Inspection on 23/08/05 for ICS 60 Ward Grove

This inspection was carried out on 23rd August 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 60 Ward Grove 31/03/09

ICS 60 Ward Grove 01/02/07

ICS 60 Ward Grove 20/01/06

ICS 60 Ward Grove 11/01/05

ICS 60 Ward Grove 04/03/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Ics - Ward Grove, 60 60 Ward Grove Warwick Warwickshire CV34 6QL Lead Inspector Warren Clarke Announced Inspection 23rd August 2005 09:30 Ics - Ward Grove, 60 DS0000004365.V252594.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 - Ward Grove, 60 DS0000004365.V252594.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 - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ics - Ward Grove, 60 Address 60 Ward Grove Warwick Warwickshire CV34 6QL 01527 546000 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 Miss Emma L Benton Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Manager to successfully complete the Registered Managers Award by 31 August 2006. Certificate for Registered Managers Award to be seen by CSCI when available and copies to be taken for file. 7th March 2005 Date of last inspection Brief Description of the Service: 60 Ward Grove is a registered care home for three younger adults (18 - 65) with a learning disability. The three service users also have physical disabilities and the home has been fully adapted to meet their needs. The home, a bungalow, is situated in a small cul-de-sac in Myton, which is on the outskirts of the town of Warwick. The home has its own transport, which is necessary as local amenities and facilities are not within easy walking distance. All facilities in the home are on the ground floor. The shared space consists of a lounge with dining area, kitchen and bathroom. There are four bedrooms, one is used as the sleep- in/office for staff. The detached garage has been adapted to house the laundry facilities. There is a well-maintained garden at the rear of the property, which is easily accessible to service users. The home is considered to be a home for life for current service users, unless the home can no longer meet service users’ needs, or they express a wish to move. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection the findings of which are based on information provided by the Registered Provider in a pre-inspection questionnaire, a visit to the Home and feedback from service users and their relatives via surveys. In the case of service users, they received assistance from staff at the Home to complete the questionnaires. Note, Relatives were favourable in their comments about the Home except in one respect, as outlined below. During the inspection visit, the inspector was able to examine the premises, interview the Manager and scrutinise relevant records. The inspector was also able to talk informally with one service user and observed how staff interacted and performed some routine care tasks in respects of all the services users. Sadly most service users and staff were away from the Home at the funeral of one of their friends during the inspection and therefore the inspector’s direct contact with them was limited. What the service does well: What has improved since the last inspection? In responses to critical observations made at the last inspection, the Manager has addressed the following:Revised the format for service users’ individual plans. Ensured that the records of meals provided are sufficiently detailed as to demonstrate that service users are receiving a varied and nutritious diet. Ensured that staff receive foundation training. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 6 Arranged for staff members to receive formal supervision at regular intervals. Acted to address staff shortages, which occurred as a result of the resignation of some personnel 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 - Ward Grove, 60 DS0000004365.V252594.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 - Ward Grove, 60 DS0000004365.V252594.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 The planning and provision of service users care is informed by ongoing assessment of their needs, which takes account of the individual’s aspirations and what has been ascertained as likely to provide him or her with an overall good quality of life. EVIDENCE: All those currently resident at the Home were admitted when it opened ten years ago thus their admissions were planned and determined by assessment of their needs carried out by their local social services and health authorities. Among their records were found evidence of further ongoing assessment, which is intended to identify any changing needs so that the care provided might be adjusted accordingly. This system was deemed to be working effectively in practice, staff having a sound working knowledge of the assessed needs, including those requiring specialist treatment, of each service user. It was noted that the format used for conducting service users’ ongoing assessment is in line with that set out in standard 2.3, which, for example, takes account of the accommodation and personal care, meaningful occupation and health care needs. These assessments are, as expected, linked to a care plan for each service user. Further restrictions on choice, as shown in two cases where diet was restricted based on specialist needs, were reported to have been discussed with the individuals and overseen by a specialist. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 9 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 and 9 Service users care is being provided on a planned, considered basis within which the Home sets out the actions it, and as appropriate, in partnership with specialist services will take to meet the individual service user’s needs, as identified by assessment. Although the Home’s approach to assessment and care planning has recently been in the process of revision, this has not caused any service user’s care to be left to chance. Service users are being cared for within an ethos in which they are regarded as autonomous adults with the freedoms and rights that go with their adult status. Staff members in their approach were considered to support and guide service users in making decisions and take steps to reduce risk rather than supplant the individual decision-making or act to unduly limit their activities. EVIDENCE: The Registered Manager provided evidence of an individual plan for each service user detailing their needs and what is being done to meet those needs. The plans take account of the service users’ health