Inspection on 06/06/06 for Hoffmann Foundation for Autism 69 Castleton Avenue

This inspection was carried out on 6th June 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hoffmann Foundation for Autism... 05/10/07

Hoffmann Foundation for Autism... 26/10/05

Hoffmann Foundation for Autism... 24/05/05

Hoffmann Foundation for Autism... 04/02/05

Hoffmann Foundation for Autism... 12/07/04

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Ashlong House

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Edenvale

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 69 Castleton Avenue 69 Castleton Avenue Wembley Middlesex HA9 7QE Lead Inspector Key Unannounced Inspection 6th June 2006 09:00 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 69 Castleton Avenue Address 69 Castleton Avenue Wembley Middlesex HA9 7QE 020 8902 1155 020 8900 0930 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Hoffmann Foundation for Autism Ms Leticia Addo Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: 69 Castleton Avenue is a registered care home for 6 adults with learning disabilities. At the time of the inspection there were 4 residents accommodated in the home. 69 Castleton Avenue is an extended semidetached house in a quiet residential road close to East Lane and Wembley High Street. It is within walking distance of shops and bus routes. The area to the front of the house has been paved over to provide off street parking. At the rear of the property is a pleasant garden with a lawn and patio area. The property consists of a ground and first floor and at the front of the house is a ground floor flat (occupied by one of the residents) which is integral to the house. The flat consists of a bed sitting room, bathroom and kitchen. The flat has its own front door and another door, which opens into the ground floor corridor. The rest of the ground floor consists of a laundry, an office, the small lounge (known as the music room), the large lounge and a communal toilet. On the first floor there are five residents’ bedrooms, a bathroom, a shower room and a staff sleeping in room. Since the previous inspection the age range and dependency levels of residents accommodated in the home has changed. A new Hoffmann care home has been opened and 3 of the residents who were living in Castleton Ave have transferred there leaving the younger more independent residents at Castleton Ave. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Tuesday in June 2006. It consisted of 2 visits, on the same day. The first visit began at 9.00 am and finished at 2.10 pm. The second visit began at 3.00 pm and finished at 6.20 pm. The Inspector would like to thank the manager and members of staff for their assistance during the inspection. During the inspection discussions with the manager and staff took place, records were examined, the serving of a meal was seen and a site visit was carried out. The Inspector spoke with each of the 4 residents and would like to thank them for their comments. In January 2006 4 comment cards were received from relatives and from residents living in the home. What the service does well: What has improved since the last inspection? Three statutory requirements were identified during the previous inspection and 2 of these are now met. It was noted that residents are encouraged to wear a dressing gown over nightclothes when using communal areas. The missing section of the worktop in the kitchen has been replaced. Since the last inspection a new Hoffmann Foundation for Autism care home has opened and 3 residents from Castleton Ave have moved there. The remaining 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 6 residents have been joined by a new resident and the residents that are now living in the home are closer together in age, levels of dependency and in lifestyle. One of the residents who is preparing for more independent living in the future has moved into the ground floor flat. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 Overall quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A programme of pre-admission visits to the home enables the prospective resident to sample life in the home and to decide whether the service provided is acceptable. A record of these visits must be kept so that the home can demonstrate that the needs of the prospective resident are compatible with those of existing residents. Standard 2 was not inspected as the resident who has been admitted to the home was transferred from another Hoffmann Foundation for Autism care home. Residence in the other home was only temporary, until a place was available at Castleton Ave. EVIDENCE: Since the last inspection 1 resident has been admitted to the home. The resident was transferred from another Hoffmann Foundation for Autism care home. Both the previous care home and Castleton Ave are within an area that was known to the resident. On the case file there was a copy of the transitional plan for the move from the previous care home to Castleton Ave. The plan set out a programme of visits, which contained the date of and purpose of each individual visit. This enabled the resident to meet members of the staff team, to meet the other residents and to view the accommodation, particularly the room that they would occupy. The resident was able to choose 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 9 between 2 rooms, which were vacant. The resident confirmed that a programme of visits had taken place and that a relative of the resident had accompanied them on one of the visits. The resident had already met the residents through the day care programme and had visited the home for social events, prior to the transitional plan being used and the resident said that they were satisfied with the placement. The home had not recorded the observations of staff that were on duty during these visits or the reactions of the existing residents or any responses from the prospective resident. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and guidelines for supporting residents have been drawn up for each resident so that the service provided can meet the individual needs of the resident. The home is able to demonstrate that changes in the needs of residents are identified and addressed through a system of regular review meetings although the monthly evaluations and reports need to be kept up to date. The resident’s right to make decisions about their life in the home is respected. Responsible risk taking contributes towards the resident leading an independent lifestyle and risk assessments have been drawn up. EVIDENCE: Three case files were examined. Each file contained a care plan that had been drawn up recently and there was evidence of review meetings taking place approximately every 6 months, either convened by the home or by the placing authority. A record was kept of persons attending the review meetings and family members and social workers were invited. The home also carries out a monthly evaluation and a copy of the report is sent to the placing authority. These were not always up to date as the last report on file varied between 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 11 April, May or June 2006. This was identified as a statutory requirement in the previous inspection and remains outstanding. Personal development plans are being drawn up for residents. It was noted that in addition to the case files comprehensive guidelines have been drawn up in respect of the individual needs of each resident and these record how the resident wishes to be supported. They have been signed by the resident and the manager said that they are drawn up after a discussion between the resident and the manager. The manager said that prior to the admission of some residents in the home their ability to make choices was not always recognised and staff had to encourage residents to exercise this right. She said that when residents go shopping for clothes it was an opportunity for a resident to watch other residents making choices and then trying this out for themselves. It was also important for residents to take responsibility for carrying out tasks for themselves and staff have had to ask other residents not to offer to do things for other residents but to let a resident build their skills and independence. Residents are involved in setting their own rules and boundaries. The manager gave the example of a resident who smoked in their room, although this is not a designated smoking area. The manager asked the resident what she should do to ensure the safety of all who live or work in the home. The resident said that the manager should put up no-smoking signs and this has been done. The resident respects these. Each of the resident attends a group advocacy session and once a month there is a meeting for residents, with an advocate, which is held in the home. The manager said that although she is the appointee for each of the residents the residents are encouraged to be involved in the management of their finances. Financial records were inspected and were satisfactory. They are subject to checking/auditing by the responsible individual and by a member of the finance department. Three case files were inspected and it was noted that these contained risk assessments dated 2005 and 2006. The risk assessments were in respect of the individual lifestyles of residents. They included risk assessments for visitors to the home, anti social behaviour, theft, absconding, breaking windows, alcohol consumption and personal harm. Risk assessments included risk management strategies. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Taking part in activities, developing new skills and using community resources gives residents the opportunity to enjoy an interesting and stimulating lifestyle. By maintaining contact with their family and friends the resident’s need for company and fellowship is met. Residents are encouraged to become more independent by making decisions and by having their wishes respected. Residents are offered a balanced diet to promote their well-being and the diet respects their religious and cultural needs. EVIDENCE: Each of the residents has their own individual day care programme, which includes college. Classes attended include education for employment, digital photography, computing and money skills. Other activities include gardening, shopping, an advocacy group and sessions with a bereavement counsellor. One of the residents said that they would like to have a job in an office, sometime in the future, and that at the moment they work on a part time basis at Head Office, gaining experience and developing administrative skills. One of 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 13 the residents enjoys playing music and plays the music for the monthly disco run by Hoffmann and helps the support worker to play the music for another disco club. A resident has expressed an interest in learning Spanish and will begin a course organised by BACES in the early part of 2007. Residents confirmed that they used resources and facilities in the community including parks, leisure centres, libraries, cinemas, restaurants, pubs and churches. On the day of the inspection, when the weather was good, 2 residents went with a member of staff to a local pub and planned to go to the park later in the