnerable adults, have been completed. What has improved since the last inspection? What they could do better: Staff need to fully understand the needs of the people in their care, some whose needs are complex. To this end they need ongoing training and support in the necessary subjects, such as behaviour that challenges and how to promote people’s independence. There are still staff who are either unable or unwilling to follow advice and instruction. Those staff are adversely affecting the lives of the people they should be caring for. The registered provider says that staff care a lot for the people at the home. Caring, although commendable, is not sufficient in itself in a home where vulnerable people live. Staff supervision needs to be effective and the management approach to poor or inadequate staff practice more robust. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 8 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. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 9 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 Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area could not be assessed, as there have not been any new people admitted to the home since the previous inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Quality in this outcome area could not be assessed, as there have not been any new people admitted to the home since the previous inspection. However, we are told by the provider that the home is in the process of developing new information for people which will help them make a decision as to whether the home is suitable for them. This is to be in different formats so that the information is accessible to all. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s needs and personal goals are now better understood but there is still much to do to empower the people at Heatherside House. EVIDENCE: We looked at the care plans of three people who currently use the service. Changing needs and personal goals should be reflected in a care plan so that staff are aware of how they are to help people improve their lives. We were told that social care staff have reviewed the care plan of each person at the home and from this new plans have been written, mostly by the manager Samantha Gomm. We saw that plans are much clearer, containing more information than previously. From these staff should be quite clear what is expected of them. One member of staff described them as “better; clearer”. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 12 Staff have received training in how to best communicate with people and so help them make more thought through decisions about what they want. At a weekly ‘communication group’ people are starting to discuss things that interest them. Other initiatives have been pictorial diaries. One person showed us hers, which described what she had been doing and some things she intends to buy. The Expert by Experience reports that he found there was “a buzz about the place” and that people wanted to talk to him more than at the previous visit. A visiting hairdresser commented that people were chatting to her more and she feels the home is: “improving all the time”. However, we were told that one staff has not done any of the things asked and agreed as part of the person’s care plan. Three weeks after agreeing to arrange for a personal diary to be put into the person’s room the key worker had not done this. Where one person was to have a foot spar, toward helping them loose their fear of bathing, the spar had been bought but not used. The manager told us that she is aware that key working roles need to be developed further. Health care professionals who visit the home said there is more of a ‘can do’ attitude now and one said: “Some things at the home are now really positive”. However, it is felt that the key-working role needs to be developed so that people benefit from an improved relationship with staff other than the manager. That relationship will be supportive to people as they look at different options available to them and feel more secure trying new things. It is felt that the home lacks insight regarding this, there still being a lack of ‘problem solving’ and the demonstration of initiative by staff. Some institutional behaviour, unrecognised by staff, continues. One health care professional said: “The culture still makes it very difficult for people to engage with the opportunities available for them, but staff attitudes are changing”. Although given examples of some good staff practice, we were also given examples of actions which had not been achieved because staff had not completed the tasks requested of them. We did not look in detail at how people manage their finances as we did previously, but were told that people still have their own bank accounts, so their money does not go into an account relating to the business. Some keep their own money. For others it is kept securely at the home with records kept of transactions. We looked at whether people are supported to take risks as part of an independent lifestyle. Care plans include the management of risks specific to individual people, such as using a hot water bottle, possible choking whilst eating and angry behaviour. Health and social care professionals agreed that people are now safe at the home. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 13 We found that there is currently no policy for how staff should respond to unexplained absences from the home, so staff will not necessarily respond in the best way should this happen. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 14 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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The daily life for people at Heatherside House is improved. EVIDENCE: People spoke with the Expert by Experience about what their daily life is like. We looked at how people could spend their day. We found that bingo is a weekly event much enjoyed by some. One person said they were going to a disco that evening. Some people were out to work and the Expert was told: “We have a jolly good time here”. The hairdresser was visiting the home but we are told other people choose to go out of the house for this. We saw that people were laughing and having fun whilst they had their hair done. One person talked about going shopping, saying: “Staff help us buy our clothes”. One person showed us pictures of the television she intends to buy. Another said: “I go out with the PT lady”. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 15 People at the home have been to see a film. One told the Expert that they are looking forward to Christmas and helping to make the Christmas cake. One said stroking the cat makes her feel calm. The home has a ‘sensory room’, but we did not see it in use during this inspection. People’s bedrooms are very personalised and appeared pleasant. We saw television and video equipment, pictures and things of interest to them. When the changes to the building are complete there will be more opportunity for people to learn new skills, such as cooking, as the facilities will be more ‘homely’. We looked at whether activities are age, peer and culturally appropriate. Heatherside House accommodates people of very variable age and their rooms do reflect this. There is regular input at the home from a local church group, giving people the opportunity to follow the Christian faith. However, the staff are predominantly female and there are many men at the home who might benefit from more time with their own gender. The Expert by Experience was invited to join people for lunch. There were two choices for the main meal, a sweet and two choices of cold drink. One person said he had a glass of beer with dinner last night. The home are continuing to try to expand the range of foods people will try. The meals available are perfectly adequate in amount, preparation and the way they are presented. Unlike the previous inspection, when people just left their plates and walked away from the table, now some help with tasks. We saw one person wiping the table and one collecting some plates. People are starting to be more involved and learning how to help themselves more. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 16 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 & 21 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most people’s health care needs are met. EVIDENCE: People receive personal care support and we saw that people’s personal care needs were clearly described in their plan of care. People’s health care needs are met through a local G.P surgery where there are several doctors, including female, so there is choice available to people. This choice was discussed with the manager. There was previous concern about the care provided at Heatherside House as health care professionals found that guidelines were not always followed and the amount of in-put needed at the home was over and above that which should be necessary. This resulted in a Safeguarding alert, which is still ongoing, but close to conclusion. It is felt that, for the most part, management of health care is now satisfactory, some good. However, one health care professional said: “I am still not happy with the level of skills and knowledge re the management of the complex needs of some people living at the home”. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 17 An example given was staff inability to record adequate information about a person’s behaviour when they had been asked to do so. Another health care professional said: “There has been some improvement in staff recordings”. Records showed us that people have access to health care, such as dentistry, district nurse, chiropody and learning disability experts. A community nurse said: “I feel that the health needs of the residents are generally being well managed and I currently do not have any major concerns. Those that require it are taken to the appropriate clinics at the GPs for monitoring and the staff act on the advice they are given. The staff will and do contact the GPs/District Nurses if they have any concerns about anyones health and respond to the advice they are given by them”. One person told us how much improved their life is now they have a walking aid. The registered manager, Miss Gomm, was proactive when new to the home in ensuring people had their care professionally reviewed. She is still proactive in this and has sought increased funding to improve the care for people. We looked at the way the home manages medicines. Currently no person who uses the service is able to manage their own. We found that medicines are now stored safely, the keys kept with one member of staff. Where a medicine was described to be given ‘as necessary’ or ‘as required’ there was good information for staff as to when it could be administered. This means that the risk of inconsistent care or inappropriate treatment is reduced. We found that when medicines are prescribed to be administered with a variable dose, such as 1 or 2 tablets, that the dose actually administered is now recorded. This means that it is possible to feed back to the person who prescribed it information about the response to treatment, as the dose given is now known. We found that the medicine records were clear and orderly which helps to prevent mistakes. Medicines had been checked into the home where they were part of the monthly pharmacist order, but where they were not that check was not always done. All medicines must be checked into and out of the home so that a full audit is possible at all times. This helps to prevent mistakes and mishandling and was a previous requirement. A person living at the home has their blood sugar monitored regularly by staff. We checked with the district nurse that she felt staff were competent to do this. She confirmed that the staff she had instructed were. We found no prescribed items of medicines that were passed the expiry date as we had previously. We were told that there is now a system for ensuring this does not happen. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 18 We checked the stock of emergency medicines kept in the home against the records. We found that the amounts tallied and it was clear where each medicine would be found. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. People are safer at Heatherside House. EVIDENCE: Some people at Heatherside House regularly visit a day centre and other out of house venues and so meet people outside the home. As all people at the home have had their care reviewed they have had contact with health and social care professionals. People who use the service regularly come to see the manager and look very relaxed in her, and many staff, company. The Expert by Experience said that, since his last visit, the atmosphere in the dining room is much more ‘upbeat and lively’ and he saw good interaction between people and staff. There is a lot of opportunity for people to talk about any concerns they might have. We previously looked at policies and procedures on complaints and safeguarding, abuse, aggression and bullying. Each was reviewed in 2008. We are told that the complaints policy has still not been adapted to be ‘user friendly’ to people with limited or no literacy skills. Staff know where the whistle blowing policy (which informs them what to do if they have concerns about people’s protection) is kept, and as previously suggested, it is now clearly displayed where staff will see it. Staff asked what to do if they had concerns which might be abuse were able to describe the correct way to respond so as to protect people and follow safeguarding guidance. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 20 We have not received complaints about the home and the manager says no complaints have been received. Staff received training in the safeguarding of vulnerable adults in autumn 2007 and three staff confirmed that it included ‘whistle blowing’. The current safeguarding meetings have not been concluded but we find that most staff, but not all, are now working closely with professionals to ensure people’s needs are fully met and so there is no neglect by omitting care. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 21 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, 26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is warm, clean, fresh, nicely decorated, and more improvements are imminent. EVIDENCE: We looked at what the home environment is like for people and how much the refurbishment had improved it for them. Everybody associated with the home agrees that it is now lighter, cleaner, fresher and altogether a more pleasant place to be. The Expert by Experience was told that all the people at the home could choose the colours and décor they wanted in their rooms an in the home. One person told him how much they liked their room. All the rooms we saw were very nicely decorated, individual and pleasant. