Inspection on 23/01/09 for Isis Care Home

This inspection was carried out on 23rd January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Isis Care Home 16 Crompton Street Liverpool Merseyside L5 2QS     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lorraine Farrar     Date: 2 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Isis Care Home 16 Crompton Street Liverpool Merseyside L5 2QS 01512074196 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Potensial Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 7 The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability - LD The maximum number of people who can be accommodated is: 7 Date of last inspection Brief description of the care home Isis is registered to provide support for seven adults who have a learning disability. It is owned and operated by a company called Potensials. They provide care services and support for people across the country. Situated in Kirkdale, Isis is in a residential area within reasonable distance of local shops, amenities and public transport. Although a purpose built bungalow Isis fits is well with other houses in the local community. Everyone living there has their own bedroom with en-suite toilet and sink. Shared space includes an enclosed garden, lounge and dining area and domestic style kitchen. There is also a bathroom and separate shower room. In addition a smoking room is provided for use by the people living there. Parking is available on the driveway with further parking on the street Care Homes for Adults (18-65 years) Page 4 of 33 Brief description of the care home outside. Staff are available at Isis twenty four hours a day to support the people living there Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that the people who live at the home experience adequate quality outcomes. We gathered information for this inspection in a number of different ways. Before we visited we sent comment cards to some of the people who live at Isis and some of the staff working there. Three of the people living there and four members of staff returned these. We also sent a self assessment form to the manager, which she completed and returned. This provided information about staffing, support provided to the people living there and future plans for the service Isis provides. We reviewed any information we have received about Isis since Potensials took over as the new owners in August 2008. All of this information helped us to plan our site visit and was taken Care Homes for Adults (18-65 years) Page 6 of 33 into account in writing this report. We carried out an unannounced visit to Isis on 23 January 2009. This took place over six hours and included reading records and looking around the building. We talked with all of the people who live at Isis and with four members of staff including the manager. We spent time looking in depth at the support three of the people living at Isis receive. This included looking at the support they get with their daily lives, care plans, health and personal care, money, activities and environment. All of this information helped us to find out what it is like to live at Isis and was taken into account in writing this report. It costs between four hundred and sixty one pounds, thirty three pence and seven hundred and sixty three pounds and sixty seven pence each week to live at Isis. What the care home does well: What has improved since the last inspection? What they could do better: As the needs of some of the people living at Isis change they may need more support Care Homes for Adults (18-65 years) Page 8 of 33 with their mobility. Current staffing levels, equipment and the environment may not be sufficient to support them as safely as possible at all times. The home needs to assess the current and future support needs of the people living there to ensure that they are able to support people safely and well at all times. Training for staff in how to support people safely with their mobility also needs to be prioritised to ensure that staff are aware of current good practice in how to support people safely and well. The systems for care planning and record keeping at Isis do not always provide sufficient information to guide staff in how to support the person. Neither do they provide a clear way to monitor the persons changing support needs. The planned system that the manager has devised will provide a clearer way to track the support provided for people. It will also provide a clear way to quickly note and deal with any changes to their support needs and choices to make sure that people are receiving the right level of support to meet their needs. The support provided to people in managing their money needs to be clearer. Records and explanations should be available on peoples files to show why their money has to be managed for them. These should also clearly show the ways in which the money is managed and that the person or their representative has agreed to this. This would not only help to ensure peoples money is managed safely it would also provide people with more information about the support they receive and with more control over their everyday lives. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient information is obtained about and provided to people considering moving into Isis. This helps everyone to decide if Isis can meet their needs and choices and is the right place for the person to live. Evidence: During our visit we talked with the people who live at Isis and one told us they would recommend living there, explaining I like the house. Its a good place to live. As nobody new has moved into Isis for several years it was not possible for us to practically assess the support that would be offered to them. However we discussed this with the manager, who explained that she would follow the companys policy. This would include obtaining as much information as possible about the persons support needs and their choices before they moved into Isis. She explained that in order to do this she would arrange to obtain initial information from social services. Staff would then meet with the person and others who support them, including their family. After an initial assessment to find out their support needs, they would be invited to visit Isis Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: on several occasions and stay overnight if they wished. This would provide them with the opportunity to meet the other people living there and also to see how the home operates. Information would be given to the person about Isis and the services it provides. This all helps the person to decide if Isis is the right place for them to live. It also helps staff to plan how they can support the person successfully if they move in. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs and choices of the people living at Isis are recognised and staff work with them to meet these. However as peoples needs change, care planning processes currently being used at the home may not be sufficient to quickly identify and plan changes in the support they require. Evidence: Individual care plans are in place for all of the people who live at Isis. However these are large documents that contain information dating back several years. This can make it difficult to find relevant information quickly. A number of care plans were available for supporting people in different areas of their life. This included plans for support with personal care, meals, finances and communication. Information in these varied with some providing a good level of detail and others providing brief details that may be insufficient for unfamiliar staff to read and be able to successfully support the person. Although regular reviews of care plans Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: had taken place these often contain statements rather than facts. For example, one review recorded, still encouraging (person) with independence. This type of review may not provide sufficient detail to establish if the support being provided for the person is effective. Risk assessments were in place for supporting people with their daily lives. However some of those we looked at had not been reviewed since April 2008, whilst others contained detailed information that had been reviewed recently. One person who requires support from staff with their personal care did not have an up to date manual handling assessment in place. This may mean that staff lack all the information they need to ensure people are supported safely. The manager told us that she is aware that care plan information may not be sufficient and has clear plans in place to provide new plans and risk assessments for everyone. We looked at a care plan and risk assessment that had been written in the new format for one of the people living at Isis. This contained clear information regarding any risks to the person. Where a risk was identified, a clear care plan and risk assessment had been provided. In the information she sent us before our visit to the home, the manager advised that part of future plans for the home also involve supporting people to assess risks whilst becoming more independent. This along with the introduction for everyone of the new planning format should provide clear guidance to staff in how to support people to meet their needs and choices. The people living at Isis told us in comment cards they sent back to us that they can do the things they want to do whilst living at Isis. During our visit we saw that the people living there constantly made everyday decisions, such as who to socialise with, where in the home they wanted to sit and how to spend their time. Meetings are held regularly with the people living at Isis. Records of this showed that these meetings provide a good way for the people living there to comment on their everyday life and things they would like. For example, we noted that some people had made requests for certain food and staff had ensured this was provided. Discussions had taken place around shopping and trips out and staff had firm arrangements in place to support people with this. In addition the meeting provides people with a good place to discuss various issues about living in a care service. At the January 2009 meetings they had the opportunity to discuss various issues including complaints and showing respect for others. This is good practice as it provides people with the chance to have a say in the everyday running of their lives as well as to discuss and learn more about the running of their home. Care Homes for Adults (18-65 years) Page 14 of 33 Care Homes for Adults (18-65 years) Page 15 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Isis are increasingly supported to live a lifestyle of their choice and to make sure they have the chance to try new activities and hobbies. Evidence: During our visit, we saw that people living at Isis were spending their time in different ways as they chose. One person had been out for lunch with staff, another person was attending their day service and a third was out and about independently. Some of the people at home chose to spend time in the lounge watching TV and socialising or in the kitchen with staff. Others had chosen to spend time in their bedrooms. Staff told us that they are supporting people to go out and about in the local community more and that this is now planned via the staff rota. One member of staff explained that they have recently obtained leaflets for a local community centre and Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: will be looking to see if there are any courses on offer that people living at Isis might be interested in. When we spoke with the people living at Isis they told us that they are enjoying getting out and about more. One person explained she was going shopping the following day and was looking forward to this, saying, I like going out. Another person told us that they are able to go out independently and can do so whenever they want. This increasing support for people to get out and about and try new activities will provide new opportunities for people to engage with their local community and enhance their leisure time. Records showed that people are able to have visitors at Isis whenever they want. A person who lives at the home told us it was their birthday soon and they were looking forward to their family visiting. A member of staff explained that currently staff go shopping for food but the staff rota has been altered so that from next month all staff will do the shopping with the people living at the home. There are a variety of local shops near to Isis and this would again provide people with the opportunity to become more engaged in their local community as well as to increase their everyday skills. Currently a menu is planned weekly with the people living at Isis. This showed that everyone living there has the opportunity to choose their favourite meal for the week. A record of meals actually served in not