Inspection on 13/06/07 for IW Cheshire Home

This inspection was carried out on 13th June 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

IW Cheshire Home 10/01/06

IW Cheshire Home 29/06/05

IW Cheshire Home 08/02/05

IW Cheshire Home 12/10/04

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

CARE HOME ADULTS 18-65 IW Cheshire Home Appley Cliff Popham Road Shanklin Isle Of Wight PO37 6RG Lead Inspector Mark Sims Unannounced Inspection 13th June 2007 14:00 IW Cheshire Home DS0000012501.V338730.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 IW Cheshire Home DS0000012501.V338730.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. IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service IW Cheshire Home Address Appley Cliff Popham Road Shanklin Isle Of Wight PO37 6RG 01983 862193 01983 866211 appley@lc-uk.org www.leonard-cheshire.org.uk Leonard Cheshire 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 Helen Stedman Care Home 13 Category(ies) of Physical disability (13), Physical disability over registration, with number 65 years of age (6) of places IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: Appley Cliff (IW Cheshire Home) is a residential home for up to thirteen adults aged 18 to 65 years, up to six of whom may be over the age of sixty-five. The provider is the Leonard Cheshire Organisation, which is a leading provider for disabled people in the United Kingdom. Mrs Helen Steadman manages the home. The home is situated on the edge of Shanklin Old Village and is approximately one mile from the main shopping area, the post office, bus and train station. The home has extensive views of the English Channel and is adjacent to Ryleston Gardens. Ryleston Gardens are for public use and have a bandstand, mini golf and café. The home is on two levels and has a passenger lift. All thirteen of the homes bedrooms are for single occupancy, none having en-suite facilities. There is one assisted bath and one assisted shower room. The home has plenty of communal areas including a lounge, conservatory, activities room and dining room. Smoking is only allowed in the conservatory or gardens. The home has gardens that are well maintained and easily accessible to the service users. Twelve of the bedrooms are for permanent service users with the other being used for pre-booked respite care. Day care is offered to a maximum of two people each day. IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the First ‘Key Inspection’ of The Cheshire Home (IOW), a ‘Key Inspection’ being part of the inspection programme, which measures the service against core National Minimum Standards. The fieldwork visit, the actual visit to the site of the home, was conducted over four and half hours, where in addition to any paperwork that required reviewing the inspector met with service users and staff and undertook a tour of the premises to gauge its fitness for purpose. The inspection process now involves more pre fieldwork visit activity, with the inspectors gathering information from a variety of professional sources, the Commission’s database, pre-inspection information provided by the service and linking with previous inspectors who have visited the home. What the service does well: Choice of Home: The foundation operates a well structured and effective admissions process, which ensures all referrals are co-ordinated by a placements officer, who is kept informed of vacancies by each service within the foundation. Individual Needs and Choices: The lifestyle of the people residing at the Cheshire home is one based on their individual wishes and self-determination being respected and promoted. Lifestyle: The service users live independent and active lives, which are well catered for at the Cheshire Home. Personal and Healthcare Support: The records maintained by the staff, indicate that people are supported to access appropriate health and social care agencies/professionals and that the service users are largely able to decide when they require visits from professionals. Concerns and Complaints: The service users, met during the inspection were found to be a well informed group, who appreciated and understood their rights and were confident that they could and would raise complaints via the staff and management if they were dissatisfied or upset with the service provided at the home. Environment: The home, during a tour of the premise, was found to be well equipped, well maintained and nicely decorated, with the individual service users rooms all individually set out and furnished, as determined by the occupant. IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 6 Staffing: The staff were found to be friendly and co-operative during the fieldwork visit. They have a clear understanding of the needs and wishes of the client group and were noted to have developed good relationships and a rapport with both the residents and their relatives. Management: The home, recently/presently, is being managed by one of the senior staff, as the registered manager is off on long-term absence. However, the home appears well managed, with the residents and the staff supportive of the management. What has improved since the last inspection? Since the last inspection the Cheshire Home management have: Views of the people using the service: o o o Increased the number of Servise User meetings. Provided Service Users with the opportunity