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 22 The planned division of the home, into three separate sections, is now closer to completion. We were shown two part-finished kitchens; each section will have it’s own ‘domestic style’ kitchen. We were told that each section would also have its own lounge, dining room and laundry. We saw no maintenance concerns and nothing that might be unsafe. The building rubble, unpleasant to see and previously a danger to people, is now sectioned off and no longer the risk it was. The laundry in use at this time contains commercial equipment necessary for the needs of the home. The room was fairly clean, but is very small and it is not possible to separate dirty from clean laundry easily, which would reduce the possibility of cross contamination should laundry be soiled. The kitchen was clean and adequately equipped. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 23 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): 31, 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff knowledge and practice is improved, but there is still much to do. Recruitment practice protects people from those who may be unsuitable to work with them. EVIDENCE: There is a long established staff team at the home and efforts have been made to recruit new staff. Each person who uses the service has a named member of staff to support them. We saw that this has been very effective for one person, who showed us the diary of what they do and their plans. Health care professional, however, gave us several examples of where the named staff was ineffective, not having completed requests, such as recording charts and exploring people’s likes and dislikes. Some staff are either unwilling or unable to complete these tasks as requested but we are told they are receiving additional support to improve the way they work. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 24 The home was previously required to improve the training staff receive in conditions relating to learning difficulty. Training called ‘Total Communication’ has led to useful weekly meetings and more interaction in the home. Training in epilepsy should ensure people are better protected. Other training is planned. Clearly, most staff have worked hard toward improving the service for people; all associated with the home say there is marked improvement. However, currently there is not the necessary knowledge or skills in place to meet the complex needs of some people at the home without a lot of professional support. Staff have never received training specific to this. The main example is continued inadequate monitoring of behavioural problems. The numbers of staff appeared to be adequate during visits. Some people have had additional funding made available so that more one to one time with staff is possible. The manager and staff recognise that more staff are necessary so as to help people attain goals and gain more independence. We were told staff say they still “have to divide their time”. Only one staff member has been recruited since the previous key inspection. Their records showed that the checks, necessary towards ensuring they are safe to work with vulnerable adults, have been completed before they started work at the home. Staff told us that the manager supervises their work and that there are staff meetings where: “All have their say”. Staff told us they feel supported. We saw evidence that staff have received regular supervision. However, some staff still under perform. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 25 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, 38, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service people receive is improving and they are safe. EVIDENCE: The registered manager, Samantha Gomm, has qualifications in care and management, which indicate she should be competent to run the home. She also undertakes training on a regular basis. The Expert by Experience felt that since his last visit the staff and management have made a “vast improvement” to the home. Health and social care professionals who provided information all spoke of improvements. One said: “I feel that progress has been made by the staff but there is still some way to Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 26 go. However I have always felt that this would be something that would not be resolved quickly, rather it would be a longer term piece of work”. Although staff receive supervision of their work professionals still tell us that a small number of staff are not engaged in trying to improve the home; not doing as requested a part of people’s plan of care. Some poor practice is still in evidence, examples being talking about a person as if they are a child: “He’s been really good today” and the wearing of a plastic apron around the home when not necessary. The home feels that staff are aware of how to make further improvement. A more robust approach is needed toward stopping outof-date practices, which demean people, where they do not succeed. Currently Miss Gomm receives supervision from people in the provider organisation who are not specialist in learning difficulties. She tell us she feels very supported by her senior management but we discussed the benefit from her receiving support/mentoring from a person with expert knowledge in the field of learning disability. We were told that there are now regular checks on staff practices, such as whether care plans are reviewed and medicines handled properly. The communication group at the home meets so that people are encouraged and helped to say what they think. The more relaxed atmosphere at the home and “more upbeat and lively” feel will help people speak up. This should help toward improving the quality of service people receive. The registered provider still visits the home frequently and reports on her findings. We saw no environmental health and safety concerns during the visits. The unsightly rubble, which posed a danger, has now been completely sectioned off from the rest of the roadway. Staff receive health and safety training, for example fire safety. We were told of plans to level the pot holed access road to the home. Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 N/A 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 2 33 2 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 2 X LIFESTYLES Standard No Score 11 2 12 2 13 2 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 2 2 X X 2 X Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 28 Yes 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 Standard YA19 Regulation 12(1) Requirement Timescale for action 19/11/08 2 YA20 13(2) 3 YA35 18(1) 4 YA36 19 (5) (b) Advice and instruction from health and social care professionals, and people’s plan of care, must be followed so they receive the necessary care and support they need. Timescale not met by 01/10/08 To ensure that it is possible to 31/01/09 audit medicines in the home arrangements must be made to record all movements of medicines both into and out of the home. Timescale only partly met by 19/11/08 Staff must be trained and 31/01/09 competent in the conditions affecting people in their care. This includes learning difficulty, challenging behaviour, autism, continence and diabetes. This will ensure they have the skills and confidence to do their work properly. Each staff must have a training plan in place once their training needs are identified. Requirement still within timescale. Staff must be sufficiently 31/01/09 DS0000069209.V373153.R01.S.doc Version 5.2 Heatherside House Page 29 supervised that they work effectively and in people’s best interest. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Heatherside House DS0000069209.V373153.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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