currently maintained. This would help to check that people are actually getting the nutrition and diet that they need. People told us that they like the meals at Isis, describing them as, smashing. They also told us that if they are able to, they can make a drink or get a snack when they want, with one person telling us they can, pick anything. We observed one person non-verbally indicate to staff that they wanted a cup of tea and staff respond positively to this request. Staff also told us that they are supporting the people living at Isis to become more involved in everyday household tasks. One person who lives at the home told us they enjoy baking and another explained they clean their own bedroom with staff support. This increased support for people living at Isis to learn and take part in everyday tasks provides good opportunities for them to increase their independent living skills and take a more active part in how their home runs each day. Care Homes for Adults (18-65 years) Page 17 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff working at Isis are aware of the health and personal care needs and choices of the people living there. However a lack of clear documentation means that changes to the persons needs may not be noted and acted upon as quickly as they should be. This could lead to people not receiving support as safely as possible. Evidence: One of the people living at Isis told us that they can get up or go to bed whenever they choose, explaining, I get up when I wake up. This was confirmed in records we saw which showed that routines are flexible and based on the persons choices at that time. We spoke with one person who had chosen to sit in their room and watch television. It was clear that staff had provided a good level of support to them with their personal care and to enable them to be comfortable. The call buzzer was within easy reach and the person told us that staff come quickly when it is pressed. During our visit we observed people choosing to have a shower and get ready for bed; staff responded positively to requests for support with this. As identified elsewhere in this report, care plans dont always provide sufficient Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: information to guide staff on how to support people fully with their health and personal care needs and choices. Records showed that one person had recently had a problem with their skin. However, the following day records reported, no issues. This was clearly not accurate as four days later it is recorded, area very sore. Skin broken, needs to be observed. Similarly staff had reported in daily records that the person was experiencing difficulty with hard skin on their feet. Records did not clearly indicate what action staff had taken regarding either this or their skin condition. Staff were able to tell us the action that they had taken about both these problems and confirm that they were now resolved. However a lack of clear recording may lead to staff not being fully aware of health problems and therefore not providing the support needed. The unclear recording also means that it is difficult to monitor the persons condition accurately and could lead to a delay in professional advice being sought. One of the people living at Isis told us that staff help them if they are not well. Records showed that people are supported to make and keep routine health appointments, such as seeing the optician, chiropodist and nurse for their flu injection. Records also showed that staff are able to identity when people are in pain and provide appropriate pain relief. There are some aids and adaptations provided at Isis to support people with their mobility and personal care. These include grab rails, call bells and an accessible shower. There is also a mobile hoist, which can be used to help people move around. Staff told us that as they have had not training on using the hoist and therefore do not use it. Staff told us about a recent visit from an occupational therapist to a person living at Isis. They told us about the advice they were given and when we walked round the home, we could see that the advice had been followed. This showed us that staff are aware of peoples changing needs and will take action to obtain advice and plan for changes to the persons support. However the lack of clear assessment and care planning may mean that this person is not being supported as safely as possible at all times. We looked at records and storage of the medication of three people who live at Isis. We found that medication is stored correctly and records tallied with the amounts of medication held in the home. An error in dealing with medication had occurred in the home within the few months before our visit. After ensuring the person had no ill effects, the organisation carried out a review of their processes for dealing with incidents like this. These include informing relevant people, discussions and training for staff and carrying out audits of medication in the home. This all helps to prevent future errors occurring. The clear medication recording that is used helps to ensure Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: that an audit trail is in place so that if an error does occur it can be quickly noted and acted upon. Care Homes for Adults (18-65 years) Page 20 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are policies and staff have received training so that the people who live at Isis are confident that any concerns they have will be listened to and acted upon. Lack of documentation means that it is not always possible to show that the money of the people who live in the home is being managed in their best interests. Evidence: The people who live at Isis told us in their comment cards that they know who to talk to if they are unhappy or have a complaint. They confirmed this during our visit, telling us they would talk to staff and are confident that they would sort it out for them. Information on how to make a complaint or raise a concern about Isis is displayed on a notice board in the hallway of the home. However this contains information regarding the previous owners and needs to be updated. Staff told us in their comment cards that they know what they have to do if anyone raises concerns about the service. Records showed that staff have had training in safeguarding adults and staff we spoke with were clear about the signs that could indicate people living at the home may be being abused. They knew what