Inspection on 06/10/08 for Hft - Falstaff House

This inspection was carried out on 6th October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hft - Falstaff House 17/10/06

Hft - Falstaff House 10/03/06

Hft - Falstaff House 26/08/05

Hft - Falstaff House 30/11/04

Hft - Falstaff House 21/07/04

Hft - Falstaff House 05/03/04

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Polesworth Group Pooley Heights

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Polesworth Group 70 Long Street

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10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hft - Falstaff House 12 Victoria Road Bidford on Avon Warwickshire B50 4AS     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: Kevin Ward     Date: 0 6 1 0 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: Hft - Falstaff House 12 Victoria Road Bidford on Avon Warwickshire B50 4AS 01789490526 01789772790 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carolyn Margaret Manktelow Type of registration: Number of places registered: Home Farm Trust care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 8 Date of last inspection Brief description of the care home Falstaff House is situated in Bidford On Avon. It is part of the Home Farm Trust group, which owns 14 homes nationwide and provides a day service separate but close to this home. People who live here usually attend HFT day services. It is a large traditional, detached property with a large, well maintained garden. People who live here receive personal care, 24 hour supervision and accommodation. The home can accommodate 8 people in 2 ground floor and 6 upper floor single bedrooms. 8 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: The quality rating for this service is 2 star. This means that people who use the service experience good outcomes. This was a key unannounced inspection, which addresses all essential aspects of operating a care home. This type of inspection seeks to establish evidence showing continued safety and positive outcomes for people. The inspection focused on assessing the main key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file by us, such as notifications of accidents, allegations and incidents. Care Homes for Adults (18-65 years) Page 5 of 30 Questionnaires were returned by two health professionals, giving their views on the home. The current fees range 788.20 and 846.92. Extra staffing is also funded for one person to live safely at the home. Additional, personal items, such as hairdressing and holidays are paid for by the people at the home. What the care home does well: The needs of people moving to the home are properly assessed and they are given information telling them about the service and support they can expect at Falstaff House. Everyone has a care plan in place containing the information that staff need to help them to meet their needs properly. People have Person Centred Plans detailing their personal goals and aspirations for the coming months. People are helped to make choices, such as what they do and what they eat and good information is in place to help staff to communicate with people so that their wishes may be understood. Meeting notes are supported by photographs and symbols to help the information to be understood and photographs are used to help people choose the food they like. People are are supported to go out to places they enjoy, such as pubs, theatres, barge trips and holidays and to use the local community shops and hairdressers. Staff at the home are friendly and attentive to the needs of people living there. The atmosphere in the home is relaxed and easy going for people. Staff support people to attend check ups and health appointments so that their health needs are met properly. The home is clean, well decorated and comfortably furnished. The people at the home have been involved in choosing the decor and furnishings and have been supported to personalise their bedrooms with pictures and other belongings. We have received no complaints about the home. Staff at the home are provided with training to recognise and report any suspicions of abuse that come to their attention, so that the people at the home are kept safe from harm. Good work has taken place to make the home safe for a blind person. Extra staffing has been provided and buttons have been fitted to doorways, which when pressed, activate a voice message stating which room is about to be entered. A walk in bath is also available on the ground floor for people with mobility problems. Most of the staff have worked at the home for a number of years and know the people well. This helps to provide consistency of care. Staff are well trained to carry out their work in a safe and sensitive manner. Vetting checks are carried out with new staff so that people ar supported by suitable staff. Good systems are in place for consulting with the people at the home, relatives and professionals to seek their views on the way the home is run. A senior manager visits the home on a regular basis to check the home is running well. Suitable arrangements are in place for checking that fire safety equipment is working properly. Fire drills are carried out so that everyone knows what to do in the event of a fire. Care Homes for Adults (18-65 years) Page 7 of 30 What has improved since the last inspection? What they could do better: 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. People are provided with information about the home so that they can make an informed decision to move in. Their needs are assessed beforehand to make sure that the home is equipped to meet their needs properly. Evidence: A new person has moved into the home since the last inspection. Staff explained that the individual concerned had been encouraged to visit and stay overnight on a number of occasions before moving in. The manager verified this and explained that the file containing this information had been sent to the main office for storing. The manager said that in future she would keep pre admission records on site until they had been seen by an inspector, as evidence of sensitive admission procedure being followed. The persons file contains an assessment completed by the manager, detailing the persons needs at the time they moved to the home. There are also a number of informative Health professional reports on file written by health professionals, when the person was at their last home, providing valuable information about their needs. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: Review notes were seen on file, as evidence that the persons placement had been reviewed, with the involvement of the persons social worker and relatives, after three months, to check that it was suitable and meeting their needs. Care files were also seen to contain a copy of the care contract and service user guide, explaining the service they can expect to receive from the home. The service user guide contains photographs and symbols to make it easier for people to read and understand. The manager said that she would include the range of fees in the homes brochure so that this information is made available to prospective people thinking of moving into the home. 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. Peoples needs are planned for and reviewed so that staff have the information necessary to meet their needs effectively. Evidence: Two care plans were checked and others were sampled to verify that health professionals have been involved where necessary. Both care plans contain satisfactory levels of information to provide staff with the guidance they need to meet peoples needs effectively. One persons file contained information about a digestive condition and dietary needs. Comments by staff verified that they understood the persons dietary requirements and took measures to make sure they are met. The care plans contain helpful information about peoples preferred care routines (e.g. the order in which they like to do things in the morning, such as whether they like a cup of tea before or after their shower or bath, etc). This is particularly beneficial where people have difficulties communicating, so that staff can respect their choices and provide them with care and support in the way they like it. The care plans have been dated, as Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: evidence that they have recently been reviewed. Social Services review notes were also seen on file, providing evidence that peoples placements are being reviewed with the involvement of social workers and their relatives, where they are able to attend. The manager explained that the provider is currently in the process of introducing a new recording system for which staff are in the process of being trained. The manager said that she is still seeking to clarify with staff, which aspects of care and support need to be recorded, as currently there is some confusion. Consequently this has led to some matters not being consistently recorded, recently, such as activities and aspects of personal care. The manager said that she would be addressing this matter to ensure that staff record all the information necessary to show the care and support provided to people to meet their assessed needs. Risk assessments were seen on files addressing hazards which are related to peoples assessed needs and everyday living, such food sensitivity, support to venturing out, money management and risks of trips and falls. Person Centred Plans were seen containing goals that people have set for themselves. One person had set a goal to go swimming and horse riding. Discussions with staff and the manager verified that these goals are being pursued, on a risk assessed basis to help people to achieve their ambitions. The person centred plans are drawn up by the people at the home, with support from staff and they take the lead on presenting this information at circles of support meetings. The Person Centred Plans have been well illustrated with photographs to make them accessible and relevant to people. Staff explained that regular meetings are held at which people are consulted over every day issues, such as meal choices, activities and holidays. This was verified in meeting notes. A copy of recent meeting notes were seen on the kitchen notice board. The notes have been illustrated with photographs and symbols to make the information easier to understand. Other pictorial information has also been produced to help people to make every day choices and decisions, including a chart containing photographs of staff on duty, a list of peoples keyworkers containing staff photographs and a pictorial complaints procedure. A box of mealtime pictures was also seen for helping people to choose their preferred foods when planning the menus. 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. People are supported to maintain contact with others that are dear to them and assisted to gain access to a satisfactory range of outings and activities so that they enjoy a happy lifestyle. People are consulted over their meals so that they can be provided with the food they like and their dietary needs can be met properly. Evidence: Comments by people at the home and staff on duty indicate that people are provided with support to venture out into the community and take part in a range of activities. Everyone attends day service provision between two and four days a week. On the days they are at home people are supported to do things in the home or go places. On the day of the site visit one person was seen to clean her room with staff support and to go to fetch some shopping and collect money from the bank. Another person was seen to enjoy building with plastic building blocks. One person said that he enjoyed Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: making jigsaws and the current one being worked on was very hard and contained a great many pieces. The manager explained that where they are agreeable people are encouraged to complete age appropriate jigsaws but that this not always acceptable to everyone. One person shared their talking photograph album, containing photographs of a recent holiday taken with several other people, in Cyprus. When a button is pressed it activates a pre recorded message describing the picture being viewed, which was very much enjoyed by