and personal care requirements and the individual preferred approach and regimen for attending to these. It was noted that the plans also address lifestyle and personal aspiration matters such as recreation and leisure, occupation/training and take full account of the inputs of specialist services which are required to address Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 10 particular identified health conditions and those associated with the service user’s disabilities. For example, where service users have conditions such as epilepsy, the agreed approach to the management of this and what the staff of the Home are expected to do in this regard, are clearly stated. The intention of care or individual plans is that they should provide a clear strategy for achieving agreed outcomes for service users and set objectives demonstrating how day-to-day care inputs will contribute to those outcomes. The Home’s revised care planning system, with the adjustments agreed at inspection, conforms to this. Each service user’s plan is presented in conjunction with their Agreement of Residency and their individual risk assessment. This is intended to show that the Home is meeting its contractual obligation to the service user and that restrictions, such as limitations on choice of food offered in some cases, are part of an agreed risk management strategy. The only critical observation here, was that the scale of charges were not shown in the service users’ Agreement of Residency and the Registered Manager was not certain what those charges currently are. At the time of inspection arrangements had been made for all service users plans to be reviewed and the Manager reported that unless individual circumstances dictate otherwise, review of the plans are usually co-ordinated with that carried out by the local authority under the assessment and care management system. This happens at six monthly intervals. All the service users have communication difficulties and so information that they need in order to make decisions or to exercise their rights is explained and presented in forms that they are likely to understand. This was demonstrated in the complaints procedure and the questionnaire, which the Manager uses to find their views about the Home and the care they are receiving. In assessing the range of provisions made to assist service users with making decisions about their lives, evidence was sought as to whether any of the service users had been assisted to engage local independent advocacy. The Manager reported that currently none of the service users have formal independent advocates, but most have family members with whom they have substantial contact and who act in the capacity of their advocates. Additionally, those who attend Day Centres are assigned a key worker thus providing someone independent of the Home to promote their interests. The Manager also reported that some of the professionals, who provide specialist services, such as the Physiotherapist, have acted in this capacity for service users in matters of health. Staff were able to explain how in day-to-day living service users were enabled to make choices, i.e., in what they wear, what they eat, when they go to bed and when they get up. No instances were observed or reported in which Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 11 decisions were made for service users other than those recorded in their risk assessment aspect of their individual plan. With regard to the service users control of their finances, none of them were deemed able to manage their entire financial situation. The Registered Provider has declared that, in respect of another of their similar homes as is the case with the service users in this, there are difficulties in getting financial institutions to co-operate with supporting service users to open accounts. Accordingly, the Registered Provider acts as the service users appointee with the agreement of the Department of Work and Pensions. The accounts kept in this regard were not examined, but the Manager explained that service users had access to small sums of their own money which they are supported to manage. No practices were observed or reported which might be regarded as curtailing service users’ ability to pursue a reasonably independent lifestyle because of over-cautiousness on the part of their carers. Indeed, the Manager explained the approach to the care of service users is such that it was inferred that there is a keenness for them to lead full, interesting lives and that risk assessments should mostly enable rather than inhibit this. Part of the Home’s risk management strategy is a procedure for responding to any unexplained absence of a service user. This procedure was seen among the Home’s portfolio of policies, procedure and guidance and no instances of unexplained absences of service users were either observed from the records or reported to the inspector. Ics - Ward Grove, 60 DS0000004365.V252594.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, 14, 15, 16 and 17 The staff work well, in some instances in partnership with other agencies, to ensure that service users have opportunities for meaningful occupation, education and leisure interests. Staff are also careful in ensuring that service users’ rights are respected and that they have opportunities to take responsibility for as much as possible of their daily lives in the areas where they are less dependent. Furthermore, the Home makes acceptable provisions that ensure that service users receive nourishing food and takes account of their preferences and health needs in this regard. EVIDENCE: At the time of inspection, the Manager reported and the records confirmed, that two of the service users attend a Day Occupation Centre on a regular basis. The Manager explained that the Day Centre provides a variety of pursuits: art and crafts and learning for leisure-type courses via the local further education college. These services, apart from providing service users with meaningful occupation appropriate to their age and interests, also enable them to meet and make friends with others with similar disabilities and to widen the scope of their social mixing and friendship groups. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 13 One service user who was not involved in day occupation outside the Home, was seen from the individual plan to have a programme of activities, which include joining staff in tasks such as doing the Home’s grocery shopping, visiting friends and places of interests. It was noted that the Home has its own appropriate transport, which makes the service user’s participation in these activities possible. In a questionnaire, which was sent to service users but was completed with their key workers’ help, service users indicate that they “have lots of things to do” in their leisure time. Among the examples of what they indicated they do is: going for walks in the park, going out for meals, listening to music and watching television. Service users’ relatives, those who responded to our questionnaire, expressed concern about service users not being provided with enough opportunities to become involved in social and leisure activities outside the Home owing to staff shortage. The registered provider might therefore consider informing relatives of the improved staffing arrangements since April 2005. Assessment has been made of this aspect of care because it is by having the opportunity to take part in these activities and going out of the Home that service users get some of the social and occupational experiences, which are likely to contribute to their self-fulfilment and quality of life. Apart from the opportunities provided for service uses to meet with others through occupation and leisure pursuits, the Home, through flexible visiting arrangements and assisting service users in use of the telephone, enables them to maintain contact with relatives and friends. This includes friends that services users have made with those in other of the providers homes. Sadly, most of the service users were away from the Home for much of the period of the inspection because they were attending the funeral of one of their late friends. Further evidence of the Home’s efforts to enable service users to maintain contact with relatives and friends, is shown in relatives’ response to the questionnaire in which they indicated that staff members welcome them to the Home at anytime and that they make visits in private if they wish. In assessing the how service users rights are respected, their privacy observed and their inclusion in the daily routines of the Home, among others, the inspector looked at: what practices are observed with regard to staff and others entering service users bedrooms; how services users and staff address each other; whether service users are unduly prohibited access to any part of the home, which is intended for their use, etc. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 14 All the bedrooms are fitted with locks, but they are not used. The inspector did not directly seek an explanation for this, but concluded from what was otherwise seen that the privacy of service users’ bedrooms is observed. For example, the Manager explained to a service user who was present why the inspector wished to look at the bedrooms and sought consent for the individual’s room to be entered. In dealing with service users mail, the Manager said that staff hand the letter to the service users to which it is addressed, explain that it is for the particular service user but since some cannot open the envelope and all are not able to read the contents, it is opened for them. The contents are then read and explained and the letter is returned to the service user who keeps it with other personal documents in a lockable cabinet in his or her bedroom. These serve as examples of some of the ways in which the Home observes and respects the rights and responsibilities of service users. The Home is run on a small family-like basis with the informality that goes with this. Accordingly, the way in which staff and service users address each other reflects this informality, i.e., they call each other by their first name. The inspector also saw that staff actively sought to involve service users. For example, the Manager explained to the service user who was present at the start of the inspection, what it was about and, where appropriate, included the service user in what was going on. It was noted that service users had access to all parts of the Home, which are intended for their use. This includes the kitchen, which has specially adapted worktops that allow wheelchair users to assist with food preparation or simply to be with staff when tasks such as washing up are being done. Areas in which it is necessary for rules to be laid down and in which service users might reasonably be expected to exercise responsibility, such as smoking and drinking alcohol, were seen to be clearly set out in the Home’s policies and procedures. Currently none of the service users smoke and no issues were reported with regard to alcohol. Full records of food provided are now being kept and evidence of this was provided as an appendix to the pre-inspection questionnaire and during the inspection. The records show exactly what each service user has been provided and monitors how much they eat. It was concluded from those records, the variety and ample quantities of food seen in store and what the Manager reported, that service users are benefiting from a nutritious diet. Further that the diet is varied takes account of service users preferences and what some of their health care regimen dictates. At the time of inspection the Manager reported that two service users were being monitored by a dietician because their health conditions necessitated this. However, the Dietician has no concerns about them because they are not losing weight. Ics - Ward Grove, 60 DS0000004365.V252594.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): 18, 19 and 20 Service users are provided personal support and care, which addresses their physical and emotional health in planned and considered ways, taking account of what the staff have established as the individual’s preferences and in accordance with his or her identified needs. EVIDENCE: As mentioned earlier, each service user’s care and support are determined by assessment and a care plan, which sets out what the individual’s needs are and what must be done to meet those needs. The care plan format has recently been amended to capture the areas specified in standard 2.3, which, for example, take account of needs such family and social contact together with physical and emotional health. This is an indication of service user’s care being properly considered and arranged systematically so as not to be left to chance. It was noted that the care plans also set out service users rights and freedom in relation to what staff must do to ensure privacy, dignity and choice. In practice the manager explained that service users cannot verbalise their choice, but staff have come to understand