Inspection on 21/10/08 for Hft - Gaston And Dolphin Houses

This inspection was carried out on 21st 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 - Gaston And Dolphin Houses 02/10/06

Hft - Gaston And Dolphin Houses 10/03/06

Hft - Gaston And Dolphin Houses 16/08/05

Hft - Gaston And Dolphin Houses 10/03/05

Hft - Gaston And Dolphin Houses 22/11/04

Hft - Gaston And Dolphin Houses 16/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hft - Gaston And Dolphin Houses 7 Waterloo Road Bidford On Avon Warwickshire B50 4JP     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: 2 1 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 - Gaston And Dolphin Houses 7 Waterloo Road Bidford On Avon Warwickshire B50 4JP 01789490664 01789772790 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Sarah Coleman Type of registration: Number of places registered: Home Farm Trust care home 9 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: 9 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) 9 Date of last inspection Brief description of the care home The home is located on rural campus on the outskirts of a village in South Warwickshire. There is another similar home, the parent bodys offices and a large resource centre on the same site, which is used by most service users. The home consists of a single property divided into two separate living areas for five and four service users, respectively. All have varying degrees of learning disabilities and some have a degree of physical disability. Those who are able to be more independent live in one house, those with more profound disabilities live in the other. The home is near to the village of Bidford-on-Avon, where there are a number of local amenities. Stratford Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 9 Brief description of the care home is approximately 9 miles away, Redditch is 12 miles and Evesham is 8 miles away, where there are a variety of facilities available. Care Homes for Adults (18-65 years) Page 5 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 6 of 30 Questionnaires were returned by 5 people at the home and a relative giving their views on the home. The inspection included seeing everyone living at the home. Due to the communication needs of some people living at the home it was not possible to get a clear impression of their views of the service. The inspection also included case tracking the needs of two people that live at the home. This involves looking at their care plans and records and checking how their needs are met in practice. Discussions took place with four staff on duty, as well as the manager. A number of records, such as care plans, complaints records, and fire safety records were also sampled for information as part of this inspection. An annual quality assurance assessment was completed and returned by the provider in time for this inspection, providing the managers views of the homes performance during the last year. What the care home does well: What has improved since the last inspection? One the kitchens has been refurbished and modernised to make it nicer for people and a new work surface has been fitted in the other kitchen to improve this area. A new computerised care planning system is currently being introduced and staff are being trained to use it. It is intended that this will further improve the homes assessment and care planning systems. Care Homes for Adults (18-65 years) Page 8 of 30 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 9 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 10 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is scope for increasing the information available to people using the service, particularly regarding any extra charges, (such as transport) in order that they are clear about their rights and responsibilities, whilst staying at the home. Evidence: There have been no new people admitted to the home since the last inspection, so it was not possible to check the experience of anyone new moving to the home. However two peoples files were checked. Both contained evidence to show that people have been issued with a service user guide and contract. Good work has taken place to illustrate the documents with photographs to make them more attractive and easier for people to read and understand. Neither contract had yet been dated and signed by the manager or the people using the service (or their representatives). A senior manager, (service manager) present during the inspection, said he would arrange for this to be addressed. The service manager explained that whilst there is no charge for day to day transport Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: charges, such as hospital appointments and general activities the people at the home are charged for longer journeys, such as holidays or visits to relatives living a long way from the home. This may also include an extra charge for the cost of any extra staffing required. The service manager agreed to arrange for this to be included in the service user guide so that people have clear and transparent information available to them. A new care planning and recording system is being introduced by Home Farm Trust which staff are able to access by personal computers. A senior manager explained that assessments are being carried out and recorded on the computer. The assessment information, when complete, is used to inform the persons care plan. A persons assessment was viewed on the computer. The assessment was observed to contain a broad range of relevant information, necessary for the development of a good care plan. Care Homes for Adults (18-65 years) Page 12 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 adequate 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 with their involvement so that their changing needs can be identified and met. There is scope for reviewing some risk assessments with a view to ensuring they include more detail about the measures necessary to ensure that risks are managed in the least restrictive manner possible. Evidence: Two peoples care plan files were examined. Both files contained some helpful information to help staff to support people in an appropriate manner. This included good information about peoples preferred care routines, such as rising in the morning. This is particularly beneficial for people who have difficulties making their needs known verbally, in order that staff are able to understand and respect their choices and provide care in the way people want