to take part in regional SUNA meeting. Provided opportunity for Service Users to take part in campaigning for accessibility rights. Equality & Diversity: o Appealed to a wider diversity of volunteers i.e. younger volunteers, disabled volunteers. Lifestyle: o o o o o Increased the number of Service Users meetings. Provided opportunity for Service Users to attend Regional SUNA forums. Visits from Regional SUNA mentor at meetings. Increased number of staff available for volunteering. Created greater flexibilty of leisure activities i.e. weekends and evenings. Concerns & Complaints: o o Provided complaints and compliments literature to all Service Users and discussed at service users meetings Updated Leonard Cheshire P.O.V.A. policy IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 7 Environment: o o o o o o o o o Completion of re-furbishment of kitchen. New lounge carpet. New metal radiator covers. New accessible patio area. Provision of new garden furniture. Redecoration of three bedrooms. Redecoration of upstairs bathroom. Two new possum systems installed for Service Users. Five stars for food hygiene ratings Isle of Wight Council Environmental Health. This information was taken from the Annual Quality Assurance Assessment (AQAA) and the dataset. 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. The summary of this inspection report can be made available in other formats on request. IW Cheshire Home DS0000012501.V338730.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 IW Cheshire Home DS0000012501.V338730.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 2: Prospective residents and their representatives have the information needed when choosing the home and have their needs assessed. EVIDENCE: Assessments: The evidence indicates that people’s needs are assessed prior to admission and their offer of accommodation managed centrally. The evidence used to make this judgement includes: o Eight comment cards were returned to the inspector prior to his visit to the home, six of the eight comment cards indicated that people ‘received enough information about the home before the moved in and so could decide if it was the right place for them’. The remaining two service users both stated ‘no’, they had not received sufficient information, prior to moving into the home. o A review of the service file for the person most recently admitted to the home, which included details of a meeting between the key parties, involved in the person’s care, and the decision to offer the client a place DS0000012501.V338730.R01.S.doc Version 5.2 Page 10 IW Cheshire Home at the Cheshire Home (IOW), based on is need assessment and care plans drafted at their current Cheshire Home. o In addition to the information on this file, a further two service user plans and resident’s files were reviewed and noted to contain either/or a care manager assessment and placement agreement or in house assessment, the latter being an informative document. Discussions and observations indicate that the people residing at the Cheshire Home (IOW), are happy at the home and appear to be suitably placed and settled. o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 6, 7 and 9: Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: Service User Plans: The evidence indicates that the service users are fully involved in planning and reviewing the care and support they receive. The evidence used to make this judgement includes: o The AQAA makes a clear statement around the role the service users play in developing and updating their service user plans and the selfassessment element of the process, which is a key component of the plans development. IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 12 o During the fieldwork visit three service users plans were reviewed each clearly influenced by the service users views/wishes and written in the first party. The service user also signs their plan and/or review to verify that they agree with its content and that it is reflective of both their wishes and their aspirations. o Five of the eight comment cards returned indicate that people ‘always’ ‘receive the care and support they need’, one person ticked ‘usually’ and two people ‘sometimes’ in response to the same question. The overall indication is that people are receiving the care and support planned and agreed. Decision Making: The evidence indicates that the people are respected and treated as individuals and their rights to self-determination and independent decision-making upheld/promoted. The evidence used to make this judgement includes: o Observations during the fieldwork visit highlighted the fact that people can and do exercise their rights to undertake individual activities, one client noticed to be in the park opposite the home, another entertaining herself within the activities room, whilst other people were involved in various social activities around the home. In discussion with one service user it was established that the foundation has created a service user forum, of which she participates, which is designed to provide a national voice to the service user group, with various meetings taking place around the country each year. Locally, residents meetings are provided/arranged for much the same purpose, enabling the service user group to come together and discuss the services they receive and any changes they would like to see