the person who owned the album. One person said that they particularly enjoyed going to the pub for a drink. Examples of other activities given by staff and people at the home included, shopping for clothing and personal items, collecting their money from the bank, eating out, cinema, aromatherapy, summer barbecues, horse riding, music therapy and numerous theatre trips. People are also supported to take part in seasonal celebrations, such as Halloween, Christmas and summer fetes and barbecues. Relatives are invited to take part in parties and festivities to stay involved in the lives of the people at the home. The manager also explained that she seeks to encourage the involvement of siblings and wider family, in addition to parents so that people maintain contact with their family circle. Evidence of this was seen in peoples review notes. As previously noted, people are encouraged to clean their bedrooms and take part in other domestic tasks about the home, such as laundry and food preparation, to demonstrate control and ownership of their living environment. In the morning staff were seen to ask people what they wanted for their breakfast and held a good knowledge of their preferred options where they are not readily able to express their choices easily. One person was seen to help with setting the tables. The crockery and cutlery used was observed to be clean and attractive for people to use. 5 weekly varied menus are followed by staff. A member of staff explained that people are assisted to review the menus and photographs are used to help people to make their choices. This was verified by a person at the home. Staff explained that they shop for low fat foods and seek to provide balanced meals to encourage healthy eating at the home. A separate record of meals eaten is kept for a person with a stomach complaint to help monitor the effects of diet on health. There is also a list of foods to be avoided so that the person concerned is provided with a suitable diet to meet their needs. Peoples weight is also charted so that any fluctuations may be identified and health professional advice support where necessary. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: 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. The people at the home are provided with the care and support they need to go about their everyday lives and stay in good health. Evidence: Staff were observed to speak to people in a friendly and respectful manner and to enjoy some good humoured banter on occasions. The people at the home looked comfortable and ease when approaching staff for advice and assistance, indicating they like their company. Everyone at the home was well groomed and dressed in age appropriate clothing, indicating they are supported to maintain a pride in the appearance and to retain a good self image. Staff explained that people are supported to make use of community hairdressing salons to get their hair cut nicely. One of the people at the home has progressively lost their sight. The health records show that this has been subject to review by health professionals. Since the last inspection, the person concerned has moved to a bedroom on the ground floor, so Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: they no longer have to climb any stairs, which would have presented a risk to their safety. Extra staffing is now being funded by Social Services to provide the person concerned with close support when they are at their most active between 8am and 8pm each day. Good work has been carried out to fit buttons to door frames, which when pressed announce the room that is being entered. The person concerned has moved to down stairs bedroom they no longer have to negotiate the stairs, which could on occasion be the cause of delay to others getting about the house, as quickly as they would like. Epilepsy protocols are in place for people to advise staff of the actions they are to take in the event of seizures. The protocols have been devised with the assistance of health professionals, who have signed the documents to verify their suitability. A member of staff demonstrated a good understanding of the actions to be taken in the event that a person at the home has a severe seizure, triggering the use of emergency medication. The managers training records show that with the exception of a new starter, all staff have been trained to give this medication safely. In a health professional survey a nurse comments that staff do not always attend appointments with the necessary information to show evidence of changes in needs. The manager explained that this had already been bought to her attention by the nurse and she was working with staff to address this problem and ensure that they attend appointments with the information the nurse requires to carry out effective health monitoring. Peoples records show that people are provided with access to health professionals and consultants where they require it. The speech therapy service has been involved to assist in the development of communication aids and to carry out swallowing assessments. In a survey a speech therapist comments I am always confident that should any of the service users living at Falstaff House require input or advice from speech and language therapy (over and above the regular/routine work we do together) my support would be sought immediately, I provide regular training on various aspects of communication skills and eating and drinking skills. Staff from Falstaff House are regular attendees and there is evidence of putting theory into practice. Two peoples health records were checked. Overall the records give a useful account of the outcomes of appointments to enable the manager and staff to keep track of developments in peoples health needs. The records demonstrate that people are being supported to gain access to community health services, such as GP, dental checks to maintain their good health. Everyone at the home requires support to manage their medication. A member of staff was able to give a good account of safe medication procedures and showed a good Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: knowledge of information in