it provided. The carer plans also contained behaviour guidelines to help staff to respond sensitively to such challenges. Both files contained only brief information about peoples communication needs and there has been no recent speech therapy involvement at the home. The service manager said Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: that he would arrange for the speech therapist to review individuals communication guidelines with the involvement of staff at the home, so that this information is made more comprehensive. This is necessary so that any new staff are able to understand and respond to people appropriately, more easily. Two people at the home confirmed that they have regular meetings to discuss everyday issues and activities. This was verified in notes of meetings. The notes are well illustrated to make them easier for people to read. Person Centred Plans are in place containing peoples personal goals. People have been assisted to make these documents bright and meaningful for them, using photographs of their choice to illustrate people and places of relevance to them. Staff explained that people are involved in leading the review of their Person Centred Plans, with support from staff. This is good practice as it helps people to exercise a degree of control over their lives. Two people at the home are involved in a group, run by Home Farm Trust, for people from various services, to discuss issues of importance to them. Risk assessments were in place covering a satisfactory range of everyday living issues or matters related to individuals personal health and well being. Some of the risk assessments contained insufficient guidance to enable staff to have a clear picture of the actions to take to manage the risk. For example a risk assessment is in place for one person to stop them accessing the kitchen and eating indiscriminately (including items which might harm them). The risk assessment indicates that the kitchen door should be kept locked but staff on duty insisted that this only occurs under certain circumstances (e.g. when there is one staff member at the home and not located near the kitchen). This was consistent with observations made during the inspection. People were seen to enter the kitchen freely during the morning at breakfast time and the kitchen was only locked later when most people had gone out and a member of staff was providing support to two people, (including the person named in the risk assessment). Some taps tops have been removed in a persons bedroom and en suite shower and a separate bathroom, as there are concerns about two people flooding areas of the home. The service manager agreed to re visit the risk assessments and consider any alternative measures for addressing this issue, possibly with the use of assistive technology (such as taps that switch off automatically). The service manager agreed to arrange for the risk assessments to be reviewed to demonstrate that the practices at the home are not unnecessarily restrictive. Care Homes for Adults (18-65 years) Page 14 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 people that are dear to them and assisted to gain access to a satisfactory range of activities and outings so that they enjoy a valued lifestyle. People are consulted over the meals they eat so that they are provided with food they enjoy. Evidence: Day activities plans are in place for everyone at the home, which have been illustrated with pictures of individuals activities for the day. The plans were seen to contain a mix of activities via HFT Resource Centre and some time spent at home. Some people are also supported to attend college courses on occasions. On the day of the site visit two people went out horse riding and two people spent time at home. This included time spent tidying rooms and going to the hairdressers. A person at the home also enjoys gardening and growing vegetables in a green house on site. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Comments by people at the home and entries in day records indicate that they are supported to venture out into the community on a regular basis, e.g to go swimming, bowling, shopping for personal items and groceries and to enjoy a cup of coffee or a meal. Examples of trips out so far this year, included a great number of outings and shows, such as X factor, Boys Own pop group, dancing on ice, come dancing, Safari Park, Drayton Manor Park, Alton Towers, Glastonbury, Granada Studios, Warwick castle and other places of interest. A person at the home explained they are looking forward to seeing Cliff Richard in concert shortly. People are also being supported to go to local celebrations, such as the carnival, bonfire celebrations and church Christmas tree festival. People at the home are supported to go on holiday abroad where they wish to do so and a folder was seen, which has been designed with information and pictures to help people to choose the type of holiday they want. Information in individuals contact records and review notes indicate that staff seek to keep relatives involved in care planning and keep them informed of issues and developments in peoples lives (e.g outcomes of health appointments). In a questionnaire, a relative states I phone, write and visit and they also phone me. I am always informed of appointments and staff phone me when they return to say what happened. The service manager explained that wider families are also encouraged to maintain contact with people at the home in addition to parents who may be aging in some cases. The home has recently sought the involvement of an advocate to support a person choosing to move bedrooms within the home, to demonstrate that this was in keeping with her wishes. In the morning, staff were seen to ask people what they wanted for breakfast and to respect their choices. The more independent people were observed to make their own breakfast and drinks, with assistance where necessary. As previously noted people are supported to go shopping for groceries so they can help to choose what they like. Comments by people at the home confirmed that they are involved in reviewing the menu so that they are provided with meals they enjoy. The recent menus indicate that people are being provided with a satisfactory variety of meals. Comments by staff indicate a fair balance is struck between encouraging people to eat healthily and catering for their food preferences. A bowl of fruit was seen in one of the kitchens for people to eat. Care Homes for