evening. The home has a minibus for residents to use or they use Freedom passes on public transport or they use taxis. An eye is kept out in the library for details of any events taking place in the local community and residents went to the funfair recently. Residents are encouraged to be as independent as possible although the use of a mobile telephone is encouraged so that residents keep in touch with the home when they are travelling on their own. This enables the resident to receive support, as necessary. Some of the residents voted at the last election. During the inspection it was observed that residents used their rooms to relax in and some residents had televisions, DVD players and music centres. Residents said that they went to discos. One resident mentioned going bowling at the weekends. A discussion took place with the manager regarding annual holidays for residents. One of the residents recently went abroad with their family and the resident who was admitted to the home since the last inspection went on holiday before admission. The other two residents did not go on holiday last year. The manager said that the care manager from the placing authority did not have time to look at the risk assessments before the deadline for booking the holiday had passed. This year the risk assessments have already been forwarded. Residents have said where they would like to go on holiday and when. It was noted that the picture on the television in the lounge was distorted and needed adjustment. Each of the residents maintains contact with their family. The residents are able to receive visits at the home and a resident said that the staff on duty make their relatives welcome. They are able to talk to their visitors either in their room or in the music room. Residents also go to visit their families and one resident sometimes stays overnight or for the weekend. Staff have provided support to a resident when the resident’s expectation of the contact they want from their family has exceeded the level and type of contact taking place and left the resident feeling disappointed. Contact is still maintained with the residents who recently left the home to move into a new Hoffmann Foundation for Autism care home and a resident confirmed that they have been to visit them at the new care home and that one of the residents who moved has returned to Castleton Avenue to visit. Another resident said that they maintained contact with a friend. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 14 All residents are encouraged to take part in the daily routines of the home so that the residents can develop their social and domestic skills. However not all residents enjoy this and it was observed that staff are cheerful and patient when trying to encourage more reluctant residents. Residents’ responsibility for housekeeping tasks are set out in their individual weekly programmes. The weekly programmes are copied onto the whiteboard in the kitchen and residents check this to see what is happening. Staff respect the resident’s privacy and knock on doors and wait to be invited in before entering. Residents are able to spend time in their rooms without unnecessary intrusions and are given keys to their bedrooms. During the inspection an evening meal was served. It consisted of either sausages or fish (or both) with chips and mixed vegetables. Residents said that they were involved in planning the menu and the weekly menus were available for inspection. Each evening or weekend meal lists a main course and an alternative dish. The menu is varied and includes dishes to meet the cultural needs of residents. It also includes details of which resident will be helping with the preparation of the meal. Drinks and snacks are available between meals. A record is kept in the daily log book of what each individual resident consumes and records were up to date. A monthly record is kept of the weight of the residents. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive prompting with personal care in a manner, which respects their privacy and dignity. Residents’ health care needs are met through access to health care services in the community. Residents’ general health and well-being is promoted by staff that assist the resident to take prescribed medication in accordance with the instructions of the resident’s GP EVIDENCE: Residents require prompting in respect of personal care tasks and for some residents the prompting may take place in the bedroom or bathroom. For this reason a member of staff of the same gender assists the resident. Guidelines for individual residents advise staff of the support requested by the resident in respect of personal care, bath time, how to support the resident in the morning etc. Advice regarding the appropriateness of clothing is given to the resident e.g. if the jacket selected is a fleece and it is a very warm day. It was noted that prompting was done in a discrete and tactful manner. A member of staff gave an example of how they helped promote the resident’s independence. Routines at the weekend are more flexible and some residents prefer to sleep later in the morning. The manager said that for this reason activities tend to take place in the afternoons. Residents choose what clothes, hairstyle, 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 16 jewellery and make up to wear. All of the residents looked clean and tidy and were smartly dressed. The home has a system of key workers and residents were able to name their key worker. When a member of staff supported a resident who was anxious the resident said, “You’re my best friend”. Two other residents said that found their key worker “easy to