Inspection on 27/11/08 for Henry Street Residential Home

This inspection was carried out on 27th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Henry Street Residential Home 06/12/07

Henry Street Residential Home 28/06/07

Henry Street Residential Home 06/06/06

Henry Street Residential Home 28/02/06

Henry Street Residential Home 15/12/04

Henry Street Residential Home 05/07/04

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Henry Street Residential Home 21 Henry Street Debenham Stowmarket Suffolk IP14 6RH     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: Sarah Buckle     Date: 2 7 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Henry Street Residential Home 21 Henry Street Debenham Stowmarket Suffolk IP14 6RH 01728861122 Telephone number: Fax number: Email address: Provider web address: lucinda.daykin@mencap.org.uk Name of registered provider(s): Type of registration: Number of places registered: Royal Mencap Society care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Henry Street was first registered as a care home for four people with learning disabilities in 1989. It is a purpose-built bungalow situated in a residential housing area on the outskirts of Debenham, Mid Suffolk. The home is managed and staffed by Mencap but the property itself is owned and maintained by Sanctuary Housing. The building is spacious and simple in design and layout. It incorporates lounge and dining facilities in addition to single bedroom accommodation. All areas of the home are wheelchair accessible. The home also has the advantage of a spacious secure garden and small sensory room. The home has easy access to local shops and amenities including a leisure centre, post office, pubs, cafe and public transport. The fees for this home start at 600.00 per week rising to 670.00 per week depending upon the assessed needs. More information about this can be obtained from the home. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection that focused upon the key national minimum standards relating to Adults (18 - 65). The inspection included 2 visits to the service on 2 separate days the 27/11/08 and 09/12/08 respectively. The inspection process included a tour of the premises, meeting and observation of two of the people who live at the home, discussions with 2 of the care staff that support the residents and with the manager of the home. Staff and resident interaction was observed and various relevant records and documents were examined. The report has been written using evidence gathered before the site visit and during the 2 days of inspection at the service. Care Homes for Adults (18-65 years) Page 5 of 30 Care Homes for Adults (18-65 years) Page 6 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Although there is marked improvement in the environment Henry Street, the process of replacing and repairing must continue. Currently a door in the shower room has Care Homes for Adults (18-65 years) Page 7 of 30 been repaired, but still poses a possible health and safety risk. The door needs to be repaired properly or replaced. Also a locked cupboard in the laundry room had loose door, which makes it insecure. The doors need repairing or replacing. Staff training is on-going at the home, however, specialist training in areas such as learning disability, autism and epilepsy need to be undertaken to ensure that all of the staff team have the skills ands awareness to meet all of the needs of the residents. The manager must ensure that a procedure is put in place for all records and documents to be available during an inspection. All chemicals and cleaning fluids must be locked away out of the reach of the residents. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 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. On going assessment is carried out at Henry Street to ensure that the needs of the residents are indentified and that the service provided by the home can appropriately meet them. Evidence: There are three residents currently living at Henry Street and they have all resided there for a number of years. There have been no new admissions to the home since the last key inspection, however, one resident has moved out as the home was unable to meet their needs. The manager discussed the process of relocating the former resident and it was apparent that this was carried out in a sensitive and thorough manner to ensure as smooth a transition as possible for the former resident. for example, their key worker from Henry Street went along to look around potential new homes with them, and lots of information was passed over to the new establishment regarding their likes and dislikes. As well as this, a member of staff from Henry Street stayed with the person at their new home throughout the first day and liaison continued until the former resident was settled. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: One care plan was looked at during the visit to Henry Street and this demonstrated that although the resident had lived at the home for a umber of years, assessments of their needs were still being carried out, both by the staff at the home and by their placing authority. The most recent review by social services had been carried out in October 2008. Contracts and agreements were seen to be in place within the residents care plan. Care Homes for Adults (18-65 years) Page 11 of 30 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. The care plans at Henry Sreet are person centred. Residents are appropriately supported to take control of their own lives and to make their own decisions and choices. Management of risk is positive, addressing safety issues whilst aiming for a good quality of life for the resident. Evidence: One individuals care plan was examined in depth. This was a well organised document split into a number of sections. The plan included a pen picture of the person containing some information about them and their likes and dislikes i.e. Hi, my name is (.......). I have 1:1 support paid by direct payments for four days every week. My supporters name is (.....) and we get on well together. We have worked together on my support programme. My programme has to be flexible as I have severe autism. Some days I like to be quiet and stay in my armchair, other days I like to go out. There was clear information contained in a communication summary which stated Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: that the person concerned liked to be spoken to by people using clear, short sentences; that they preferred not to make eye contact and preferred a peaceful environment. It stated I communicate by actions and body language. I do understand what you are saying to me. It was clear from the care and support plan that the needs, likes, dislikes and wants of the person had been identified over a period of time and these were recorded in detail i.e. I like to sit in a specific chair so that I can see things going on around me and I like a choice of clothes that fit properly. I prefer trousers to skirts. I dont like fussy clothes and I dont like tights; food to be cool as I dont like it too hot and I like to put plate/cups in sink etc. Staff spoken with were clearly aware of the residents like and dislikes and behaviours. One member of staff spoken with was able to explain the the resident liked to go out some days, but sometimes liked quiet days at home. They said that the plan of the day was down to how the resident responded and that it was their choice. Risk assessments were completed for the resident. Where activities posed a risk to the resident or to other people, the assessments were made to allow the activity to continue, but with hazard restriction measures in place. For example, after a display of challenging behaviour whilst out in the car with one member of staff, one risk assessment was updated to stated that two members of staff must accompany the person on all car journeys. An independent assessment was also carried out and a plastic shield suggested between the driver and the rear of the car. The manager stated that they had decided on a shield and this should be put into the car in in 2009. Other risk assessments included medication, bathing, shopping, accessing the kitchen, having a hair cut, medical appointments, accessing the community, safety in the event of a fire and risk of abuse. All of the risk assessments has been reviewed since they were completed. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provided by Henry Street has a strong committment to enabling people to develop their social, emotional, communication and indendent living skills as far as this is possible. Evidence: On the first day of the inspection all of the residents and staff were initially out. One resident had gone to their usual day care centre and the two other residents had gone out in their car to Needham Market. These two residents spent the afternoon relaxing in the living room. On the second visit to this service, one resident was out in Stowmarket and the other two residents had gone to Genesis and then for a picnic in Felixstowe. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: There was information contained within the care plan examined about the daily activities of the person concerned, and these included a coastal visit, lunch out, personal shopping, out to Ipswich, to visit family, Genesis day centre, walks in local areas, relaxation at home and post office to pay rent etc. In discussion, the manager stated that this weekly plan is a guideline and depends on how the person is feeling on a daily basis. The daily care notes for this resident were examined and these confirmed that activities undertaken depended on how they were feeling i.e. 22/11/08 they went out to do weekly shop, had a weekend take out, looked at the snow, watched X Factor; on 23/11/08 they made their own breakfast, put away dirty cups, bowl and plate, was running about and had a little ponder outside. In the afternoon the resident was tea tipping and running up and down the corridor, closed bathroom door lots of times the notes state that the person was encouraged to do activities i.e. blocks, but was not interested. During the course of this week, the resident did not go out as they were too agitated to go to Genesis and on 26/11/08 they had a very sleepy day. However, on both inspection site visit days the resident was out in the community or at a day care centre. An activity file was examined, and this was like a scrap book, full of photographs and explanation of what the people who live at Henry Street had been involved in. This included working on the garden to improve it, birthday parties and one resident on a trawler, which the manager stated was something they had always wanted to do. In the care plan examined it was positive to note that there was a copy of a monthly letter sent home to the persons family, written by their key worker detailing all of the things they had been doing over the last four weeks. Family relationships are important at Henry Street and work like this is done to foster and maintain their