Adults (18-65 years) Page 16 of 30 Care Homes for Adults (18-65 years) Page 17 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: Two people at the home with good verbal skills said that they liked the staff. Staff were observed to be friendly and respectful when providing support to people. The people at the home looked comfortable and ease in the presence of staff indicating they like them. Everyone was well groomed and dressed in age appropriate clothing, indicating they are supported to maintain a good self image. People at the home confirmed that they had been shopping to choose their own clothes with staff support. Guidelines were in place for a person with a swallowing problem and staff were seen to provide the necessary support necessary for this person to eat slowly and safely. There has been no recent speech therapy involvement for the person concerned. The service manager said that he would arrange for the speech therapist to review the eating Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: guidelines to ensure they remain appropriate. One person has fluctuating weight and is having their weight routinely recorded so that their weight can be monitored. The records show that the persons weight is currently quite low but has been lower in the past. The person has previously seen the GP about this. Discussions with staff indicate that they are aware of the need to record food intake and keep weight records but were not sure which weight might be considered unsafe and trigger a further referral to the GP for additional advice. The team leader was off duty at the time and could not be consulted for her advice. The service manager agreed to arrange for this detail to be added to the care plan. Three peoples health records were checked. Overall the records give a good account of outcomes of appointments, necessary to monitor peoples health care needs. Entries in the health records show that people are being supported to access health professionals to monitor their general health, such as well persons checks, dental checks and eye tests. Staff explained that everyone at the home requires assistance to manage their medication. A staff member demonstrated a good understanding of the medication procedure. All staff spoken to confirmed they had received medication training and said that new staff are assessed by the manager to check they have understood the procedures. A sample of medication records show that medication is recorded into the home when it is received so that medication can be accounted for properly. Currently there are not medication protocols in place for medication taken on an as needed basis. One person had been prescribed Fybogel on an as needed basis and this had been given very frequently. The service manager said that he would arrange for a protocol to be put in place for the person concerned and for anyone else prescribed medication or creams, on an as needed basis in the future, to ensure that these are given correctly. Staff confirmed that no one is currently on as needed medication for epilepsy or behaviour management purposes. The service manager said that he intended to introduce a weekly medication audit so that any shortfalls in the medication procedures may be picked up quickly and addressed. 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 incidents of abuse so that people are able to raise concerns and are protected from harm. Evidence: There have been no complaints to us about the home and in the annual quality assurance survey the manager reports that there have been no complaints made directly to the home. The complaints log was viewed and contained no recent complaints. House meeting records show that this includes an opportunity to check that people are happy at the home as well as to make plans together. An easy read complaints procedure, containing photographs, is available in the service user guide and pictorial information is available to help people to express how they are feeling, e.g pictures of people with happy or sad expressions. Relatives are invited to take part in care review meetings which also provides an opportunity for them to raise any concerns they may have. Four staff, spoken with, confirmed that they had been provided with training to help them to recognize and report any suspicions of abuse that may come to their attention. They also knew who to contact in the event that they have any concerns Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: about the running of the home, should this be necessary. There have been no abuse investigations at the home since the last inspection. Two peoples money were sampled. In both cases the records show that two staff routinely sign to verify expenditure and receipts are held on file. The manager completes a form each month to check that peoples bank statements balance correctly with their money records. Periodic audits are also 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 is clean, attractive and well maintained, providing a comfortable place for people to live in. Evidence: Gaston and Dolphin House consists of two adjoining houses, each with four bedrooms. All the bedrooms were viewed. All were clean, fresh well decorated and tidy. One person was seen to tidy her bedroom with staff support during the site visit. All the bedrooms provided ample evidence to show that they have been personalised to peoples liking, reflecting their personal interests. e.g. with photographs, pictures, equipment and other belongings. People have the option of using a bath or a shower and grab rails have been fitted where necessary to help people to stay safe and independent. The lounges in both houses are comfortably furnished, well decorated and homely, providing attractive areas for people to relax in. The dining rooms have large dining tables providing enough space for everyone to eat together. The grounds are attractive and well maintained for people to use. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Both kitchens were clean and tidy. A new kitchen has been fitted in Gaston house and a worn work surface, noticed at the last inspection, has since been replaced. A cleaning schedule is in place to ensure that kitchen equipment is kept clean and hygienic and a member of staff explained the various cleaning tasks that take place on different days of the week. Protective gloves and aprons are stored in various areas of the home and red disolvable bags are available for carrying and laundering soiled items of clothing, to make the process more hygienic for staff. Three staff spoken to said they had received infection control training. 