action they should take to make sure that people who live at the home are protected. Potensials, the company that runs the home, acts as appointee for the benefit money of most of the people who live at Isis. We checked samples of records and amounts of Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: money held in the home for people and found that these tallied with clear records kept of what had been spent. A bank statement showed that people have been supported to open bank accounts in their own name. However the last bank statement for one person that was available was issued in July 2008. This makes it difficult for staff to help the person to check and audit their account regularly. No explanation was available as to how the organisation manages peoples benefit money or what accounts it is paid into. This would help to ensure that people are supported to manage their money safely and well. It would also help to ensure they are as informed as possible about the support they receive. Care Homes for Adults (18-65 years) Page 22 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Isis is well maintained so that people live in a clean, welcoming home. However, as their support needs change, action needs to be taken to make sure they can continue to be supported safely and appropriately. Evidence: Isis is a purpose built bungalow that is domestic in style so that it does not stand out as different from the houses in the local area. It is in Kirkdale and is well located for reaching local facilities including shops and public transport. This helps to make sure that the people living at Isis live an ordinary life, in keeping with their local community. The people living at Isis told us in their comment cards that their home is always fresh and clean and we observed this during our visit. The home appeared, clean, tidy and welcoming. Everyone living at Isis has their own bedroom with an en suite toilet and basin. They are able to decorate their rooms to their tastes and interests. People told us that they like their bedrooms with one person saying, I sleep very, very well in there. Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: Although most areas of the home we visited felt warm, one of the bedrooms towards the side of the house felt cooler. As some of the people living at Isis choose to spend time in their rooms, the temperature should be monitored to ensure it is comfortable and warm enough for their individual needs. There are two lounges at Isis, one of which is designated as a smoking lounge for the use of the people who live there. At the front of the house a through room provides a homely lounge and dining area for people to share. In the hallway a large notice board contains photos of the people living there at various events. However it also contains leaflets and information that detract from the more homely atmosphere of the rest of the house and which may not be needed in such a small, domestic home. The kitchen is domestic in appearance and there is a separate laundry room. Staff are provided with disposable gloves and aprons, which help to prevent an outbreak or spread of infection. There is a bathroom and separate shower room within the home that everyone can use. The shower is easily accessible and a shower chair is available along with grab rails and call buzzers. One person told us that they have had to use this buzzer and that staff responded to it quickly. Staff we spoke with told us that they find one persons en-suite bathroom does have enough room for them to provide care, as the persons needs have changed, and they are concerned that an accident may occur. Alternatives to this including increased use of the larger bathroom or offering a larger, vacant room are available and should be considered. Staff also advised us that, as peoples mobility needs alter they may not have the equipment or training to support the person safely. For example, although a mobile hoist is available in the home to aid people with their mobility, staff are not trained in how or when to use this. This may mean that the people living at Isis are not being supported as safely as they should be. Care Homes for Adults (18-65 years) Page 24 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Isis are supported by an experienced staff team in whom they have confidence. However as their needs change current staffing levels may not be sufficient to make sure that people living at the home are supported safely, in the way they prefer, at all times. Evidence: The people living at Isis told us in their comment cards that staff listen to what they say and treat them well. This was confirmed during our visit to the home when people told us that staff provide the support they need and described them as, very nice and all right. Staff we spoke with during our visit showed a good knowledge of the support needs and choices of the people who live at Isis. They were able to explain how they support people with their health and personal care, their chosen lifestyles and with how they manage their behaviour. During the night there is one member of staff working at Isis; there are also times during the day when a member of staff is working alone. Records showed that one of the people living there fell recently whilst a member of staff was working alone. Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: Appropriate support was provided to the person to ensure they suffered no ill effects from their fall. However staff recorded in the notes that, I had to leave (person) on the floor for 15 minutes whilst I waited for (staff) to come on duty. Some of the staff we spoke with during our visit said that due to the changing needs of the people living at Isis, they believe two staff should be on duty at all times. Current staffing arrangements may not provide sufficient sufficient support at all times to ensure the people living there receive the support they need and choose. The information the manager sent us before the visit stated that before anyone starts work at Isis a series of checks are carried out on them. This includes obtaining written references and checking with the Criminal Records Bureau. We looked at a sample of staff files during our visit and found that records confirmed this. These checks help to ensure that the people employed to work at Isis are suitable to work with people who may be vulnerable. Staff told us that they attend training which helps them to support the people living at Isis. Their comments