Inspection on 07/06/06 for Iona

This inspection was carried out on 7th June 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Iona 26/02/10

Iona 11/08/09

Iona 14/09/07

Iona 25/01/06

Iona 25/07/05

Iona 02/03/05

Iona 03/08/04

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 Iona 104 Well Street Biddulph Stoke On Trent Staffordshire ST8 6EZ Lead Inspector Peter Dawson Key Unannounced Inspection 7 June 2006 09:00 Iona DS0000004962.V297767.R01.S.doc Version 5.2 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 Iona DS0000004962.V297767.R01.S.doc Version 5.2 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. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Iona Address 104 Well Street Biddulph Stoke On Trent Staffordshire ST8 6EZ 01782 523396 F/P 01260 289107 Iona@imladris.me.uk 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) Mrs Jill Stockdale Mrs Wendy Scully Care Home 6 Category(ies) of Learning disability (6), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: Iona is a care home for younger adults providing personal care and accommodation for six people with a learning disability. One place can be used to provide a service for someone with both a learning disability and mental health needs (Mental disorder).The home is situated close to local amenities very close to Biddulph town centre. There are good public transport links to the home. The building is an older type semi-detached house with adequate secluded garden area with lawn and patio. There is one single ground floor bedroom with shower cubicle, further 3 bedrooms on the first floor - 2 double and one single room which has en-suite facility. There is a bathroom on the first floor. The communal rooms provide adequate lounge and dining space. The main lounge is of good size and comfortably furnished, the dining area is little used since the kitchen was refitted which is the preferred dining area for residents. The former dining area is little used being used for activities or visitor use. The home is run on ordinary life principles where residents are supported as needed but are encouraged to maximise their potential with assistance from a professional and caring staff team. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The weekly fees charged by the home are currently £334 - £530. this information was given by the provider following the inspection. Written feedback was received by the Commission from all 6 residents. Comments about the home were positive and included ”I like going to the Red Cross shop and college, I also like writing in the evening and knitting” “I can do what I want to do, but need support and supervision from the staff” “I like watching telly and colouring with crayons and enjoy going out with staff and fellow peers” All residents completed feedback forms with assistance from staff. Four written feedback forms were received directly by the Commission from relatives. Many expressed generally positive comments about care provision. Two said that they did not know how to make a complaint and also that they did not have access to inspection reports. – Requirements/recommendations regarding this are included in this report. A relative expressed concerns about aggression towards his relative from another resident. He also expressed concerns about privacy during bathing times. Both issues have been made subject to requirements in this report. A relative questioned food provision in the evenings, this was investigated with reference to menus and discussions with residents and staff – the indications were that residents made positive choices about food and were involved in shopping and preparation assisted by staff. Two feedback forms were received from two Social Care professionals, both making positive comments about the home and care provision. The inspection commenced at 8.45 a.m. which gave the opportunity to observe early morning routines and talk to residents before some left for day centres. It was useful also to observe the staff hand-over. Five of the six residents were seen (one left for day-services prior to arrival of the inspector). All five were spoken with at length. They all spoke enthusiastically about life at Iona. All are receptive to visitors and there is always a complete openness in what they say regardless of the audience. One had been admitted to hospital overnight and returned the previous day. He was excited to relate his experience and clearly enjoyed the attention it brought. Staff had correctly swiftly summoned paramedic help when the person had complained about his health. There was no serious outcome. There are routines and plans for daytime activity and care which includes a range of services in the community tailored to the educational, social, recreational and emotional needs of residents. One resident complained that the shower in her bedroom was not working correctly. This was inspected and found later to be fully operative. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 6 The Manager left this home in December 2005. The proprietor has been managing the home in the interim period. The home must have a Registered Manager approved by the Commission and a requirement is made that an application will be made to the Commission within 3 months of this inspection. At the time of the last inspection there were concerns about many aspects of care. All staff had left in the previous 12 months and the inspector was not happy about the number of staffing hours provided. This has been subject to previous discussions and requirements. Ten requirements and two recommendations were made on the last inspection and the proprietor told that improvements must be made in several areas. It is pleasing to report that considerable efforts have been made since the last inspection to improve standards. In fact 9 of the 10 requirements have been addressed, or partially addressed (see