implemented or trialled at the home. The next residents meeting scheduled for 03/07/07, as advertised around the home via notice boards, etc. o The information provided above, regarding the self-assessment process and the service users involvement in the development and agreeing of their own care and support packages. o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 13 Risk Taking: The evidence indicates that service users are appropriately support when taking risks within their own lives. The evidence used to make this judgement includes: o The service users plans reviewed as part of the case tracking process indicates that risks to the service users are assessed and reasonable and responsible plans drafted to manage those risks, these are agreed with the service user. People, as stated above were noticed undertaking independent activities away from the home, i.e. visiting the local park, the staff were made aware by the resident that they intended going out. The information presented above, which indicates that five of the eight comment cards returned stating that people ‘always’ ‘receive the care and support they need’, one person ticked ‘usually’ and two people ‘sometimes’ in response to the same question. o o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 15, 16 and 17: People who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. EVIDENCE: Entertainment: The evidence indicates that people are participating in activities, which they are enjoying and embracing. The evidence used to make this judgement includes: o Information displayed on the notice board confirmed the following forthcoming events: 1. Appley Olympics – 18/06/07 2. Appley Sports Day – 26/06/07 IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 15 3. Service Users Network Representatives visit o The notice board also contained photographic evidence of people’s involvement in and/or attendance of an ‘it’s the knockout’ style event organised by the foundation, a ‘Mad Hatter’s’ tea party, which was arranged locally in appreciation for the work undertaken by the volunteer workers and the annual fete. As previously mentioned the home has a large activities suite, which is extensively used by the service users and provides access to a range of entertainments, crafts and pursuits including, painting, drawing, creative materials, computers, puzzles, etc. The main lounge has a large flat screen television mounted on a wall at one end, and all service users have access to digital television services, etc, within their rooms. Comments provided by the service users, with four people indicating that there are ‘always’ activities arranged that they can participate in, two people stating ‘usually’ and two ‘sometimes’ to the same question, although one of the people commenting ‘sometimes’ added: ‘Some facilities are already occupied and I can’t access them (computers), which suggests there are activities but that they are well used and not always available when this person would like, as apposed to activities only being sometimes available. o o o Community Contacts: The evidence indicates that the people residing at the Cheshire Home (IOW) enjoy/maintain good community contacts. The evidence used to make this judgement includes: o During the visit the manager explained that the service has three vehicles, which are used to take people out. The vehicles are driven either by the permanent driver, who works fifteen hours per week, the volunteer driver or any of three staff members trained to drive the vehicles, all vehicles are capable of taking wheelchairs. o The AQAA makes clear that service users attend regional SUNA, (service user national association) forums, which provide people with networking opportunities. Discussions with people during the visit, when trips out to local pubs, theatre’s, shops, etc were discussed, as were visits to the home by external groups like the local scout group, who have been asked to help maintain some of the garden by the volunteer gardener. DS0000012501.V338730.R01.S.doc Version 5.2 Page 16 o IW Cheshire Home Relationships: The evidence indicates that people are maintaining contact with families and friends as they wish and that relationships are allowed to flourish within the setting of the home. o There was clear evidence within the service users plans to support the fact that people are being able to maintain contacts with their families/friends as they wish. During the fieldwork visit one service user was observed taking a call from their daughter, whilst another service returned from an outing with their mother, which according to the staff was a regular occurrence. It was also evident from the photographic evidence, mentioned earlier, tea parties, etc, that families do support their next of kin and the home by attending open events. Within the home, people have clearly developed friendships, relationships and bonds, with some of the younger members of the service user group, able to exercise/develop their sexuality/sexual identities via social interactions and flirtation, a non-sexual but still empowering experience. o o o Rights and Responsibilities: The service users are encouraged to exercise their rights and be aware of their responsibilities within the home. The evidence used to make this judgement includes: o During a discussion with a service user it became apparent that they enjoy participating in