Inspection on 07/11/05 for ICS 1 Dexter Way

This inspection was carried out on 7th November 2005.

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

Other inspections for this house

ICS 1 Dexter Way 22/05/09

ICS 1 Dexter Way 08/06/07

ICS 1 Dexter Way 13/06/05

ICS 1 Dexter Way 22/01/05

ICS 1 Dexter Way 05/08/04

Similar services:

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

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

CARE HOME ADULTS 18-65 Ics - Dexter Way, 1 Off Birchmoor Road Polesworth Warwickshire B78 1AZ Lead Inspector Warren Clarke Unannounced Inspection 7th November 2005 14:50 Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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 Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ics - Dexter Way, 1 Address Off Birchmoor Road Polesworth Warwickshire B78 1AZ 01827 331713 01527 546888 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) Individual Care Services Mrs Susan Partlow Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Susan Partlow successfully completes the NVQ Registered Managers Award or a qualification equivalent to a Diploma in management studies (NVQ4) by July 2007. Susan Partlow notifies the Commission for Social Care Inspection when she has achieved this qualification. 13th June 2005 2. Date of last inspection Brief Description of the Service: 1 Dexter Way is a large domestic-style house situated on the corner of a modern housing estate close to the village of Polesworth. The service is for five adults with a learning disability and each service user has their own bedroom. Two of the bedrooms are situated on the ground floor and have en suite facilities. There is a lounge with a dining area, a kitchen and a small utility room. There are three bedrooms on the first floor, a bathroom and separate toilet. One room upstairs is designated as an office/ sleep in room for staff. Externally at the rear of the house, there is a patio and garden landscaped to meet the needs of the service users. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, follows on from the announced inspection visit in June 2005. The inspection took place in the afternoon and early evening at times when some and all of the service users were present. On this occasion the Registered Manager was on leave, but the Deputy Manager and two other members of staff assisted. In conducting the inspection account was taken of the findings of the last visit; observations were made of staff carrying out their duties and how they treated the service users and the premises and relevant records were checked. The Manager was interviewed and conversations were held with service users and staff. Throughout the report this particular home is referred to as the Home and where the standard(s) or the regulation(s) are cited, this relates to the National Minimum Standards for Care Home for Younger Adults (18 – 65) and the Care Home Regulations 2001, respectively. What the service does well: At the last inspection the inspector concluded the following and on this occasion nothing has happened to change this positive observation:This home provides service users a good material standard of living and takes care to find effective ways to communicate with them so as to establish their personal goals and help them to lead fulfilling lives. It was concluded that this is a very good home, which is providing service users with high standards of care and where staff work well in partnership with other agencies to ensure service users receive the services they require for their health and general well being. In short, service users presented as cheerful, content and, in the inspector’s opinion, are being well looked after and afforded a good quality of life. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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 Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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): 2 and 4 Service users benefit from the decision for their admission to this Home and the way their care is provided being informed by the assessments of their needs carried out by specialists involved in their case. There are also real benefits in the arrangements made for service users to spend time at the Home and to be introduced to it at their pace before their admission is confirmed. EVIDENCE: On this occasion a sample of two case records was examined and in both instances there was evidence of assessments carried out by various specialists involved in the service use’s’ case. Where relevant, there was assessment information from psychiatrists, social workers, psychologists, speech therapists and others such as occupational therapist and day care staff. Indeed in some instances, including other records examined but not tracked through, there were notes of professionals meetings to determine whether the Home was a suitable facility for the individual in light of his or her needs as identified by the assessment. As is shown in the comments for standard 6, the Home uses assessment information to good effect in developing service users’ individual plans. Although taken together all the assessment information on file covers the areas specified in standard 2.3 (health, cultural/faith needs, assessment of risk, etc), there is not in all cases a summary of the single Care Management assessment as directed by standard 2.2 or a copy of the single care plan. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 9 Since having a single summary assessment document and care plan is likely to make it easier for staff to assimilate, it is suggested that these documents are sought for existing service users and form part of the referral or admission documentation for those admitted in future. The Home’s admission process recognises the need for service users to be properly introduced before they move in permanently. Those responsible for the Home have left the admissions process deliberately flexible in recognition of the differences in service user’s circumstances and needs. Each service user can therefore be introduced at their pace and in a way more suited to their needs. For example, some might need to spend substantial periods getting to know the staff and other service users and to be acquainted with the layout of the Home. Others might only be able to cope with several short visits. The Home has also shown, as observed in one case, that it can successfully introduce and settle young people who are being transferred from children homes to its facility for younger adults. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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 and 10 The Home continues to demonstrate that it understands and is able to plan and provide care relevant to service users changing needs and personal aspirations. EVIDENCE: At the last inspection, all the key standards related to service users’ needs and choices were assessed and the Home was deemed to be complying in full to those standards. On this occasion, therefore, only standards 6 and 10 have been assessed and reveal the followings:Each service user’s record includes a plan, which shows what the individual’s needs are in relation to his or her health, disabilities, lifestyle and personal goals. Against this is shown the actions taken in the daily care of the service user to meet those needs. For example, there remain clear agreed strategies, where relevant, for responding to service users’ episodes of fits and other health care requirements such as medication regimen. In recognition of service user’s communication difficulties, they each have a communication passport, which provides all the essential information about them, and their basic care requirements. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 11 One aspect of the individual plan was noted to include detailed instructions about each service user’s daily routine. That is, when they prefer to go bed at night and get up in the mornings, what is understood of how they wish to have particular aspects of their personal or intimate care conducted and monitoring charts for weight and food intake, where relevant. Another aspect of the individual plan, described as the Daily Living Goals continues to be used and this details what has been established as the service user’s interests, strength and difficulties. The purpose of this is to ensure that arrangements are made for service users to pursue their particular interests, that they have opportunities to practice and enhance their abilities in the things they can do and receive the support they need in the activities with which they experience difficulties. It was also noted that a risk assessment formed part of each service user’s individual plan. Those risk assessments were conducted and documented to make clear the strategy for safeguarding the individuals in the circumstances in which they might be vulnerable or at risk. For example, they note where service users might be at risk from traffic because their road awareness is limited or say, danger of injury during fitting episodes. Each service users individual plan is summarised and presented in a form that they are likely to understand and though on this occasion we did not seek the views of service users relatives, at the last inspection they indicated that they were involved in the assessment and planning process. With this and that mentioned above in mind, the inspector considers that this standard has been met. A check was made of the measures taken to ensure that information given by service users and that which staff members acquire in the course of their work is kept confidential in order to assure service users’ privacy. Staff (the deputy manager) was able to cite the Home’s confidentiality policy, which was seen and sets out clear guidance in terms of how staff should deal with information given in confidence, records and other personal information about service users. It was noted that all personal records are securely stored and that where it was necessary to discuss service users personal details, this was done in private. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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, 16 and 17 A real commitment on the part of the Manager and staff and recognition of each individual’s interests, preferences and lifestyle has resulted in service users been provided opportunities to live fulfilling lives in which they participate in community life, have access to meaningful occupation and leisure activities and are able to assert their individuality. EVIDENCE: As reported at the last inspection, each service user’s individual plan sets out the arrangements made for that persons social, occupational, cultural and leisure activities. At the time of inspection, two service users continued to attend a Day Occupation Centre where they are involved in carrying out tasks in a sheltered setting in keeping with their abilities and interests. These are said to include preparing pots for planting, recycling of waste paper, and arts and crafts. They receive a small financial reward for this, which has the effect of causing the service users to feel that they are making a contribution and are able to participate in ways not dissimilar to their peers who do not have a disability. When the inspector asked the service users about the Day Centre they both smiled and one confirmed that she attends the Centre. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 13 Staff said that this response was positive, i.e., in the service users’ communication repertoire, this means that the Centre is associated with a good experience. Two other service users’ conditions continue to merit them having occupational programmes tailored to their particular needs. Their programmes include attendance at a local centre for adults with disabilities where they are able to meet with others of similar age and take part in activities such as assisted painting. One, the youngest service user, in addition attends a group for young people where he is able to share his interest in pop music. The records showed and staff confirmed that service users continue to be provided with a range of social and leisure activities which include the usual visits to places of interest and entertainment and pub lunches which they particularly enjoy. More recently the Home hosted a Halloween party, to which service users were able to invite their family and friends. A holiday at Centre Parc is planned for all the service users later this month. The extent to which service users are involved in the local community has not changed since the last inspection when it was found that they used local facilities such as the shops, hairdressers and attend local shows, etc. Using these local access facilities and having the Home’s own specially adapted transport to facilitate access to them means that service users are