Inspection on 07/03/06 for Inglenook House

This inspection was carried out on 7th March 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Inglenook House 04/09/07

Inglenook House 28/09/06

Inglenook House 19/09/05

Inglenook House 19/10/04

Inglenook House 04/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Inglenook House 46 Lipson Road Lipson Plymouth Devon PL4 8RG Lead Inspector Wendy Baines Unannounced Inspection 11:00 7 March 2006 th Inglenook House DS0000003533.V252005.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 Inglenook House DS0000003533.V252005.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 Older People and 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. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Inglenook House Address 46 Lipson Road Lipson Plymouth Devon PL4 8RG 01752 229448 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) Jan Limited Dawn Florence Bartlett Care Home 10 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (10), Physical disability (10) of places Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Learning disabled adults some of whom may have a physical disability Age 18yrs Date of last inspection 19th September 2005 Brief Description of the Service: Inglenook House is a care home Registered to accommodate 10 Adults with a Learning Disability, some of whom may also have a Physical Disability. The Registered Provider is Jan Ltd, and the owners of the home are Mr & Mrs Nicholson who are also the owners of the property next door, which is a Registered care home. The range of needs catered for includes, adults with medium to high levels of dependency. The house is a large, mid-terraced property situated in the Lipson area of Plymouth and is close to the city centre and local shops and parks. Service users are accommodated in six single, and two double bedrooms. There is a large lounge, separate dining area, kitchen, laundry, and garden/patio area. There is level access to the rear of the property and a ramp that can be fitted to the front access to support service users requiring the use of a wheelchair. Service users are supported to partake in a range of daytime and leisure activities dependent on their assessed needs. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 7th March 2006, between 11am and 3pm. The Registered Manager, Dawn Bartlett was present throughout the day. The inspector was able to meet with and observe all staff on duty and spend time with all service users who were at home. A tour of the premises took place and records relating to service users, staff and the running of the home were made available. The atmosphere of the home was warm and welcoming. What the service does well: The home provides current and prospective service users and their representatives with sufficient information to enable them to make an informed choice about where they live. A care plan and risk assessment is completed and this information is regularly reviewed with input from outside agencies when possible. Staff have a good understanding of service user needs and methods of communication and are able to use this knowledge to encourage choice and decision making about day-to-day life in the home. Service users are encouraged and supported to partake in a range of activities inside and outside the home and staff encourage and support service users to maintain contacts with family and friends. The home is located close to the city centre, local shops, health services and the main bus route. There is also a mini-bus available for service users who may need support and transport arrangements to access opportunities away from home. The homes recording procedures ensure that changes in health are monitored and there is regular contact with Health services and Specialist learning disability services to assist the home to review the care needs of each individual and to advice staff about particular health needs. Staff attend a range of training opportunities relating to the home and needs of individual service users and this is regularly updated. Service users and staff benefit from an open, positive and inclusive style of management. Regular support and supervision is available for the staff and management. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Care plans and information available to staff should; - cover all aspects of personal, social and healthcare needs. - Set out clear guidelines for staff to ensure consistency and continuity of support - Be agreed as part of Person Centred approach to ensure that service users likes/dislikes and personal preferences have been considered. Any agreements, which may restrict a service user or infringe on an individuals rights’, choice, privacy must only be agreed as part of a multi-disciplinary process. This information must be documented and regularly reviewed. The Registered Provider must review the homes current arrangements for managing service users finances. Any arrangements to support a service user must be agreed and documented as part of the service user plan. Any accounts must be in the name of the individual and be interest bearing. The Registered Provider should support service users to open their own personal bank account, with input for advocacy services/representatives if necessary. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 7 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. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1.1.2.3.4.5. Current and prospective service users are provided with sufficient information to enable them to make an informed choice about where they live. EVIDENCE: The home had a Statement of purpose and service user guide. This information has been provided in an accessible format and one service user said that information about the home had been provided in her own folder with pictures and symbols that she could understand. All the current service users have lived in the home for many years and there had been no new admissions. Discussion took place with the Registered manager about the homes admissions procedure, which she said included a pre-admission assessment, visits and trial placement. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 10 A statement of terms and conditions had been completed between the home and the service user/representative. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6.7.10. Service user plans are completed for each individual, however these were not in all cases sufficient in detail to reflect the level of care and support described by staff and management. Service users are encouraged and supported to make decisions and choices about day-to-day life in the home. EVIDENCE: Individual records are kept for each service user and these contained general information, care plans and risk assessments. A sample of service user plans were seen during the inspection. The manager said that this information is reviewed every six months or before if there is a concern or significant change. The home endeavours to include service user representatives including care managers within these meetings, however this Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 12 can at times prove difficult when service users do not have a allocated care manager. Following reviews the home makes referrals to outside agencies, such as the GP and Learning Disability services if there are any areas of concern. Discussion took place with the manager for the need to ensure that the detail within care plans reflected the level of care being provided to ensure that staff had the information they required to fulfil their role and meet needs. Several service users were spending more time at home due to changes in day care arrangements. The manager said that staff were exploring options for service users and considering new opportunities inside and outside the home. Discussion with the manager confirmed that baby monitors are used in bedrooms when a service user has been unwell. This practice must be reviewed to consider whether the equipment is still required, and to ensure that all other options have been considered. Any restrictions, which may affect an individuals choice, freedom and/or privacy must be agreed as part of a multi-disciplinary process, documented and regularly reviewed. Staff demonstrated a good understanding of service user needs and were observed supporting them to make choices about their care and plans for the day. Where necessary referrals have been made to the Speech and language services, and staff have attended Total communication courses. Service users records and other information relating to the home were stored safely and appropriately, and information seen during the inspection was found to be up to date. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13.14.15 Service users are encouraged and supported to maintain and learn life skills and participate in a range of opportunities inside and outside the home. The home supports service users to maintain links with family and friends. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 14 EVIDENCE: Discussion, observation and records confirmed that service users have a range of skills, and require different levels of support to access and partake in opportunities’ inside and outside the home. The home is situated close to the city centre, local shops, GP practices and main bus route. A mini-bus is available and used for taking service users to planned activities, visits home and day trips out. The manager confirmed that all service users have a mix of planned and unplanned arrangements during the week and these have been agreed as part of the individuals care plan. Activities include; day centres, hydrotherapy, music therapy, Physiotherapy, shopping, and attending the local leisure centre to make use of the gym. This information was not documented within service user plans and it was therefore not clear how this information would be reviewed. The manager said that due to recent changes to individuals’ day care arrangements and deterioration in health some service users would be spending more time at home. For several service users their current arrangement for regular planned day care would cease. It was evident that the home had liaised with the specialist learning disability services and day centres to express their concerns about these changes and to ask for advice and guidance to support these needs within the home setting. The home had started to develop a weekly timetable of individual and group activities, and for one service user an exercise programme had been agreed with support from the Physiotherapy services. On the day of the inspection several service users were at home and during the afternoon staff supervised a group drawing activity. Through observation it was not evident that this was an activity, which all the service users enjoyed or were able to fully partake in. Discussion took place with the Registered Manager for the need to incorporate a Person Centred approach to planning care, and to ensure that opportunities/activities meet the needs and wishes of the individual. Service users are supported by the home to maintain their links with family and friends. One service user spoken to said that she visited home regularly and that the staff helped her make these arrangements and provide the transport that was needed. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) 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. The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. EVIDENCE: Service user plans and records provided information about individuals personal, emotional and healthcare needs. General information had been documented within files regarding contact numbers for the GP and other health services and a record kept of routine health checks. Since the last inspection the home has developed additional information when health needs are considered more complex and information is agreed and documented regarding; support required, staff training and other agency involvement. The manager said that the level of support required by service users to attend to personal care tasks can vary and this has increased for some service users due to deterioration in health particularly due to the onset of Dementia. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 16 The information in Service user plans and guidelines for staff did not in all cases reflect the level of care being provided, and service users preferences about how care is delivered. The homes daily recording, hand-over meetings and staff meetings ensure that service users health needs are monitored and potential problems are identified and dealt with at an early stage. External professional advice and support was sought when necessary from local healthcare professionals and Learning Disability services. A mobility and exercise plan had been completed for one service user with advice from the Physiotherapy services. Records confirmed that the home liaises with the specialist learning disability team to ensure adequate support is available when a service user is admitted to hospital. The home has regular contact with the Specialist Learning Disability services regarding the screening of service users with Dementia or for those who may be at an increased risk of this condition. Staff have undertaken training relating to Dementia care. The system of medication, storage and administration was in keeping with the Royal Pharmaceutical Society guidelines for care homes. A clear record was kept of all medication received and administered, and a separate fridge was available for any medicines requiring low temperature storage. The manager advised that senior and night staff administer medication and receive training relevant to this task. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) 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. Service users can feel confident that any complaints are taken seriously and all service users are given the opportunities to express their views. The homes current practices for managing service users money do not ensure the full protection of individual’s finances. EVIDENCE: Neither the home nor the Commission have received any complaints regarding the service since the last inspection. The home has a written complaints procedure, which was available within the Statement of Purpose and service user guide. Throughout the inspection staff demonstrated a good understanding of the individual communication methods of service users, and were able to use this knowledge to respond to requests, and pick up on cues displayed in mood and behaviour. The homes daily recording and key worker system is also used to ensure that any concerns/ problems are documented and can be addressed. The management and staff team were aware of issues relating to abuse and written adult protection procedures including the Alerters guide and a ‘whistle blowing policy were available. A ‘quick glance’ flow chart is also available in the office to alert staff of what to do if they suspect an incident of abuse has occurred. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 18 Guidelines were available for staff relating to service users who may be aggressive towards themselves or others and it was evident that the home had liaised with the specialist learning disability and Challenging Behaviour services when agreeing these arrangements. The manager said that this information is regularly reviewed. The manager said that all service users had been assessed as requiring support to manage their finances. Money held in the home belonging to service users is stored safely and records are kept of all transactions. However, service users do not have individual bank accounts and benefits for each service user is currently paid into one account set up and managed by the Proprietor. Discussion has taken place with Mr and Mrs Nicholson regarding this matter and they have advised the Commission that they are currently reviewing this arrangement to ensure that the regulations relating to management of service users money is met. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 19 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24.25.26.27.28.29.30. Service users live in a clean, safe, comfortable and well-furnished home. EVIDENCE: A tour of the premises took place and all service users bedrooms were seen during the inspection. The home has sufficient shared and communal space to accommodate the number and needs of service users. There are six single rooms and two double rooms, and one service user requiring a wheelchair is accommodated on the ground floor. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 20 The home was found to be clean and tidy throughout and service users bedrooms contained many personal items and sufficient fixtures and fittings. Since the last inspection the dining room has been redecorated and a new carpet fitted. A new three- piece sofa has also been purchased for the communal sitting room. There are several items of specialist equipment in the home including a hoist and adjustable bed. The home regularly liaises with Occupational Therapy and physiotherapy to review the need for and use of equipment. Bathrooms/toilets the laundry and kitchen were inspected and found to be clean, hygienic and well maintained. Discussion took place with the manager regarding the difficulty of a service user to access private and communal space when using a wheelchair. The home must ensure that the issue of access continues to be addressed to ensure that the home can continue to adequately meet the needs of service users with a physical disability. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31.32.33.34.35.36. Staff are provided with a range of training opportunities to ensure they have the skills to meet service user needs. The homes recruitment procedures are robust and protect service users. Staff are well supported by each other, outside agencies and the management team. EVIDENCE: Staff demonstrated a good understanding of service users needs and were observed responding sensitively, respectfully and promptly to service users needs and requests. Staff spoken to were keen to understand the inspection process and showed an enthusiasm to further improve practice and to consider new opportunities for service users. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 22 The Registered Manager said that she felt that staff were sufficient in number to meet the assessed needs of service users and said that the number of staff on duty could alter dependent on the time of the day and arrangements that had been made. A rota was available, which confirmed that three to four staff would normally be on duty and additional staff may work when a trip out has been arranged. Records confirmed that staff attend a range of in-house and external training opportunities. Health and Safety training including; First Aid, Manual Handling, food hygiene and Fire Safety is included as part of the homes induction programme and is updated regularly for all staff. In addition to the mandatory training staff attend courses specifically relating to the home and needs of individuals including; Dementia care, Total Communication, Sexuality, and Epilepsy training. All staff are registered to undertake an NVQ qualification and the home has achieved the requirement for 50 of care staff to be qualified to NVQ Level 2 by the end of 2005. Staff files inspected confirmed that the home has a robust recruitment procedure and all necessary checks had been completed. All staff are provided with a contract of employment and job description. In addition to daily discussion, communication books and staff meetings staff also have regular 1:1 staff supervision. Staff supervision takes place every 6-8 weeks and the meeting is documented. Staff spoken to said they felt well supported by other members of the staff team and management. All staff spoken to said that since the last inspection there had been some changes of care staff. It was felt that these changes had been positive, had improved moral and resulted in staff being more open and inclusive in their style of work. Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37.38.39.41.42. Service users and staff benefit form an open, inclusive and positive style of management. Service users health, safety and welfare are protected and promoted. EVIDENCE: Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 24 Mrs Dawn Bartlett is the Registered Manager for the home and was available throughout the inspection. Mrs Bartlett was able to demonstrate a good understanding of service users needs and of the areas in which the home needs to improve. The Registered Manager is also well supported by Mrs Amanda Nicholson, the home- owner and the Registered Manager of a care home situated next door to Inglenook and also owned by the company. Throughout the inspection staff were open and supportive to each other. A new member of staff recently appointed to the home and a senior were able to give a clear account of their role, responsibilities and issues relating to the care of service users and day-to-day running of the home. All staff were keen to discuss and consider ways to improve practice and to ensure more fulfilling lives for service users. The home has a quality assurance system, which includes service user and relatives questionnaires. The feedback from this information is discussed in team meeting and an action plan agreed. Records within the home were well maintained and the Registered Manager was aware of when information needed to be more detailed as service users needs change and increase. A system of monthly checks is in place to address health and safety in the home. Staff receive regular health and safety training as part of an on-going training programme. Risk assessments had been completed for water temperature, hot surfaces and windows and necessary safety devices had been fitted where a risk had been identified. The Registered manager must continue to review these areas of risk as service users needs change. The homes Fire log -book was seen and all checks of equipment were recorded and up to date. Staff receive Fire safety training every six months. Inglenook House DS0000003533.V252005.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. Where there is no score against a standard it has not been looked at during this inspection. 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 4 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 2 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT 37 3 38 3 39 3 40 3 41 3 42 3 43 X Standard No 6 7 8 9 10 LIFESTYLES 11 12 13 14 15 16 17 Score 2 3 X X 3 X X 3 2 3 X X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 26 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 YA6YA6 Regulation 15 Requirement Timescale for action 01/05/06 2 YA23YA23 20 The Registered Provider must review the use of ‘baby monitors’ in the home. This practice must cease unless it has been agreed as part of a multi-disciplinary review where all other options have been considered. Any arrangements, which may restrict a service user or affect their choice/ privacy must be agreed, documented and reviewed as part of a multidisciplinary process. The Registered Provider must 01/06/06 review the current arrangements for managing service users finances. The Registered Person must not pay money belonging to a service user into a bank account unless; - The account is in the name of the service user, or any of the service users, to which the money belongs (Regulation 20Care Homes Regulations 2000) - Service users must have instant access to their money. DS0000003533.V252005.R01.S.doc Version 5.0 Inglenook House Page 27 -Individuals must have interest accredited to their account. - Individuals must be able to have a itemised statement of their account - There must be protection from seizure of their money by a third party. 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 YA6YA6 Good Practice Recommendations Service user plans should be further developed to include sufficient detail relating to all areas of care. The Registered provider should give consideration to incorporating Person Centred Planning into the care planning process to ensure a more holistic and long-term outlook. The Registered Provider should ensure that a Person Centred approach is used when considering and planning day time opportunities and activities for service users. The Registered Provider should ensure that sufficient detail is provided for staff regarding the daily personal care needs of service users. Consideration should be given to involving service users in this process to ensure that personal preferences about how care is delivered is recorded and followed. As part of the homes review of the management of service users money all service users should be supported to open individual bank accounts. The Registered Provider should ensure that access arrangements continue to be appropriate for service users with a physical disability and requiring the use of a wheelchair. 2 3 YA14YA14 YA18YA18 4 5 YA23YA23 YA29YA29 Inglenook House DS0000003533.V252005.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Inglenook House DS0000003533.V252005.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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