the national forums, arranged by the foundation and that they are happy representing the home and their fellow service users at such events. The above service user has also completed a training course, arranged by the foundation and now participates in the recruitment interviews of all prospective new staff. A second service user is hoping to undertake the same training course shortly, providing increased flexibility within the home, when creating the interview panel. o Smoking is currently permitted within the home, although this is restricted to one specific area, which the service users who smoke are DS0000012501.V338730.R01.S.doc Version 5.2 Page 17 o IW Cheshire Home aware of and were noted during the inspection to be adhering too. o As mentioned earlier the service users have the right to undertake independent activities, such as outings and/or going out, although risk assessments are completed to ensure any potential harm, etc is kept to a minimum. Meal and Menus: The evidence indicates that the meals provided meet the service users needs and are based on their preference and wishes. The evidence used to make this judgement includes: o The AQAA indicates that the service users have met with the catering staff and have been involved in creating the current menus for the home. Copies of the current rotational menus were noticed to be on display during the tour of the premise. Observation of the evening meal, indicated that it was a social occasion, which took place across two sittings in order to facilitate easier access for the service users, as most are wheelchair dependent. In conversation with the service users and the cook, it was acknowledged that the menus are a guide and subject to change if the service users wished to sample/try something different. The service users appeared to enjoy the meal service, which would appear to support the statements made via the comment cards with all eight people ticking ‘always’, in response to the question: ‘do you like the meals at the home’. o o o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 18, 19 and 20: The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Personal Care: The service users are receiving the personal care they require. The evidence used to make this judgement includes: o The service users plans, which are both created in association with the service users as well as reviewed and updated with their agreement, as reported above. The views of the service users, which indicates that five of the eight people ‘always’ ‘receive the care and support they need’, one person ‘usually’ and two people ‘sometimes’ receive the care they require. o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 19 o Observations of staff supporting service users with their personal care needs, which was clearly undertaken in a sensitive and private manner and was executed in an efficient and professional way. The dataset and AQAA make it clear that the home has policies and procedures for the staff around the delivery of care/support and their roles, which are incorporated within the handbook provided to staff. o Health Care Needs: The evidence indicates that people’s health care needs are appropriately managed. The evidence used to make this judgement includes: o o The view of all eight service users, to respond via the comment cards, indicated that they felt they: ‘receive the medical support they need’. These statements were supported by the evidence contained within the service users plans, which contained completed ‘health assessment plans’, records of visits by health and social care professionals, details of appointments and correspondence with health care providers. The tour of the premise, established that the home is extremely well equipped, with specialised pieces of equipment, sealing hoists, bath hoists, bath/shower chairs, adaptive beds, individually adapted wheelchairs, hoists. The views of the service users, which indicates that five of the eight people ‘always’ ‘receive the care and support they need’, one person ‘usually’ and two people ‘sometimes’ receive the care they require. o o Medication: The evidence indicates that the service users are being appropriately supported with their medications. The evidence used to make this judgement includes: o o o o The AQAA and datasets, which make clear that policies and procedures are available to guide staff when handling service users medication. Storage facilities were seen during the inspection and considered satisfactory. Staff advised that only trained carers dispense medications and that training is provided, which is confirmed by a statement within the AQAA. Medications are dispensed from a ‘monitored dosage system’ (MDS), which is provided by ‘Boots’. IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 22 and 23: People who use the service are able to express their concerns and have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: Complaints and Concerns: The evidence indicates that service users are both able and happy to raise issues with the home and/or the staff if they need. The evidence used to make this judgement includes: o The service user comment cards indicate that they are aware of how to make complaints, all eight people ticking ‘yes’ in response to the question: ‘do you know how to make a complaint’ and ‘do you know who to speak to if you are unhappy’. Copies of the home’s complaints and adult protection literature have been provided to all service users within the last 12 months, according to the AQAA. Quarterly monitoring and/or auditing of the complaints and compliments received, occurs, as per the Leonard Cheshire Foundation policy. o o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 21 o o The dataset establishes the existence of the home’s complaints and concerns procedure, which was last updated in August 2005. The dataset also contains details of the home’s complaints activity over the last twelve months: 1. 