involvement. One resident goes to visit their family every couple of weeks and another goes once a month. Family members are welcome at the home and there were photographs showing them present at birthday parties. The manager stated that two dogs visit the home as PAT (pets as therapy) dogs and that all three residents had been on holiday separately to places that they would like. One resident went to a farm in Norfolk, one to Centerparcs and one to a holiday camp. There were photographs showing the residents enjoying themselves. On the day of the second site visit two of the residents had been out for a picnic. There was evidence that take aways were bought for the residents and that they were able to have a varied menu and a choice of food. An example of the food that one person had eaten is, cornflakes and peanut butter toast for breakfast, a tuna sandwich with crisps and a kit kat for lunch with a cup of tea and chicken stir fry for dinner and rice Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: krispies for breakfast, tuna mayo sandwich for lunch and quiche with salad and pasta for dinner. There were stocks of food in the cupboards and fridge and freezer. Care Homes for Adults (18-65 years) Page 16 of 30 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. Personal support at Henry Street is appropriately responsive to the varied and individual needs and preferences of the people who live there. The healthcare needs of the residents are clearly recorded and intervention sought as needed. Medication is well managed. Evidence: Care and support plans were seen for matters relating to the personal care of the individual within the home and these were clearly tailored to the specific needs of the person including their abilities as well as support needs i.e. run bath, check temperature, add creme/oil to bath, say (residents name) bath. (The resident) will undress (themself), needs assistance with ....zips. Will get into bath (themself). Needs hair washed. etc During the first site visit one resident went into the toilet and removed their clothes. This situation was sensitively and respectfully dealt with by the persons 1:1 support worker. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: The care plan examined had details of the persons medication profile, which was completed and contained a photo of the person, the medication they took and the reasons for taking it i.e. Clomipramine Hydrochloride 50 mg. Why? Treatment of phobic and obsessional states and depressive states. When? 3 tablets to be taken at night 9pm. Side effects: Dry mouth, sedation, blurred vision etc. This detail was completed for all medication to be administered, and is an example of good and thorough practice. The care plan also contained a professional, social and medical treatment needs history, which contained details of all professionals involved in the persons life, including their contact numbers and reason for involvement i.e doctor, dentist, community nurse, optician, social worker, chiropodist, occupational risk assessor etc. Visits to medical professionals were also recorded along with their outcome and these included dentist for yearly check up, nurse for flu jab, chiropodist and hairdresser visits. The medication administration records were examined for all of the residents at the home. There were no omissions noted. A photograph of the resident was in place within the MAR file for identification purposes. Medication was stored securely. It was noted that where as required (PRN) medication had been administered the recording of information as to why this had been given was not consistent. It is good practice to record on the back of the medication administration sheet where as required medication has been given, the reason and the outcome. One resident who had Oxazepam 10mg prescribed an an as required basis was given this on 16/11/08 at 16:30 hours and the reason was recorded as agitated and aggressive state and the result was calmed. This medication had been given on two further occasions 19/11/08 and 27/11/08 and no record regarding reasons and result was seen. It was positive to note that a document had been devised for each resident called How to help me when I am in hospital. This included a photograph of the resident and information about them such as their GP, social worker, medication, orientation and behaviour, continence, things I need help with etc. This was a clear and detailed record outlining the support the person required in a hospital setting. Care Homes for Adults (18-65 years) Page 18 of 30 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. Residents can be assured that the manager and staff are aware of their duties and responsibilities to report any suspected abuse appropriately and know how to do so. Evidence: According to the annual quality assurance assessment (AQAA) completed by the manager of the home, there have been no complaints received by the service in the last 12 months. The complaints log was examined during the inspection and this confirmed that no complaints have been recorded. The complaints procedure was displayed within the home, however, it would be unlikely that the two residents who were met during the inspection would be able to access this information from a written display. In discussion, the manager of Henry Street stated that the residents were non verbal and were unable to access sign or symbol means of communication, but were able to express some choice, satisfaction or dissatisfaction through bodily responses. For example, if