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 that people at the home receive the support and care they need from suitable, well equipped staff. Evidence: Two staff were on duty in each house during the morning and a member of night staff was also on hand as people started to rise for the day. Staff confirmed that there are always at least two staff in each house and extra staff are provided to assist some people to go about community activities safely, with one to one support, where necessary. This was verified in recent staff rotas. Discussions with staff indicate that there are sufficient staff on duty to meet the needs of the people currently living at the home, given that the people in one house are quite independent in many aspects of personal care. The service manager explained that there have been no new staff during the past 2 years, thus supporting consistency of care at the home. Two staff files were checked. Both files contained evidence to show that staff have been subject to interviews and vetting checks before starting work at the home, including identification checks, Criminal Record Bureau checks and two references. Staff confirmed that they are provided with regular planned supervision to support them in their practice. A Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: summary record of supervision checks showed that most staff had received supervision in the last three months and some had received it on a monthly basis. Comments by four staff confirmed that they are provided with regular training updates in Health and Safety related practices, such as first aid, food hygiene, moving and handling, fire safety, safeguarding against abuse and medication. Staff also confirmed that they are provided with access to other courses, depending on their individual training requirements, such as autism, communication, person centred planning and epilepsy. This was verified in training certificates, seen on two staff files. In the annual quality assurance questionnaire, completed by the manager, she reports that 90 per cent of staff now hold appropriate National Vocational Qualifications to equip them for their roles. This is a positive achievment for the home. 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 with people so that they can contribute to the development of the service and so that the home is managed in a way that meets the needs of the people living there. Evidence: The Registered Manager is currently on maternity leave and the home is being covered by an experienced team leader. The service manager is also based in an office at the same site address and is available to provide additional management support. The service manager was present throughout most of the inspection site visit to facilitate access to relevant records. The service manager explained that there are plans to for an annual consultation exercise to take place shortly. This is to be led by an assistant director, with responsibility for quality assurance and will include seeking the views and experiences of the people that live at the home, as well as others involved, such as relatives and professionals. A report and action plans will then be devised to address any shortfalls Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: identified. Regular quality assurance visits are carried out by the service manager each month and his reports are available on computer for the manager to follow up on any actions identified. The reports are also accessible on computer for senior managers to use for monitoring purposes. In the annual quality assurance questionnaire, completed by the manager, as part of this inspection, she explains that in addition to house meetings, the people at the home are also able to attend meetings involving people from other services. A staff member explained that the people involved are setting their own agenda and will be able to influence common issues that effect them and the development of Home Farm Trust services. Staff meeting notes demonstrate that staff are meeting routinely to discuss policy and practice in the home to support consistent teamwork. As previously noted, management checks are in place for reconciling peoples income and expenditure with their bank statements so that their money is properly accounted for each month. A number of Health and Safety records were sampled. The fire maintenance record shows that ongoing work has taken place to maintain the fire system in good working order and that drills have have taken place at the home. The record show that there has been a recent break in testing the fire alarms but these checks have now re started again. A member of staff who shares responsibility for this task with another team member, explained that this was due to both staff being on annual leave at the same time and said that this would considered in future so that the same problem does not reoccur. The records show that the emergency lights are being tested routinely each month, as required. A landlord gas safety certificate was seen, as evidence that gas appliance have been checked and a log is being retained of hot water temperatures to make sure people are not placed at risk of scalding. 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 Any extra charges, such as transport should be included in the service user guide and shared with people who use the service / their representatives, so that they are clear about their rights, entitlements and responsibilities Action should be taken to involve the speech therapist to support the ongoing development of communication guidelines for people. This is necessary so that everyone is clear about the meaning of individuals non verbal gestures, to ensure that the people at the home are properly understood. Proceed with plans to review the risk assessments to ensure that they have sufficient information in place to ensure that practices for reducing hazards are as least restrictive as possible (e.g circumstances under which kitchen door may be locked and the use of assistive technology to prevent the risk of flooding instead of removing tap tops). Proceed with plans to introduce weekly audits of the medication system so that any shortfalls in practice are picked up quickly and addressed. 2 6 3 9 4 20 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. 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