included, training is lots better and a good few courses are booked. This was confirmed by the training records we looked at which showed that staff had undertaken training in various aspects of care including, protection of vulnerable adults, medication and fire prevention. In addition a recent staff development day provided staff with the opportunity to become more involved in planning future changes to the service they provide. The training provided helps to ensure staff are up to date with current good practice. However some staff had not had recent training in moving and handling people and the manager advised she had not yet been able to book this. As the needs of the people living at Isis are changing it is important that staff receive regular training in this area so that they are up to date in how to support people safely. Care Homes for Adults (18-65 years) Page 26 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Isis is well managed with a clear management structure, quality checks and clear plans for improvements to make sure the home is run in the best interests of the people living there. Evidence: The manager of the home took up post in November 2008 and is experienced in working in a management capacity and with adults who have learning disabilities. She has started the process to become registered with the commission, as required by the Care Standards Act. This process helps to ensure that managers are suitably qualified and experienced to manage a care home. The manager works at least two days a week at Isis and spends a further two days a week at its sister home nearby. In order to provide further management support a deputy manager is also based at Isis. Staff working at Isis told us that they find the manager, supportive and helpful. Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: The manager was clear about areas of the service at Isis that could be improved for the benefit of the people living there. In order to plan these improvements a recent team development day was held which provided staff with the opportunity to give their opinion and take part in the planned changes. In addition, the manager has put together a clear list of actions that need to be taken to ensure that identified improvements are carried out within a reasonable timescale. The manager told us in information she sent to us that since Potensials took over they have introduced a series of regular checks at Isis. We saw samples of these that included checks of medication, staff issues and health and safety with clear areas to record any action that needed to be taken. These checks provide a good way to quickly identity and act upon any issues that may arise. The views of the people living at Isis are obtained by having regular meetings with them. In addition they will have more opportunities to express their views at the planned monthly meetings with their key worker. More formal methods such as sending surveys to others involved in supporting the person as well as to the person are not currently in use. This would provide people with a way to formally give their opinion on the service provided and be more involved in future planning. Records and certificates showed that regular checks are carried out on the building and equipment to ensure they are safe for the people living and working at Isis. Care Homes for Adults (18-65 years) Page 28 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 13 A manual handling assessment must be completed for the person identified during the inspection. This will help to ensure staff can and are supporting the person safely. 13/03/2009 2 6 15 Up to date care plans must 13/03/2009 be in place for everyone living at Isis. These must contain sufficient information to guide staff on how to support people safely with their health and personal care. This includes any support they require with their mobility. This will help to ensure staff have sufficient information available to support people safely and well and meet their health and personal care needs. 3 23 20 An explanation must be available as to the support 31/03/2009 Care Homes for Adults (18-65 years) Page 30 of 33 people are provided for their benefits money and bank accounts. This must include information about which account the money is paid into and if not paid direct to the person then an explanation of how soon it is transferred. This will help to ensure that people are supported to manage their money in a way that is both safe and in their best interests. 4 24 23 A full assessment of the 31/03/2009 environment must be carried out to ensure it meets the needs of the person discussed during the inspection. This must include ensuring any aids and adaptations are in place and staff are aware of how to use them. This will help to ensure that people are supported safely. 5 33 18 A written review of staffing levels must be carried out. This must take into account the current and changing needs of the people living at Isis. This will help to ensure there are sufficient staff available at all times to support the people living at Isis safely and well. 6 35 13 Training must be arranged for all staff in moving and handling people. 31/03/2009 31/03/2009 Care Homes for Adults (18-65 years) Page 31 of 33 This will help to ensure staff have up to date skills to support people safely. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 17 A record of actual meals served should be maintained. This would provide a clear way to assess and monitor that individuals are getting the diet and nutrition they need. The complaints procedure displayed in the hallway of Isis should be updated to include accurate information about the new owners. This will help to ensure people have up to date information about how to raise any concerns that they may have about the service. Bedroom temperatures should be monitored and recorded to ensure they are at a comfortable heat to meet the peoples needs and choices. Consideration should be given to the use of the large notice board in the hallway. Use of this may be unnecessary and detract from the overall homely atmosphere within Isis. Different ways to obtain the views of the people living at Isis and others who support them should be explored. This will provide more opportunities for people to have a real say in how the home operates and to influence future improvements. 2 22 3 24 4 24 5 39 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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