one resident did not want to have a bath one day, they simply would not go into the bathroom; if they did not want to get up, they would put the duvet over their head. It was positive to note that one of the residents who was referred to at the last key inspection as putting residents and staff at risk of harm, has moved out of Henry Street to a more appropriate environment. The manager stated that this has had a Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: good impact on the remaining people that live at the home. The manager stated that the financial anomalies which were raised at the last inspection concerning a resident being charged for a carpet, contrary to the service user guide, had been dealt with and the resident reimbursed. Staff spoken with during the inspection knew the procedure they needed to follow if an incident of abuse was suspected. The manager stated in the AQAA that there has been one adult protection alert raised in the last twelve months, and that this was regarding financial abuse. The appropriate action was taken by the manager in relation to this and the matter is now a criminal investigation. Two staff files were looked at in relation to training and both of these had evidence of training in the safeguarding of vulnerable adults. The AQAA states in the what we do well section of the complaints and protection outcome group, that All staff receive POVA training and that residents are in receipt of a pictorial copy of the complaints procedure. Care Homes for Adults (18-65 years) Page 20 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Henry Street is comfortable, homely and clean. It sufficiently meets the needs of the people who live there. Evidence: A tour of the premises was completed as part of the inspection process. The home is spacious but has a simple layout, which includes a communal lounge, dining room and kitchen, a small sensory room, bathroom, shower room and toilet. There are four single bedrooms, although only three of these are currently occupied. Each room was decorated to reflect the personality of the resident, and all had personal artefacts and objects in them. Some refurbishment and redecoration has taken place since the last key inspection, which includes the dining room being repainted and new cushion flooring in the hallways. The bathroom which was in need of redecoration at the last key inspection is more inviting as a large mural has been painted on the wall. The bottom right hand corner of the shower room door is broken, with a triangle of wood that has been repaired. This is a potential health and safety hazard as the wood could become separate from the door, or cause splintering and needs to be repaired Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: properly or replaced. The laundry room had a locked white cupboard on the wall, however the doors themselves were loose which made the lock insecure. The doors or cupboard would benefit from being replaced. In a separate cupboard within the laundry room cleaning fluids, including bleach based products were found which were not locked away. This is hazardous. The kitchen was clean and tidy. Food that had been opened in the fridge was covered and labelled with the date of opening. There were no odours in the home on the day of the inspection. Care Homes for Adults (18-65 years) Page 22 of 30 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. There are enough staff available to sufficiently meet the needs of the people who live at Henry Street. The manager ensures that core training is available to the staff team and a high level of importance is placed upon training. The recruitment process is robust and the supervision of staff members takes place on a regular basis. Evidence: On the first day of the inspection there were two staff on duty and two residents at home. The duty rotas were examined and these demonstrated that there was a core staff team in place and that agency staff were no longer being used at the home. One member of staff spoken with stated that the last time agency staff had been used was approximately 3 months ago. Two staff records were examined during the site visit to Henry Street in relation to recruitment processes. It was positive to note that all of the required information was in place on both of the files seen i.e. a completed application form, with no gaps in employment history, completed Criminal Records Bureau checks, proof of identity, 2 references, a signed declaration of medical fitness etc. On the day of the first visit to Henry Street the manager was not present and there Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: was no access available to some records which were locked away. This was discussed with the manager on the second visit, who stated that a procedure had been in place until recently, whereby a member of staff had access to a key if she was not present during an inspection. However, this member of staff was no longer in employment at the home and a new procedure had not yet been implemented. She said that she would ensure that this was put in place as soon as possible. Two staff files were also examined in relation to training. The first of these had completed first aid appointed person on 26/04/08; fire safety 17/10/08; risk assessment briefing 29/01/08; violence and aggression in the workplace workshop 24 and 25/01/08; unisafe level 4 01/12/07; drugs and medication course 05/02/08; manual handling 26/09/05; unisafe level 2 physical de escalation 20/11/06; POVA 26/01/07; guided study re