talk to”. Case files contained evidence of access to health care services in the community e.g. dental services, appointments with the GP and of access to routine screening e.g. blood tests. The home responds to changes in the overall wellbeing of residents and there was evidence on the case files that medication reviews took place for residents and that staff supported residents when the resident attended outpatient appointments with the psychiatrist at the hospital. A resident asked about a dental appointment and one had been arranged at a local surgery. Medication is kept in a locked cabinet. The home uses a weekly Nomad dosette system. These boxes were examined and the tablets that had been removed were those for the days and times prior to the inspection. Records of the administration were examined and were up to date and complete. There is a separate section in the records for each resident and within these there is information for staff on the medication, which is prescribed for the resident. Staff have received training in the administration of medication. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Overall quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A complaints procedure is in place to protect the rights of the residents. An adult protection procedure and training in protection of vulnerable adults procedures help to promote and protect the welfare and safety of residents. However when an allegation is made it must be reported to the Commission for Social Care Inspection. EVIDENCE: The home has a complaints procedure in place, which has timescales for each stage of the process. If a complaint cannot be resolved locally a senior manager within the company deals with the complaint. The policy advises the complainant of their right to contact other agencies who are involved in the process e.g. the CSCI, the local authority and the Ombudsman. Residents said that if there was something that they were unhappy about they could talk to a member of staff or to the manager. The complaints book was seen. A record is kept of the date, on which a complaint is received, the details of the complaint and details of and the date on which the investigation is carried out. Complaints are investigated promptly and there were no outstanding issues. Two comment cards completed by relatives had a tick against the statement that they were not aware of the home’s complaints procedure. The home has an adult protection procedure in place and has a copy of the local authority’s interagency guidelines. Staff files contained evidence that staff had undertaken training in adult protection procedures. Since the last 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 18 inspection 3 referrals have been made to the Adult Protection team on behalf of residents. The CSCI was only received notification of 2 of the allegations. The manager said that restraint is not practiced in the home. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is comfortably furnished and provides a pleasing environment for residents to relax and enjoy. The privacy of residents is respected by the provision of single bedrooms, which are decorated and furnished to reflect the individual tastes of the residents. Bathing and toilet facilities in the home are sufficient in number and are conveniently located within the home to protect the privacy and dignity of residents although some minor repairs are needed. A variety of communal areas allow residents the choice of socialising or relaxing own their own. However communal areas should not be used to store items and worn furniture needs to be replaced. Residents live in a home where standards of cleanliness are good. EVIDENCE: The premises were comfortable, bright and cheerful. Rooms were light but the bedrooms on the first floor were very warm, even when some of the top windows had been opened. (The inspection took place on a day when the temperature was approximately 27 degrees C). The home is situated close to the high street and residents said that is within walking distance of shops and 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 20 local transport routes. The premises are accessible to all current service users, who are mobile. The care home is registered for 6 residents and there are 5 single bedrooms and a self-contained flat for the use of residents. The flat is situated on the ground floor and the manager said that the resident has moved into the flat in preparation for supported living, in the future. All bedrooms or bed sitting room are a minimum of 10 square metres in size. The resident that had transferred from another Hoffmann Foundation for Autism care home said that they preferred the bedroom that they now had as it was more comfortable and had plenty of space. Residents are offered a change of décor when they move into the home and the changes were noted during the site visit. Rooms were individual in character and reflected the personality and interests of the occupant. Bedrooms contained essential items of furniture and the 5 single bedrooms contained a wash hand basin. Residents are provided with a key to their bedroom. The curtains in the bedroom of the resident who had transferred from another care home were slightly short. The kitchen in the flat was not in use and the door was locked. The manager said that a new cooker was on order for the kitchen in the flat. This room was being used as a storage area. The flat on the ground floor has its own en suite facilities. The remaining 5 residents have the use of a toilet on the ground floor, which is close to the communal areas. The 5 bedrooms are situated on the first floor. On this floor there