below). Six further requirements and 2 recommendations are made in this report. The requirement which has not been addressed is the state of a shared bedroom which must be improved and swiftly. There are reported to be positive plans in place to do this when residents are on holiday. The efforts of the proprietor and staff have been very positive over the past months to improve areas of staffing, care planning, risk assessments and odour management. These will be further monitored on future visits. What the service does well: What has improved since the last inspection? The staffing hours have increased from 98 – 136 per week providing much needed cover at peak times. Mal-odours present in the home at the time of the last inspection have been eliminated. Staff recruitment procedures have been tightened with appropriate references and checks now carried out. There has been a programme of staff training put into place following requirements of the last report. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 7 An electrical socket in the kitchen area has been made safe. Care planning information has been updated, reviewed and re-written – vastly improving the poor standard which existed. Risk assessments have been similarly revised, reviewed and updated. All staff are involved in an excellent distance learning course for medication administration which will be completed by July. All staff have received the required standard of induction using the Skills for Care programme. A resident who paid for transport costs to attend college has now been reimbursed and continues with free transport costs. All staff have received first aid training. 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. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 8 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 Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 9 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): 1–5 The quality of this outcome is good. This judgement made using available evidence including a visit to this service. EVIDENCE: There is a statement of purpose/service users guide available in the home. The home provides a home for life facility for people with a learning disability and the present group of 6 residents have been at the home for a considerable time. There have been no new admissions for sometime. It is the homes policy for prospective residents to visit the home prior to admission in order the make an informed decision about admission. All residents have contracts provided by funding local authorities. Iona DS0000004962.V297767.R01.S.doc Version 5.2 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 - 10 The quality of this outcome is adequate and will be monitored on future visits. This judgement is based upon available evidence including a visit to the service and discussion with 5 of the 6 residents. EVIDENCE: At the time of the last inspection care plans and risk assessments were dated and inadequate. A requirement was made for them to be updated and rewritten with regular reviews established. Considerable work has been done in completely re-writing care plans and risk assessments. All have been appropriately updated and revised. Regular review dates are identified. Several plans were inspected and all information included in one place. Plans included a health care record sheet, allowing monitoring, behavioural record sheets as required for person being seen by Behavioural Services staff. Monitoring of weight and health checks were recorded. Risk assessments have been revised e.g. risk assessment whilst using the kitchen. Checks established for improvements in personal hygiene. Personal goals included in one instance as an “aim to go to the gym with staff each Monday”. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 11 There has been a vast improvement in care planning information which is now current and accurate. The requirement of the last report has been addressed. Daily recording of information was also seen and has improved in style and relevance. At the time of the last inspection residents meetings had ceased. They have now been re-established and an external independent voluntary visitor now chairs the regular residents meetings, allowing some input into daily decision making in the home. Discussions with residents indicated that they were involved in decisions about their daily lives. They gave examples of choices relating to food, activity, clothes and holidays. Residents are not involved in policy reviews, joint staff meetings, staff selection or service user questionnaires and this is an area which can be developed. Iona DS0000004962.V297767.R01.S.doc Version 5.2 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): 11 - 17 The quality of this outcome is good. This judgement is made using available evidence, including a visit to the service. EVIDENCE: There are a range of educational, social and recreational activities which are accessed outside the home for residents. Two people go to college regularly, two access day services unit at Kidsgrove. A resident attends a weekly garden-based project in Leek run by the Rethink Organisation – additional funding is provided for this purpose. Two older residents who prefer not to attend external day centres are encouraged on external visits – shopping, outings, eating out etc. One goes each day to the local shop sometimes alone (a risk assessment must be put into place in relation to this activity) The usual range of indoor activities are provided in the home on an ad-hoc basis to meet the social needs of residents. There are visits to local places of interest and to pubs, bowling, theatre and restaurants as time and staffing allow. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 13 A requirement was made in the last report to review the travelling expenses paid by a resident to attend college. This has been done and those expenses now paid by the home. All residents have an annual holiday and generally most have 2 holidays of approximately 5 days. Residents appear to prefer to go on holiday together. The four ladies were due to go to Skegness in 4 days and they spoke excitedly about their preparations and plans, clearly enjoying the preparation and the holiday. The two gentlemen will go as they return. All are escorted by 2 staff. The home has a 7-seater mini-bus always available for outings, with staff cars used as back-up where required. A resident assists in the local Red Cross charity shop in Biddulph 500 metres from the home. She enjoys her work their immensely, she has been working there for 6 years and says she is included in all the social events. She spoke of a celebration party she was due to attend. This clearly enhances her confidence and self-esteem. Relatives and friends are welcomed into the home, this was indicated in written feedback from relatives and from discussions with residents. Most visitors spend time in the home and take their relatives out for the day, for meals or to their home. Residents spoke with enthusiasm and affection about regular visits from relatives. Relative involvement is encouraged and promoted by staff as an integral and important part of care. A relative had questioned the evening meal provision in the home. Sample menus sent to the Commission indicated a balanced and varied diet. All residents spoken to said that they liked the food at Iona and were involved in menu planning, shopping and preparation of food – clearly subject to their practical skills and risk assessment. Residents had no complaints about the food provided. They were seen preparing breakfast and drinks of their choice with staff oversight as required. There are weekly visits to restaurant for meal or take-away which are planned or decided spontaneously. Healthy eating is a need for most residents with weight gain being a problem for many. Staff assist and support them in a healthy eating diet where possible, although unhealthy external food attractions are difficult for some residents to resist. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 14 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 – 21 The quality of this outcome is good. This judgement is made using available evidence including a visit to the service. EVIDENCE: The majority of residents require only oversight for personal needs. There are no moving & handling requirements. Three residents require continence management support including one person incontinent of faeces and two incontinent of urine. Clear routines exist to provide this aspect of personal care which is given respecting the principles of care. One resident requires oversight to dress, choose clothes etc. All required assistance with bathing to ensure safety. A relative in written feedback expressed concerns about privacy of a resident whilst bathing. This was discussed with the proprietor in detail and a requirement is made to ensure that the bathing arrangements for the person must be defined and known to all staff to ensure privacy and dignity. This had apparently been raised with the home by the relative but not recorded as a complaint. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 15 Routines were visible upon arrival at the home prior to 9a.m. One resident had just left for day centre the remaining 5 were busy preparing/eating breakfast after rising, some with assistance as required from staff. Two were preparing to attend college awaiting taxi, one was ready to be taken by staff to weekly gardening project several miles away. The scene resembled a normal large family-type setting. All spoke readily about their lives and activities at Iona and clearly respond very positively to visitors. Two staff were on duty (there was previously one at this time) and this allowed the necessary time to support residents in their routines with timescales to be met. It was useful for the inspector to later be involved in a verbal hand-over as staff changed. The needs of residents were seen to be met adequately and in a positive way. At the time of the last inspection health care records required updating and review with clear plans of care required to meet health care needs. A health care record has been established for all residents with all required information and actions in place to meet those needs. A resident gave a very positive account of his recent hospitalisation and return to Iona the previous day. it was clear that staff had acted promptly to concerns about his health and complaint of chest pains. Tests had been carried out and medication provided. This resident was subject to re-assessment of needs on a multi-disciplinary basis at the time of the last inspection and indeed – still is. Records required to monitor his behaviour and presentation had not been completed at the time of the last inspection but this is now in place and is satisfactory. The resident has regular 3 monthly appointments with Psychiatrist and involvement of the Learning Disability Psychological Services. Primary health care services for all are accessed in the community. The GP surgery/health centre is directly opposite the home. Residents attend as required and access the usual routine screening clinics there. Positive feedback was given at the last inspection to the Commission directly from a local GP. Medication is provided in MDS (blister-packs) from local Coop pharmacy and a good service reported. There are regular checks in the home by the pharmacy. Records relating to the storage, administration and disposal of medication were seen. There were no omissions and records were clear and accurate. Returns to the pharmacy are recorded and countersigned. All staff administer medication. None had received medication training at the time of the last inspection and a requirement made to provide this. All staff are currently involved in a distance learning course in relation to medication administration which is preferable to the usual brief 2-3 hour course. All staff will complete this course by July 2006. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 - 23 The quality of this outcome is poor. This judgement is made using available evidence including a visit to the service. EVIDENCE: Residents were asked if staff listened to them and act upon their wishes. One resident said “staff do listen to me and are good to me, they help me a lot” Two relatives in feedback indicated that they did not have access to a copy of the complaints procedure in the home or to inspection reports. There is a copy of the complaints procedure in the office area which relatives do not generally have access to. It is required that a copy of the complaints procedure should be given to all relatives and a copy posted in the home and available for all visitors. There is a copy of inspection reports in the office area also and this must be readily available in the home for all visitors. It is also important that the complaints procedure is explained to all residents in an appropriate way and consideration of a copy in a format which will be understood by residents. There was evidence that complaints from relatives had not been adequately recorded. This related to privacy and dignity. A relative indicated in feedback concerns about aggression towards his relative from a male resident who is particularly vulnerable. This has apparently been discussed with the relative but there is no evidence of recording. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 17 A requirement is made that all incidents of aggression/bullying must be recorded and steps taken to reduce the risk or harm to residents under Regulation 13(6). Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 18 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 – 30 The quality of this outcome is adequate. This judgement was made using available evidence including a visit to the service. EVIDENCE: The home is clean and comfortable, furnished along domestic lines and provides adequate space. There is one single bedroom with shower on the ground floor and 1 singe and 2 shared bedrooms on the first floor. There is a toilet area on the ground floor and bathroom with toilet on the first floor. A resident did inform the inspector that her shower was not working correctly, this was checked and found to be fully operative. On the first floor a shared room has been fitted with vinyl flooring to deal with continence needs. This room was unsatisfactory on the last visit and a requirement made to suitably furnish and equip the room to present a more comfortable and personalised appearance. The room was stark and basic. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 19 This had not been done on this visit, although when the 2 occupants of the room are on holiday in 2 weeks time arrangements have been made to build fitted wardrobe space and provide some privacy screening, the room then needs to be softened and personalised to present a homely appearance there are no chairs in the room. A further requirement is therefore made in relation to this. There was a mal-odour in several areas of the home on the last inspection and requirement made to resolve this. This has been done and there were no malodours in the home at the time of this visit. Double glazed units are being replaced on a phased basis – none since the last inspection and relatives in feedback indicated there had been promises of fitting double glazed unit in a ground floor bedroom. The proprietor stated that this will be fitted in due course. The home is not identifiable as a care home in the community. It has a small garden area at the front and excellent small patio area at the side which good seating which is much used in the summer months. Residents have free access to the kitchen area and assist preparing food and drinks. A twin electrical socked was unsafe on the last inspection and has now been relocated eliminating any risk. There is a comfortable lounge area beyond a dining room which is no longer used since the refitting of the kitchen. The proprietor plans to switch these two areas providing a comfortable lounge area and the present lounge area beyond can be used as a quite room for visitors, for meetings and give staff space to complete written records etc. The proprietor has plans to refurbish the first floor bathroom area later this year with possible shower installation also. The kitchen area is to be repainted whilst residents are away on holiday in the summer. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 20 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): 31 – 36 The quality of this outcome is adequate. This judgement was made using available evidence including a visit to the service. EVIDENCE: This is a small home providing care for 6 residents with a mild learning disability. Waking night staff are not required at this time and a member of staff sleeps in at all times and is on call. There has previously been only one member of staff on duty throughout the day and there have been previous discussions with the proprietor and requirements made to review the staffing levels of the home which were felt to be inadequate. Staffing levels have been increased since the last inspection and now provide 136 hours per week an improvement on the previous 98 hours per week. Additional hours are provided by the Registered Manager with approximately 20 hours per week “hands-on” care. There is presently no Registered Manager and the proprietor (previously Registered Manager) is providing cover to make required improvements in the operation of the home and some hours are also “hands-on” care. The previous Manager left the home in December 2005 and all 5 care staff left the home during 