abuse/neglect 19/11/07 and a lone worker workshop. They had also completed skills for care induction standards and an NVQ Induction session 13/06/08 as they were in the process of undertaking NVQ 3. The second file examined had evidence of Induction being completed, NVQ 3; medication handling and awareness run by Mencap 16/10/08; fire safety 15/07/08; working with families 11/07/08; food hygiene 11/05/06; manual handling 08/08/06; respond and respect 13/06/06, protect and respect 12/06/06; health and safety 16/05/06; lone worker training 20/10/07; risk assessment briefing 29/01/08; epilepsy 15/01/08; violence and aggression in the workplace 24 and 25/01/08 and autism awareness 26/02/08. Specialist training was discussed with the manager of Henry Street and she stated that all of the staff team will be completing learning disability specific training in January 2009. It was positive to note that one member of staff had completed training in autism as one of the residents has severe autism. It would be beneficial for all of the staff team to access this and other specialist training. One member of staff spoken with stated that they were new to the service and to the caring profession but that they had received a lot of training and an induction on starting work at the home. They said that they had completed training in manual handling, first aid and fire safety and that their induction had included both competency training and shadowing of other staff members. A second member of staff spoken with stated that they had completed NVQ 3 and that all core training was made available to all of the staff team. They said that person centred care planning training was booked for January 2009. They also stated that the manager of the home is very good. Both of the staff files examined had evidence of regular and on-going supervision i.e. one staff had received supervision on 15/01/08; 31/03/08; 04/06/08; 12/09/08 Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: (informal discussion); 11/11/08 (informal discussion). A second member of staff had been supervision on 29/12/07; 22/02/08; 12/05/08; 18/06/08; 13/08/08; 10/10/08. Care Homes for Adults (18-65 years) Page 25 of 30 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. The manager at Henry Street has the required qualifications and experience and is competent to run the home. Evidence: The manager at Henry Street has experience in the field of social care and stated during discussion that she had worked previously with older people, particularly those with Dementia or Alzheimers disease. She has completed her NVQ 4 and is in the process of completing her Registered Managers Award, which she intends to complete by February 2009. In discussion it was clear that the manager had set up and established systems and structures to enable the smooth running of the home. She was able to talk with knowledge and understanding about the residents and their needs and to show the documents and records she had put in place since she took over as manager. Minutes of both resident and staff meetings were looked at during the inspection and Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: these were clearly taking place, although resident meetings were not as frequent as staff meetings. Mencap undertake a service inspection on an annual basis and set out the improvements that need to be made at the home as a result of their findings. Regulation 26 visits are carried out monthly by the home managers line manager. These were looked at and were comprehensive documents with clear action pints for the manager to follow where improvements were needed to be made. The manager showed an continuing improvement plan which was kept on the computer so that any member of staff could add to it and record the changes as they were made. Alongside these quality assurance tools surveys had also recently been sent to relatives and stakeholders. The manager was advised to compile a report of the findings of these surveys and forward a copy to the Commission. Health and safety records were looked at and these were well maintained. The certificate of insurance liability was displayed. Records of 3 monthly emergency lighting tests were looked at as were fire evacuation records. A number of certificates were checked. The PAT certificate was completed on 04/09/08. The infection control procedure was signed as read by the staff team. Training in areas relating to health and safety is in place and on-going. The manager must ensure that all cleaning fluids are kept locked away. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 42 13 The registered person must 22/12/2008 ensure that all parts of the home that the residents have access to are free from hazards to their health and safety. This is in relation to cleaning fluids, including bleach being placed at floor level in an unlocked cupbaord in the laundry room. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 24 34 The shower room door and laundry cupboard would benefit from proper repair or replacement. A procedure for ensuring all records and documents are available for inspection should be put in place as soon as possible. Specialist training relating to the needs of the people who live at Henry Street should be put in place alongside the ongoing core training to ensure that their holistic needs are understood and met by all of the staff team. 3 35 Care Homes for Adults (18-65 years) Page 29 of 30 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. 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