2. 3. 4. 5. No of complaints: 2. No of complaints substantiated: 0. No of complaints partially substantiated: 0. Percentage of complaints responded to within 28 days: 2. No of complaints pending an outcome: 0. Safeguarding Adults: The evidence indicates that the service users’ welfare is promoted and that the management and/or staff seek to protect people from abuse and harm by their practices. The evidence used to make this judgement includes: o The Commission’s database’s evidence that one adult protection referral has been made since the last inspection and that this has been successfully resolved. The AQAA also states that all staff, volunteers and service users are provided with ‘protection of vulnerable people’ (POVA) training and/or educational literature, and that the Leonard Cheshire policy document has recently been updated. The service user comment cards indicate that they are both willing and able to speak to people if they have any concerns regarding any aspect of their care. All eight people ticking ‘yes’ in response to the question: ‘do you know who to speak to if you are unhappy’. o The service users raised no concerns, either during their conversations with the inspector, who found the general atmosphere of the home to be relaxed. o o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 24 and 30: The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: Environment and cleanliness: The evidence indicates that all service users live within a well-maintained, clean and tidy environment that meets their immediate and long-term needs. The evidence used to make this judgement includes: o The tour of the premise highlighted no concerns with all areas of the home being well maintained, decorated and furnished. IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 23 Significant quantities of specialised equipment where seen around the home and in use by the service users, this equipment designed to maximise peoples independence, as mentioned earlier. o The tour of the premise and discussions with service users also established that people are heavily involved in the design and decoration of their own rooms, all of which were unique and individual. The AQAA indicates that since the last inspection the following changes have been made to the environment: 1. 2. 3. 4. 5. 6. 7. 8. Completion of re-furbishment of kitchen. New lounge carpet. New metal radiator covers. New accessible patio area. Provision of new garden furniture. Redecoration of three bedrooms. Redecoration of upstairs bathroom. Two new possum systems installed for Service Users. o The AQAA also establishes that over the next 12 months the management team hope to over see the development and/or upgrading, replacement of: 1. 2. 3. 4. 5. Installation of new shower room. New boiler . Additional accessible patio area. Revamp activities room. Creation of dedicated accessible computer room with automatic door to which Service Users have electronic passes and staff access code. 6. Provide storage facilities in each bedroom. Work on the creation of the new shower facility, is already in hand and underway, as witnessed during the tour of the premise. Cleanliness: The evidence indicates that the home is generally clean, tidy and free from odours. The evidence used to make this judgement includes: o Again the tour of the premise raised no concerns with regards to the cleanliness of the home, the domestic staff undertaking the majority of IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 24 the cleaning, although were possible the service users are encouraged to assisted/participate in keeping the home tidy. o o All eight-comment cards were ticked ‘always’, in response to the question ‘is the home fresh and clean’, one person adding ‘very’. The dataset establishes that the staff have access to infection control guidelines, if required and that as with other documents these were last reviewed in the March of 2007. IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 32, 34 and 35: Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. EVIDENCE: Training & Responsibility: The evidence indicates that the training opportunities for the staff are good. The evidence used to make this judgement includes: o The AQAA makes a clear statement that staff receive a full induction on recruitment to the Leonard Cheshire Foundation, which includes a three day introduction at a Regional Training Centre. The AQAA also makes clear that staff receive full mandatory training and access to skills and awareness training sessions. o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 26 o The files of two newly recruited staff were inspected and found to contain evidence of training events/courses attended, including: 1. 2. 3. 4. 5. 