is a bathroom, containing a toilet, and a shower room, containing a toilet. Doors to bathing or toilet facilities are lockable. In the first floor bathroom there is a missing tile that needs replacing. The sealant around the bath needs replacing and cracked tiles near the basin need replacing. On the ground floor there is an open plan dining and kitchen area. The dining area contains a large refectory table, which is sufficient in size for residents and support workers to sit down together for a meal. Next door to this room is a small lounge known as the music room as it is decorated with a large mural, which has famous musicians and singers as its theme. The room contains a television and comfortable seating and a resident said that she uses this room when she wants to be by herself or when her family visit. It was noted that a new mattress was being stored in this room. The next room is the larger lounge and it was noted that the arms on the settee were worn and shabby. There are doors leading from each of the 3 rooms to the patio area. The garden was attractive and well kept and one of the residents was tidying the garden and planting some bedding plants. During the site visit it was noted that the premises were clean and free from offensive odour. There is a small laundry room on the ground floor. An extractor fan has been fitted, as there is no window, and the door is held open on a magnetic door closure fitment. The washing machine includes a sluicing 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 21 cycle, although at the moment the home is not servicing incontinent laundry. Staff have received training in infection control procedures. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. NVQ training enhances the general skills and knowledge of carers and the home has met the target of at least 50 of carers achieving an NVQ level 2 or 3 qualification. The rota demonstrated that there were sufficient staff on duty to support the residents and to meet their needs. Recruitment practices, which include checks and references, protect the welfare and safety of residents and the home needs to ensure that evidence of all of these is kept on the staff file. Residents benefit by being supported by staff who have access to both induction training and training to meet the needs of the particular client group. EVIDENCE: During the inspection care practices were observed and staff were patient and understanding in their interaction with residents. A discussion took place with the manager regarding the progress of staff in meeting the target of 50 of carers achieving an NVQ level 2 or 3 qualification and the manager said that this has now been met. In addition to the manager and the deputy manager there are 11 carers working in the home, including bank staff. Of the 11 carers, 4 carers have successfully completed level 2 training and 2 carers are qualified nurses. Another carer is currently working towards an NVQ level 2 qualification and one carer is working towards an NVQ level 3 qualification. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 23 The rota was available for inspection and it was noted that there were a minimum of 2 support workers on duty during the day. The manager said that if an additional member of staff was needed to support a resident in the community or when the resident was attending an activity, this was arranged. The manager’s hours were supernumerary and there is an on call rota for managers of the home and for senior staff within the company. The deputy manager works alternative weekends and the manager works occasional evening or waking night shifts so that they can monitor the consistency of the care provided. The home was maintaining agreed staffing levels and there are sufficient staff to meet the needs of residents both inside and outside the home. A number of bank staff are currently working in the home and the manager said that permanent staff would be recruited once the vacancies in the home were filled. Four staff files were examined. It was noted that each file contained proof of identity and that this included a photograph of the member of staff. Evidence of a valid work permit, where required, was on file. Three files contained evidence of 2 satisfactory references but one file did not contain any references. The manager said that this file belonged to a member of staff that had transferred from another Hoffmann Foundation for Autism care home. This file also contained an enhanced CRB disclosure that had been obtained in February 2005 and named a nursing agency as the employer. Although one member of staff had been employed as a permanent member of staff in 2006, after previously working as a bank support worker, the CRB obtained in 2003 was still on file. This did not include a pova first check. Induction training consists of 2 parts. There is the training organised and held centrally in the company and there is the in house training that takes place. The training that is held centrally includes sessions in respect of autism and person centred planning. The manager said that a resident from one of the care homes speaks to the new members of staff to give their view on how support is provided. In addition the company has a training programme, which covers the period of a year, and a copy is sent to the home. The manager said that having prior notification helps her to balance the needs of staff for training with the need to ensure that staffing level are maintained in the home. The home has a training budget, which can be used to purchase external training. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 42 Overall quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager continues to develop her knowledge through further training and this contributes towards understanding the needs of residents and staff. Service satisfaction questionnaires, forums and meetings help to monitor the quality of the service provided to residents and contribute towards the development of the service. Training in safe working practice topics enables members of staff to safeguard the health, safety and welfare of the residents. Regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use and the manager needs to ensure that appointments for all checks are made before certificates expire. EVIDENCE: 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 25 The manager has successfully completed her RMA qualification and her certificate dated May 2006 was available for inspection. She is hoping to complete her NVQ level 4 in care in September 2006. The company has a number of ways in which feedback on the quality of the service is obtained. Feedback from relatives is obtained during their visits to the home. The company organises a relatives forum (which is held on a quarterly basis). Comments can also be given during the review meetings, to which relatives are invited, if the resident wishes. In addition, on a quarterly basis a sample of relatives are sent a quality assurance feedback form. In respect of the placing authority a sample are sent a quality assurance feedback form. Comments can be given during review meetings and there is contact between the home and the placing authority by email. Residents attend a daily meeting in the home, after returning from their day care programmes, and this is used to obtain feedback from residents. A monthly meeting between staff and residents also takes place and residents have a monthly meeting with an advocate, which is held in the home. In addition meetings take place between the resident and their key worker and between the manager and the resident. Staff receive training in safe working practice topics and there were recorded risk assessments. The manual handling risk assessment was dated 2004 and was a brief document. The accident book was available for inspection. There were certificates to confirm that most systems and equipment in the home were checked and serviced on a regular basis i.e. the electrical installation, the Landlords Gas Safety Record, the fire extinguishers, and the fire alarms/call points/smoke detectors/emergency lighting. The testing of the portable electrical appliances had last been carried out in September 2004 and was overdue. There was evidence that the fire alarms are tested on a weekly basis and that fire drills are held on a monthly basis. A letter from the LFEPA dated the 26th May 2006 noted that certain action was required and a timescale for compliance was set. 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 2 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 27 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA4 Regulation 12.1 Requirement That records are kept of the visits made to the home by the prospective resident during the transition plan. These records are to include the observations of managers and staff, reactions by existing residents and feedback from the prospective resident. That monthly reports are up to date. (Previous timescale of 1st December 2005 not met). That all significant events in the home e.g. allegations that are reported to the adult protection team are reported to the CSCI That the missing tile is replaced in the first floor bathroom. That the sealant around the bath is replaced and that the cracked tiles near the basin are replaced. That the sealant around the bath in the flat on the ground floor is replaced. That the settee with worn and shabby arms is replaced. That the mattress being stored in the music room is placed on the bed DS0000017432.V290201.R01.S.doc Timescale for action 01/09/06 2 YA6 15.2 01/08/06 3 YA23 37 01/08/06 4 YA27 23.2 01/10/06 5 YA28 16.2 01/10/06 69 Castleton Avenue Version 5.1 Page 28 for which it is intended. 6 YA34 19.1 That there are 2 satisfactory references on each staff file and that the home obtains a CRB disclosure for staff, where CRB disclosures are not portable. That the portable electrical appliances are tested and that a copy of the certificate is forwarded to the CSCI That the requirements of the LFEPA, as set out in their letter dated 26th May 2006, are met and that confirmation of this is forwarded to the CSCI. 01/09/06 7 YA42 13.4 01/08/06 8 YA42 23.4 08/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA14 Good Practice Recommendations That the home contacts the placing authorities to confirm that the risk assessments have been approved and that bookings are then made. That the picture on the television set in the lounge is adjusted so that the distortion is removed. That the home provides relatives with a copy of the complaints procedure. That fans are provided in bedrooms when the rooms are very warm, despite having windows open for ventilation. That curtains are replaced if they no longer touch the windowsill. That items being stored in the kitchen in the flat are removed ready for when the new cooker is installed. That when a member of staff who has been working as a bank support worker becomes a permanent member of staff a CRB disclosure, including a pova first check is obtained, if not already held. That the manual handling risk assessment is reviewed and redrafted to include more detail. 2 3 4 5 6 7 YA14 YA22 YA24 YA26 YA26 YA34 8 YA42 69 Castleton Avenue DS0000017432.V290201.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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