not isolated in their neighbourhood. Visiting arrangements for service users’ family and friends remain flexible and elicited no adverse observations Nothing was observed or reported to suggest that service users’ rights are not respected and their responsibilities are not recognised. For example, they were seen to have access to all parts of the Home which are intended for their use except, of course, areas such as the kitchen where risk factors mean that they have to be supervised when they wish to use this. Service users’ right to privacy is in part respected in that all the bedroom doors are fitted with suitable locks. Staff members were seen to knock and wait to be invited into service users rooms and to seek their permission to enter in the case of those whose permission was not directly sought by the inspector in the inspection process. The inspector did not check whether each service user had been asked how they prefer to be addressed and this was not noted in their individual plan, but it was noted that informal terms of address are used (first name) for both service users and staff. This seems to work well and is in keeping with the homely informality inferred from the Statement of Purpose. Catering continues to be organised on the same basis as reported at the last inspection. That is, on a domestic scale so that though there is no dedicated cook, a member of staff on each shift is nominated to prepare the meal during this period. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 14 All staff members are reported to have received Food Hygiene training. All meals – four per day at least one of which is hot and including a light supper – are prepared subject to a forecast menu. Service users are involved in planning the menus insofar as staff members try to find out from them the foods that they prefer and reflect this in the menus. As presented, the menus showed that service users are provided with a varied and wholesome diet. Typically, the menus are a continental breakfast, salad and sandwiches/other light meal for lunch and a two course hot meal for dinner usually a meat or fish dish and a variety of hot and cold desserts. As was the case at the last inspection, staff members were seen to take particular care in the preparation and presentation of the meal, which was served during the time of the inspection. It was also noted that the meal was consumed in a relaxed unhurried way, staff using the occasion to engage actively with service users and generally acting to make it an enjoyable occasion. Staff members continue to monitor and record each service user’s diet and work effectively with specialists where diet and eating problems feature among service users’ needs. It was encouraging to note from the records that significant progress has been made in the case of a service user whose eating problems were giving rise to concern at the last inspection. Taking account of all the observations made above, it is considered that the Home is achieving the outcomes for the standards assessed and is complying with the quality indicators for each of those standards. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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): Service users continue to be provided with care that responds effectively to their health needs and those arising from their disabilities. Their personal care is arranged so as to preserve their privacy and dignity and their medication is being looked after and administered in line with procedures intended to avoid risks. EVIDENCE: As earlier reported the Home has a system, which forms part of service users individual plan and which sets out how each person prefers to be assisted with his or her personal care. For example, there is clear guidance on how each service user is to be assisted with bathing and toileting where this is required. Each service user’s preferred daily routine – bedtimes and time for getting up in the morning – is documented and according to their daily notes is put into effect. Service users choose their own clothes both in what is bought and what they wear each day. Staff explained that they give service users some guidance in this, i.e., in selecting clothing appropriate for the occasion and weather condition, but even where the individual is not able to communicate verbally, sets of clothes of different colour and styles are presented to them to choose using their communication medium. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 16 Each service users has a key worker part of whose duty is to support the individual such that he or she has all the toiletries that they need, are properly groomed and able to maintain a preferred style. It was observed that where service users need technical aids and adaptations these are provided. For example, bathroom and toilet aids and a hoist are provided to help with the safe moving of some service users with significant mobility difficulties. Where service users need additional specialist support services such as speech and occupational therapy are provided. Indeed, staff cited in this connection, the recent referral of a service user to the speech therapy service. All service users at the Home have been registered with a practice of GPs and have access to dental and optical care. The Home also arranges for service users to have access to a chiropodist every six weeks. The records showed that health of all service users is monitored and that staff are diligent in seeking medical opinion and making timely referral for specialist treatment where necessary. In relation to the measures taken by the Home to ensure that service users medication is looked after and given safely, it was observed that staff are provided with a clear medication procedure and guidance about some medicines and their effects. The Deputy Manager advised that all staff who administer medication have received training to do this and previously the Manager reported that new staff are not permitted to administer medication until they are deemed competent to do so. Medication is stored in a secure metal wall-mounted cabinet in a location which is also secure, and to which only staff have access. The medicine cabinet is equipped to store controlled drugs. A check of the medication records revealed that they were all up to date and the quantities recorded as given to date for the week when the inspection took place, were reconciled with what was left in the containers. At the time of inspection reasonable risk factors meant that none of the service users retained or administered their own medication. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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 and 23 Measures put in place by those responsible for the Home are likely to ensure that service users’ views are listened to and that they are protected from abuse in all its forms (except financial abuse, which was not assessed) and other forms of ill or unfavourable treatment. EVIDENCE: The Home complaints procedure has not changed since the last inspection and therefore continues to conform to requirements of the National Minimum Standards. This procedure has been reproduced in a form appropriate to service user needs, is clear and seeks to reassure service users and those who might wish to complain on their behalf that any concerns that they have will be taken seriously and dealt with accordingly. The information given to promote the Home complaints procedure makes clear to potential complainants that they may, if they wish, complain direct to the Commission. There remains a comfortable feeling in the Home in the ways that staff treat service users. They are keen to ensure that service users are content and that any difficulties they have will be picked up and dealt with before there is any need to invoke the formal complaints procedure. The Manager has designed a service users satisfaction questionnaire in a communication medium that they can understand and this is administered periodically. The last time they were administered – just prior to the previous inspection – the results indicated that service users were content with their care and the running of the home. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 18 The registered person has developed and introduced a policy to guard against the abuse of service users. The policy, which is aligned to others such as that for whistle blowing and gifts and bequests, was examined and deemed to be effective for its purpose. At the last inspection the Manager was advised to make available to staff in the Home, a copy of the local multi-agency Vulnerable Adult Protection Procedures and to ensure that the Home’s procedure is in accord with them. This was because in the event of any allegation of abuse of service users in the Home, it is those procedures that would be followed. A copy of said procedures was seen in the Home and the Deputy Manager said that staff members had received awareness training about its contents. The complaints record could not be found, but the Deputy Manager said she did not recall any complaints being made at all or since the last inspection. There was also no record of any alleged abuse and no staff members have been referred for inclusion in the Protection of Vulnerable Adults register. All the evidence here suggests that care is being taken to protect service users none of whom appeared to be abused or in any way neglected or ill treated. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 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, 27 and 30 Service users are provided with a normal comfortable living environment adapted to their individual needs and which is maintained in clean and hygienic condition. EVIDENCE: Operated from premises on a modern housing estate, which have been adapted from a conventional family dwelling to its current use, this home is indistinguishable from others in the neighbourhood. Service users are therefore unlikely to feel conspicuous living there. The home is close to the village centre and the usual amenities such as shops, pubs, hairdressers, etc. It continues to be maintained in very good structural and decorative order offering single bedroom occupancy and en suite facilities in two rooms. All the bedrooms are spacious contributing to the comfort of their occupant and enabling staff to assist them where necessary with relative ease and safety. The communal areas remain the same providing a large sitting/dining room, kitchen, and pleasing rear garden, which is well maintained and wheelchair accessible. All the rooms are furnished and fitted with items of good quality and which are domestic in design and scale. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 20 Bathrooms and toilets are provided in excess of the required ratio for the number of service users: there being three bathrooms (two of which are en suite) for five service users. In addition, there are two separate toilets, one on each of the two floors. The numbers and location of these facilities mean that they are easily accessible to service users wherever they are within the Home thus enabling them to have privacy and comfort. Although maintained in clean condition throughout, what the Deputy Manager reported as an overflow of water from a washbasin in one of the bedrooms on to the carpet has left the room with an offensive odour. It is understood that arrangements have been made to remedy this, but this will need to proceed with some urgency. Throughout, the Home is adequately lit by both natural and artificial light and is adequately heated and ventilated. Curtains, floor coverings, beds and bedding, including bedding in store, were all in good condition. The home has its own transport, which is adapted for wheelchair users thus service users’ access to local amenities and other facilities is not a problem. The adaptations which have been made to the Home also means that service users have access to all areas registered for their use, regardless of their disability. Satisfactory provisions have been made for the premises to be kept clean and hygienic. There is a utility room sited such that laundry does not have to be taken through the kitchen or the living/dining areas. Aprons and disposable gloves are also available in all the areas where their use might be necessary and hand washing and drying facilities are provided in all the key locations. It was also noted that proper arrangements have been made for the disposal of clinical waste. Staff members were seen to be scrupulous in their hygiene routine particularly when preparing food and this is more generally reflected throughout the Home, which was found in clean and hygienic condition. This and the other measures reported above are considered to be sound precautions for avoiding infections and limiting their spread. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 21 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 Service users are benefiting from a staff team in which a significant number of its members are accredited as competent and who collectively demonstrate this. EVIDENCE: At the last inspection standards 34 and 35 were assessed and were seen to be satisfied therefore on this occasion only standard 32 was assessed resulting in the following observations:Staff explained their work in ways that indicated that they are committed to the Home’s particular service user group and principles and methods, which it applies in caring for them. This, the inspector considers, acts as a motivator for staff members who during this inspection and previously were seen to carry out their duties with purpose, enthusiasm and with attention to detail. For example, they take great care in food preparation and presentation, treat service users with respect – listening and relating to them using means of communication appropriate to the individual’s needs and which recognise the service user’s adult status. In their routine care of service users as gleaned from the records and observed during the inspection, staff members demonstrate a good understanding of service users disabilities and specific health condition. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 22 There is documented evidence that they work effectively with specialists such as GPs, Dietician, social workers and others involved in the service users care as seen in the protocols for the care of service users with epilepsy and eating difficulties. Currently all the service users accommodated at the Home share a common culture and the practice of their religion is not significant to any. However, staff members are aware that there are aspects of service users’ lives, say those for minority groups, which might require a different approach to satisfying their religious and cultural needs. As people, staff members seen on this and at the last inspection, presented as friendly, helpful and approachable. They work well together and in the inspector’s judgement are the kind of people that service users are likely to feel comfortable to approach with any difficulties they might have. Indeed, service users were observed to be entirely at ease with the staff members who were on duty on this occasion and during the previous inspection visit. The Registered Provider has other care home facilities and therefore is able to arrange certain functions such as staff training and development as one of the central support services of its business. Accordingly, there is an established induction and foundation training programme for all new staff members, which is intended to ensure that they understand and are able to work efficiently within the Home’s Statement of Purpose and in so doing respond effectively to service users individual needs. In ensuring that staff members have the competencies to discharge their duties effectively, the Registered Provider has fulfilled the requirement for 50 of care staff achieving National Vocational Qualification (NVQ) level 2 by 2005. This is likely to be improved upon when the newly appointed staff are similarly accredited and those currently working towards NQV Level 3 accreditation complete this process. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 23 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): 42 Service users health, safety and welfare continue to be promoted and safeguarded by the careful measures taken to protect them from avoidable risks. EVIDENCE: At the last inspection standards 37 and 39 were assessed and deemed to be met except for one detail in standard 37, i.e., the needs to fit restrictors to the first floor bedroom used by service users to reduce the risk of anyone attempting climb out and injuring themselves. It was noted on this occasion that this requirement has been met. These standards were therefore not fully assessed on this occasion. A check was made to find out whether there had been accidents in the Home since the last inspection since this is one of the indicators of how effective or otherwise the safety measures are. It was found that there had been no accidents to service users or staff and that where previously there had been accidents, risk assessments had been completed and instructions issued on how to avoid similar occurrence in future. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 24 The Deputy Manager reported that all staff members, except the two most recently appointed, have received training in First Aid, Food Hygiene and in Lifting and Handling. Training in these areas, is intended to ensure that staff are able to keep service users comfortable and limit any adverse consequences should any service user have an accident or any medical emergency. The fire safety records were examined and showed that all the detection alarms and fire fighting systems and equipment have been checked by technicians at the appropriate intervals. Alarm system tests and checks of the emergency lighting were also recorded as being conducted. On the last occasion when the Fire Service conducted a fire safety inspection of the premises (04/9/04) they reported that all was “Satisfactory” Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 25 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 4 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ics - Dexter Way, 1 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000004248.V268033.R01.S.doc Version 5.0 Page 26 No 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 YA24 Regulation 16 (2) (k) Requirement The Registered Person must act to eradicate the unpleasant odour caused by the reported flooding of the carpet in one of the first floor bedrooms. Timescale for action 31/01/06 Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 27 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 YA2 Good Practice Recommendations Where service users’ records kept at the Home do not include a copy of the individual Care Management assessment, the Manager should seek a copy from the relevant social services department in order to complete the records. Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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. Extracts may not be used or reproduced without the express permission of CSCI Ics - Dexter Way, 1 DS0000004248.V268033.R01.S.doc Version 5.0 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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