how they prefer their care and support to be given and seek to comply. Service users get up in the morning and go to bed at night, at times of their choice though some guidance is given if they have to attend appointments or fulfil other commitments. It was also reported that service users ablutions are, unless dictated by unforeseen Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 16 circumstances, carried out at the times they prefer. For example, some service users prefer to be assisted with bathing/showering in the morning and others at night. During the inspection where service users were being assisted with their toilet and changing their clothes, both activities were seen to be conducted discreetly and in private. That is, they were taken to the bathroom or their bedrooms (as appropriate) where these activities were done behind closed doors thus preserving their privacy and dignity. The records showed that all service users are registered with a GP and arrangements have been made for them to have dental and optical care. This ensures that they receive effective health care by having access to the primary health service to which they are entitled. In regard to each service user’s specific health and disability it was also noted that arrangements have been made for them to have any ongoing specialist treatment and monitoring that is needed. Such specialist services include: medical consultants, physiotherapy, speech and language therapy and occupational therapy. An example of how the staff of the Home work in partnership with these specialist services was illustrated in a plan which was developed to respond to the particular symptoms of a service user’s condition. In essence, the Home is assessed as doing all that is required to ensure that service users receive the physical and emotional health care that they need. This applies to the safe custody and administration of their medication, which, as is expected, is managed within guidelines laid down in the Home’s procedure and overseen by Home’s pharmacy suppliers. All the records, which are kept in this connection, were seen to be current and accurate. Ics - Ward Grove, 60 DS0000004365.V252594.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 Service users at this Home are protected by the approach, which has been adopted to find out their concerns. Their welfare is further safeguarded by the policies and procedure in place to ensure that they are not in any way abused or subjected to adverse treatment. EVIDENCE: The Manager explained that because service users are not able to readily communicate any concerns they might have, deliberate efforts are made to observe their reactions to the way their care is being delivered. Staff members have come to understand and interpret from service users body language what pleases or offends them. For example, expressions such as frowns and smiles serve to give an indication of whether service users are content or displeased. This approach combined with a service users satisfaction questionnaire set out in pictorial form and recently administered shows that the registered persons are taking the steps necessary to find out service users views about their care and the running of the Home in a proactive way. There is a formal complaints procedure, which was seen and deemed to conform to the relevant standard. The procedure is clear in relation to whom complaints might be made, the process for dealing with any complaints and the timescales for so doing. The Manager advised that no record is kept of complaints and was reminded of the requirement to keep such a record. Since concerns have been expressed, via Comment Card survey for this inspection, about the impact of staff shortages this might be entered in the complaints record as a concern so that if similar concerns are expressed in future the Registered Person is able to monitor any pattern, which might be emerging in this regard. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 18 In taking steps to ensure that service users are protected from abuse or unfavourable treatment, the Registered Person has set out guidance and a procedure for staff to follow in the event of there being any suspicion of, or actual, abuse. The guidance explains the nature of abuse and in conjunction with the whistle blowing policy, the basic training that staff receive and the declaration earlier mentioned about the handling of service users’ finances is assessed as fulfilling standard 23. A copy of the local Vulnerable Adults Protection Procedures was not available in the Home. The manager was advised to get a copy of those procedures, make staff familiar with the contents and ensure that the Home’s procedure is compatible with them. This is because the locally agreed POVA procedures would be invoked in the event of any incidents of abuse at the Home. Ics - Ward Grove, 60 DS0000004365.V252594.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 and 30 Service users’ health and well-being are served by the high standard of material comfort that the Home provides and the safe and peaceful and hygienic environment in which it is operated. EVIDENCE: The Home is a detached bungalow in a quiet neighbourhood and it has been specially adapted for the needs of the service users such as those currently resident. Accordingly, it is entirely accessible for wheelchair users and is equipped with aids relevant to the needs of the existing group of service users. Each service user’s bedroom provides sufficient usable floor space to enable staff to assist the occupant in safety and comfort. Those rooms also appear to be furnished, except for a broken chest of drawers in one bedroom, to a high standard and adorned such as to reflect their occupants’ taste and interests. All the communal areas - sitting/dining room, bathroom and kitchen – are equally well equipped and being maintained in good decorative order. In short, the premises, including its pleasing gardens which are also accessible to those who are wheelchair users, are being maintained in sound condition and its décor, furnishings and fittings combine to provide comfort and a homely ambience. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 20 The Home is equipped with central heating and provides sufficient ventilation and light, both natural and artificial. Throughout, floor coverings were found in sound condition, as were window coverings and beds and bedding. The Manager gave an account of the planned maintenance, which together with the foregoing confirms that thought and planning is being given to maintaining the Home’s environment to the required standards. Nothing was seen that might be considered counter to the good hygiene practices as might be expected to control infection and therefore safeguard service users’ health. Provisions for hand washing/drying are made and other hygiene measures such as the availability of disposable gloves and aprons were also being taken. It was noted that the laundry is located so that it is well away from cooking and dining areas and does not necessitate unclean laundry being taken through the living areas. The laundry room is equipped with washing machine of a type suitable for soiled laundry and proper arrangements have been made for the disposal of clinical waste. Apart from this the Home is maintained in clean condition throughout ensuring that the risk of any spread of infection is greatly reduced. Ics - Ward Grove, 60 DS0000004365.V252594.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): 34 and 35 Service users are protected and their welfare is being promoted and safeguarded by the care taken in staff selection, training and development. EVIDENCE: A sample of two staff member’s records was examined and they revealed that selection of the Home personnel was being conducted in accordance with standard 34 and its quality indicators. For example, candidates for positions at the Home are required to complete an application form, which seeks verifiable information such as employment history. This is to enable assessment of the person’s relevant experience for the post and to contribute to the vetting process in relation to their fitness to work with vulnerable adults. Also in this connection, it was noted that references are taken up; potential employees’ identities are verified and criminal records checks are made. Short listed candidates are invited to the Home prior to or at interview thus, as the Manager reported, service users are able to meet with them. The candidates’ approach to the service users and the latter’s responses are also taken into account as a means of indirectly involving service users in the process. Other measures such as an annual staff training plan developed by the Manager to ensure that staff members are equipped to fulfil the Home’s objects and therefore the needs of service users were seen to be in place. A similar situation was also seen to exist in relation to individual staff members training and development profiles. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 22 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): 39 and 42 The system in place for seeking feedback on the running of the home and the care of service users combined with the planning and development strategies, indicate that the registered person is taking reasonable steps to operate the Home in an open and responsive way. This is matched by the appropriate health and safety measures, which are being taken to protect service users from potential harm. EVIDENCE: The Manager provided evidence in the form of questionnaires, which have been specifically designed for service users, their families and others with an interest in the home. These surveys seek their views about the running of the Home and the quality of service users’ care. The questionnaires had only recently been administered and therefore had not been analysed at the time of inspection, but the Manager is aware of that the outcomes and any proposed actions that will be taken in response to them needs to be notified to the Commission and those who participated in the survey. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 23 As mentioned earlier, the Manager has ensured that each service user has an individual plan for his or her care. The recent revision of the structure of the plan will make it straightforward to see the ‘year on year’ developments in each case as prescribed in standard 39.5. This measure together with the surveys mentioned above and the Manager’s action plan for areas such as staff training and development, and repairs and maintenance provide further evidence of the review and planning necessary for assuring quality of the service users’ care. Further, that this is not being left to chance. Checks were made to establish whether the Registered Person was ensuring that the measures for the safety of service users and staff, as outlined in standard 42 were being fulfilled. It was concluded that they were being fulfilled. That is, on the basis that precautions such as regulating the hot water temperature and testing it at regular intervals at the outlets to which service users have access were being done. Other measures such as tests of the gas and portable electrical appliances, implementation of a COSHH policy and taking the necessary fire precautions also confirmed compliance. It was noted that where service users’ conditions such as epilepsy places them at particular risk, staff have received instructions in how to respond. The Manager reported, all staff members have received training in Manual Handling and the majority have also had training in First Aid and Basic Fire Safety all of which are intended to contribute to keeping service users safe. Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 24 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 x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ics - Ward Grove, 60 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x DS0000004365.V252594.R01.S.doc Version 5.0 Page 25 Are there any outstanding requirements from the last inspection? No 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 23(2)(c) Requirement Repair or replace the broken chest of drawers in one of the service users’ bedrooms. Timescale for action 30/11/05 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 The Registered Person should inform service users’ relatives of the improved staffing situation since earlier this year and of any contingency plans for ensuring that service users’ range of leisure activities will not in future be significantly affected by staffing difficulties. The Registered Person should ensure that the home’s Protection of Vulnerable Adults (POVA) procedure is in line with the local area POVA procedures and that a copy of the latter is made available to staff at the home. 2 YA23 Ics - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 26 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 - Ward Grove, 60 DS0000004365.V252594.R01.S.doc Version 5.0 Page 27 - 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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