6. Protection of Vulnerable Adults. Moving and Handling. Disability Legislation. Infection Control. Leonard Cheshire Induction. Food Hygiene. o Information taken from the dataset and confirmed during the visit, indicates that currently the home employs 24 carers (this includes bank/agency). 11 of 24 carers have completed a National Vocational Qualification (NVQ) at level 2 or equivalent, which gives the home a percentage of 46 of its care staff possessing an NVQ at level 2. o The AQAA also indicates that, within the last twelve months: 1. 2. 3. 4. 2 members of care staff completed N.V.Q. 2. One member of care staff is undergoing N.V.Q.2. 2 additional care staff passed team leaders award. Administrator completed team leaders award. Recruitment and Selection: The evidence indicates that the recruitment and selection process is now being appropriately operated. The evidence used to make this judgement includes: o As stated above the file of the last two people employed at the home were reviewed and found to contain the following information: 1. An application form 2. Two written references 3. Dates of employment 4. Protection Of Vulnerable Adults (POVA) clearance 5. Criminal Records Bureau (CRB) check outcome 6. Induction details 7. Photo Identification 8. Contract 9. Interview questions and responses 10. Medical/Health declaration 11. Training Records IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 27 o Brief discussion with the staff confirmed that they had completed an induction, as mentioned above, and that they had undergone a reasonable recruitment process, the roles they had applied for being learnt about via advertising and that each person had receive a copy of the home’s handbook. The dataset establishes that a recruitment and selection strategy/procedure exists to support the management staff when employing new staff. In discussion with the management it was established that all recruitment administration is managed centrally, with the manager of the service involved in identify the vacancies, short listing and interviewing candidates and overseeing the inductions. o o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 28 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 37, 39 and 42: The management and administration of the home is based on openness and respect, and has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: Management: The evidence indicates that the home is currently being managed to a satisfactory standard. The evidence used to make this judgement includes: o All of the information contained within this report supports the fact that this service is being well run and operates in the best interest of the service users. DS0000012501.V338730.R01.S.doc Version 5.2 Page 29 IW Cheshire Home o o o The feedback from the service users: who clearly enjoy and value their lives at the Cheshire Home (IOW). The well structured and maintained records/systems observed in place during the fieldwork visit. The views of the staff, who find the management and direction of the home satisfactory. Quality Audit: The evidence indicates that service users are afforded the opportunity to comment on the service provided at the home and the foundation nationally. The evidence used to make this judgement includes: o As mentioned earlier within the report regular residents meetings occur, with the next meeting scheduled to take place on 03rd July 2007. It is also evident that the service users meet with the cooks regularly, again as mentioned to discuss and plan the home’s menus and meals. o Currently one service user from the home participates in the national forums arranged by the Leonard Cheshire Foundation, acting as the representative for the home and raising/exploring issues of concern to the group. The records of the home, which were all appropriately updated and reviewed, with clear evidence of the service users involvement in each step of the process noted. Quarterly reviews of the home’s complaints and compliments, which are feedback centrally. o o Health and Safety: The evidence indicates that the health and safety of the service users and staff is being reasonably well managed. The evidence used to make this judgement includes: o The AQAA and dataset information establishes that full health and safety policies/guidance documents are made available to the staff and that equipment is regularly maintained and serviced, gas, electrical installations, portable electrical appliances, hoists, baths, etc. Health and safety training is clearly made available to staff, with the Staffing records evidencing that staff have completed moving and handling, infection control and food hygiene training recently. o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 30 o Maintenance issues are also being appropriately identified and recorded by staff and responded to within a reasonable time period by the maintenance personnel, as demonstrated by a work roster/log observed outside the staffing office. The tour of the premise, when no immediate health and safety issues were identified. o IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 31 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 32 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Good Practice Recommendations IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 IW Cheshire Home DS0000012501.V338730.R01.S.doc Version 5.2 Page 34 - 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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