the medication file. A sample of medication records show that medication is recorded into the home as it is received to keep an accurate account of medication in the home. Separate records are kept for PRN (as required) medication to keep track of the number of tablets left in box. A persons PRN tablets were counted and found to balance accurately with the record. A well written PRN protocol was seen advising staff of the most appropriate actions to take prior to giving medication to a person with a history of self harmful behaviour. This is necessary so that medication is not misused and only given when necessary. The records show that this medication has not been used for some time. The manager explained that the person concerned was now much more content with the current people at the home and far more relaxed in herself. Four staff, spoken with, explained that they had received medication training and had been observed by the manager before being allowed to give out medication. Staff sign a record confirming they have understood the procedures (sample seen) before they start to give out medication. A staff member explained that is the practice of the home to check the medication records before giving out any medication to check that medication was given out and recorded the last time it was due. The manager agreed to bring this check forward to shift handover times so that any medication errors may be identified at an early stage, before staff go off duty. Care Homes for Adults (18-65 years) Page 19 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. Complaints procedures are in place and staff are trained to recognise and report suspicions of abuse so that the people they support are protected from harm. Evidence: There have been no complaints to us about the home since the last inspection and the manager said that there have been no complaints made to the home. The complaints log was viewed and contained no recorded complaints. The manager said that the house meetings are used to check if anyone has any concerns or complaints, as well as to make plans with people. A complaints procedure is on display in the kitchen advising people how to complain. Care review notes show that relatives are encouraged to take part in care planning. This also provides an opportunity for them to raise any concerns should they need to do so. Four staff spoken with confirmed that they had been provided with training to equip them to recognise and report any suspicions of abuse that may come to their attention. They also demonstrated a satisfactory awareness of the whistleblowing procedure and to whom they should report any concerns about the running of the home, should this be necessary. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: Two peoples money records were sampled. In both cases the records show that two staff routinely sign to verify any expenditure and receipts are held on file, to account for peoples money. The manager completes a form at the end of each month (recent records seen) to reconcile individuals bank statements with their money records, to account for peoples money in their bank accounts. The manager also explained that periodic audits are carried out by a senior manager in the organisation. Care Homes for Adults (18-65 years) Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides, clean, comfortable accomodation that meets the current needs of the people living there. Evidence: Most of the bedrooms are upstairs making the home suitable for able bodied people. Since the last inspection a blind person has moved to a downstairs bedroom and no longer has to climb the stairs which posed a potential risk of falling, particularly if other may be wishing to pass on the stairs. Good work has taken place to fit large plastic buttons to bedroom doors, which when pressed activate a voice message, to let the person know which room they are about to enter. The lounge has been refurnished and is pleasantly decorated, creating a homely atmosphere. The furniture is comfortable and of a good quality. A person at the home explained that they had recently been shopping to choose a leather recliner, which they were seen to enjoy sitting in. Peoples bedrooms were clean and tidy. As previously noted a person at the home was seen to do a good job of cleaning and tidying their bedroom in the morning, with Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: assistance from staff. The bedrooms are well decorated and people have been supported to personalise these areas with pictures, family photographs, music playing equipment and other personal belongings. One of the people at the home confirmed that they had chosen the decor in their bedroom and had been involved (with others) in deciding what colours other areas of the home were decorated. The home has an upstairs shower and a walk in bath on the ground floor, suitable for people with mobility problems. Staff at the home were seen to make appropriate use of protective aprons and gloves for personal care tasks. Red dissolvable bags area available for carrying and laundering any continence laundry items. The laundry room is situated outside the main building and there is a covered walkway so staff are able to avoid passing through the kitchen with dirty laundry, which could otherwise present an infection control hazard. A suitable clinical waste contract is in place at the home for the hygienic disposable of relevant waste items. The home was clean and free from any unpleasant odours. Care Homes for Adults (18-65 years) Page 23 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. Staff are properly recruited and trained so the the people at the home receive support and care from a suitable and well equipped staff team. Evidence: The majority of the staff at the home have worked together for a number of years and are very familiar with peoples needs, providing consistency of care. There has been little staff turnover in the last year. One member of staff has transferred from another home run by Home Farm Trust and a new member of staff started work at the home during the course of the site visit. Staff were observed to be caring and friendly