2005 and replacements were appointed. At the time of the Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 21 last inspection all staff were relatively new and there had been no training programme for them. Requirements were made in the last report to provide training for all staff. This has been actioned: all staff have undergone training in First Aid and Food Hygiene. All are presently engaged in a distance learning course for medication. All have undertaken induction training under Skills for Care arrangements. One is to commence NVQ3 training in the near future, other staff will be given the opportunity of NVQ training as they complete the basic post induction training. The proprietor is an approved moving & handling trainer and although techniques are not presently used for residents this training will be provided by her as time allows in the near future. There has been a vast improvement in staff training generally since the last inspection. This needs to continue. None of the staff in this home at this time have received NVQ training. Staff files were inspected on the last visit and recruitment procedures found to be unsatisfactory A requirement was made to obtain suitable references and question any CRB offences listed. This has been done – a further reference has been obtained to replace an inadequate one and a reference obtained for another staff member. Details of CRB entries have been discussed and clarified and the proprietor feels that this is satisfactory. Staff on duty showed skills in discussions with residents, were able to listen, interpret and advise residents in an appropriate way. A resident when asked about staff changes said that “staff are good to us and we like them” Staff meetings were previously intermittent and have been held regularly in the past 6 months. Staff confirmed they had been consulted and involved in the changes being made in the home and were positive about the opportunities for training which had taken place and are planned. Staff meeting minutes confirm these comments and observations. There was a relaxed atmosphere in the home, even at the busy early morning peak time. Exchanges with residents were friendly, appropriate encouraging and professional. Iona DS0000004962.V297767.R01.S.doc Version 5.2 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): 37 - 43 The quality of this outome is adequate. This judgement is made using available evidence and a visit to the service. EVIDENCE: There is no Registered Manager in the home at this time the skills of the Manager can therefore not be assessed at this time. The previous Manager left the home in December 2005 and since that time the proprietor who previously worked as the Registered Manager in the home has been running the home and implementing the required changes in the running of the home, staff training, improved record keeping and changes to the environment. This is satisfactory at this time but it was agreed with the proprietor that a new Manager will be appointed in the next 3 months and application submitted to the Commission for approval of a new Registered Manager. There is no quality assurance system in place at this time. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 23 Relatives have indicated inspection reports are not available in the home. On this visit the reports were in the office area and must be made readily available to visitors. Policies and procedures were not inspected on this visit. The Pre-inspection questionnaire indicated there was not a policy on bullying. In view of issues raised elsewhere in this report this policy is required. Residents finances were spot checked on the last visit but not on this visit. Care records were previously unsatisfactory. Considerable work has been done in this area resulting in a great improvement in the standard of care planning information. Fire records were inspected and found to be satisfactory. An up to date fire risk assessment of the building must be completed. The proprietor was advised to contact the Fire Officer in relation to options for the 2 fire doors which separate the ground floor living area. These doors present some hazards to staff and residents. COSHH items are safely locked away. Data sheets must be obtained for all items used, this was mentioned in the last report and will be pursued by the proprietor. All staff sleep in but have all now had the required first aid training. Risk assessments in relation to resident activity have been updated and reviews as required in the last report. Iona DS0000004962.V297767.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 2 26 1 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 x 2 2 2 2 2 3 2 Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 30/09/06 1. YA25 16(2)(c) 23(2)(f) 2. 3 YA42 YA37 23(4)(a) 8(1) C.S.A 2000 12(4)(a) 4. YA18 5. YA23 13(6) 6. YA23 22 Bedroom identified must be suitably equipped to present a more homely, comfortable, personalised appearance Previous requirement date not met. A fire risk assessment of the building must be completed. A Registered Manager must be appointed to run the home within 3 months from the date of this inspection. Bathing arrangements for person identified must be defined & known to all staff to ensure privacy & dignity. All incidents of aggression/bullying must be recorded and acted upon to reduce the risk of harm. The complaints procedure must be available in the home for residents and visitors. All complaints must be recorded. 30/06/06 07/09/06 08/06/06 08/06/06 08/06/06 Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard YA42 YA32 Good Practice Recommendations 1. 2. Provide data sheets for all COSHH items used. Continue the staff training programme with progression to NVQ training for all staff. Iona DS0000004962.V297767.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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