and responsive to peoples needs. The staff rota shows that there are typically between 3 and four staff on duty during the morning when staff are at their busiest and this reduces to two or three staff during the day according to the number of people at day services. Comments by staff at the home confirmed that this is sufficient to meet the needs of people currently at the home. There are typically three staff on duty at the weekends and the manager said that extra staffing is provided to support specific outings that are planned at weekends, Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: such as theatre trips. A new member of staff confirmed that she had completed a Criminal Record Bureau check and had provided two references before being allowed to start work at the home. The manager explained that the recruitment file was being collated at the head office and would be sent to the home for safekeeping shortly. Two other staff files were checked. Both contained evidence to show that relevant checks and references had been carried out as part of the recruitment procedure. These checks are necessary to safeguard the people living at the home. Four staff were asked about training opportunities provided them. All confirmed that they had been provided with training in safe practices, such as first aid, food hygiene, fire safety, moving and handling, safeguarding against abuse and medication training. Similarly all said they had completed National Vocational Qualifications (NVQs). These courses are necessary to equip staff to carry out their work effectively. The managers training records show that six staff have now completed NVQ training and one staff member had started training. The manager confirmed that The new starter would also be put forward for this training. In addition to safety related training, staff training records included examples of other training courses undertaken by staff at the home to support good practices, such as epilepsy awareness, dementia, recording practices, person centred planning, advocacy and empowerment and communication. Four staff have been provided with autism training in the past. The manager said that she intended to increase the number of staff trained in this subject, to assist in meeting the needs of a person recently moved into the home. The manager also agreed to make arrangements for staff to receive equality and diversity training. The new starter was issued with an induction folder, which includes a first day induction checklist. The checklist fails to include the fire safety procedures. The manager explained that the checklist had very recently been revised and the prompt to show new starters the fire safety procedures had been omitted. She brought this to the attention of a senior manager during the site visit so that it could be rectified. 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. Satisfactory arrangements are in place for consulting relevant people so that they can contribute to the development of the services and so that the home is managed in a way that meets the needs of the people living there. Evidence: The manager has seven years management experience at the home and holds the Registered Managers Award and the National Vocational Qualification in Care, level 4. These qualifications equip her for the role of registered manager. The home has a number of quality assurance measures in place to support the smooth running of the home. The manager reports that a quality assurance exercise was recently carried out by a senior manager, which involved meeting with the people at the home and surveying the views of relatives and professionals. The manager explained that feedback from the consultation exercise is due to be made to everyone involved, by the senior manager concerned, shortly. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The manager explained that in addition to house meetings, the people at the home are invited to attend a residential care committee where they are able to meet together with other people living in other services run by Home Farm Trust, so that they can contribute their ideas to the development of the services. Staff confirmed that they receive regular staff supervision and staff meetings routinely take place at the home. This was verified in staff supervision and training records. A senior manager visits the home each month, as part of the quality assurance programme. This includes checking various records and talking to the people at the home and staff on duty. The senior manager confirmed that areas identified for improvement are brought to the managers attention so they can be addressed. A number of Health and Safety records were sampled. The fire log shows that fire alarms and lights are being tested at the correct frequencies and that fire equipment is being properly maintained. Fire safety evacuations are also taking place at regular intervals so that everyone knows what to do in the event of a fire at the home. Hot water is being monitored and logged so that it remains at safe temperature for people to use. Fridge and freezer temperature records are also being kept, so that they are maintained at the correct operating temperatures. A gas certificate was seen, demonstrating that the gas equipment has been properly maintained. The electrical equipment record shows that a test is now due. The manager said that she would be arranging this imminently. Staff confirmed that they are able to access management support at night if required. Staff have also been issued with a pendant alarm that they can use in an emergency to trigger help from a call centre. 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 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 1 The home fees should be included in the service user guide or home brochure so that people planning on moving to the home have clear information made available to them explaing the current charges. Proceed with plans to increase the number of staff trained in autism and equality and diverity to further equip them for their work. 2 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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