Inspection on 28/02/07 for Jean Marshall House

This inspection was carried out on 28th February 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

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Insight - Eastchurch

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33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Marshall House 15 Wilbury Avenue Hove East Sussex BN3 6HR Lead Inspector Jane Jewell Key Unannounced Inspection 28th February 2007 10:00 Marshall House DS0000068102.V326467.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 Marshall House DS0000068102.V326467.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. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Marshall House Address 15 Wilbury Avenue Hove East Sussex BN3 6HR 01273 772866 01273 773109 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) The Outlook Foundation Mrs Jean Marshall Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of residents to be accommodated is nine (9). Service users with learning disabilities only to be accommodated. Date of last inspection New service Brief Description of the Service: Jean Marshall House was opened in September 2006 and is a registered care home for up to nine people who have a learning disability. The home is owned by a charity the Outlook Foundation who also operates another registered care home and supported accommodation unit within the Brighton area. The homes aims to provide three long-term placements for residents aged over 25 years and six placements for residents aged 18 to 25 years. For residents who are aged 18 to 25 the home offers a programme of further education and life and vocational skills over a maximum period of seven years. This is with the intention of residents developing sufficient skills and confidence to be able to live an independent life when they leave. For residents over 25 years the intention is for them to be supported to maintain their independence. The home is a converted domestic dwelling within a residential area on the outskirts of Hove. It is located near to train and bus links into Brighton and Hove. The home is presented across three floors with resident’s accommodation consisting of six ensuite bedrooms and three bed sits. Communal space consists of a lounge and conservatory, which is used as the dining room. There is a small courtyard garden to one side of the home. The homes literature says that it aims to help residents learn new skills, provide support to do the things that residents are good and work with residents so they can live more independently. The fees for residential care are currently £44K to £45K per annum, depending on the services and facilities provided. Extra such as: Hairdressing, chiropody, holidays and toiletries are additional costs. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information contained in this report has been comprised from an unannounced inspection undertaken over 4 ½ hours and information gathered about the home. This includes: residents survey questionnaires, discussion with relatives and stakeholders involved in resident’s care and records submitted to the Commission for Social Care inspection (CSCI) including a Preinspection questionnaire. There were four people living at the home under 25 years and one resident over 25 years at the time of the inspection. This is the homes first inspection since it opened in September 2006. The inspection involved a tour of the premises, observation of the interactions between residents and staff, examination of records and discussion with residents and staff. The inspection was facilitated by Mrs. Jean Marshall (Registered manager) and in part by Jo Decie (Assistant care officer). The focus of the inspection was to look at the experiences of life at the home for people living there. The Inspector would like to thank the residents, staff and management for their assistance and hospitality during the visit. What the service does well: Residents live in a comfortable, clean and a homely environment with their personal space decorated to a high standard in accordance with their individual preferences and needs. The educational and occupational opportunities for residents is extensive and well managed. This ensures that residents are equipped with the necessary skills to support their move onto more independent lifestyles, following completion of the programme. Each resident has a person centred plan which is tailored to their individual needs , goals and aspirations. Staff follow the plan to ensure that residents received consistent, sensitive and dignified support. All residents consulted spoke positively about their experiences at the home. A sample of their comments include: “I am happy when I came here and the staff are good” “I am very happy at Marshall House” and “I like living here” A sample of comments by residents regarding staff include: “Really like the staff my keyworker is “nice”; “great”; “friendly”; “they always treat me well” and “they always listen to me and help me”. There is a strong commitment to improving staff skills through an ongoing training programme both in practical matters and the broader aspects of working with people who have a learning disability. This ensures that staff Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 6 have the competences and skills to meet the needs of residents and to achieve the aims and objectives of the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 4 5 and 6 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The home provides both prospective and existing residents, with a good level of information about what services are provided and what to expect when living at the home. Residents are only accommodated if the home is satisfied that it can meet their needs. The home is able to identify and meet the needs of residents. EVIDENCE: There is a range of well-documented information about the home and the services it provides, this includes a statement of purpose and residents handbook. The handbook for residents is extremely well presented and comprehensive, covering most aspects of life in the home. It includes photographs of the staff and answers any questions residents may have when moving to the home. These documents are updated promptly to reflect any changes. They are freely accessible within the home and copies provided to any interested parties. It is recommended that the homes literature distinguishes the different types of programmes /services offered for the under 25 years and the over 25years and that some life skills lessons may be held in the evening. This is to ensure Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 9 that residents have all of the necessary information to make informed choices about living at the home. There is a clear admissions criteria in line with the homes aims and objectives and registration categories. There is a lengthy and vigorous assessment process to ensure that prospective residents needs can be met and that they are suitable to undertake the programme. This involves interviews and visits, which can range from an overnight stay to weeklong assessments. During the weekly assessment, a comprehensive individual assessment programme is developed. This covers standard skills and the current range of abilities. A resident spoke of the assessment as being a positive experience as it helped them make up their mind that they would like to live at the home permanently. There was a wide range of evidence that the home is able to meet the needs of residents. Staff were able to demonstrate a clear knowledge and understanding of the needs of each resident and also how those needs are consistently met. All residents consulted spoke positively about their experiences at the home. A sample of their comments includes: “I am happy when I came here and the staff are good” “I am very happy at Marshall House” and “I like living here”. A sample of relative’s comments includes: “we are fabulously happy with the home” and “I have noticed a vast improvement in language communication and independence in the short amount of time that he has been at the home” Each resident has a contract with the home. The manager stated that signed copies of which are retained at the organisations headquarters. A copy of the terms and conditions is contained within the homes literature, which residents and their representatives can access at any time. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 8 9 and 10 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Residents’ benefit from comprehensive individual plans which details the information about their individual development needs and the guidance for staff on how to support them to achieve their goals and aspirations. Services are designed to provide appropriate care and support, in ways that maximise independence and choice for residents. The home balances well the rights of residents to take reasonable risks as part of an independent lifestyle. EVIDENCE: Comprehensive information is gathered about each resident and compiled into an individual plan. Care plans for residents under 25 years contain personal information, health action plan and a life skills plan. Life skill plans identify resident’s individual educational and development goals and the targets leading to their achievement. Each plan is different and is tailored to suit the needs and level of understanding for each resident. For example one resident Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 11 has their monthly achievements shown in a graph format, as this is a medium that they enjoy. This is to be commended. Residents are actively involved in the development and review of their care plans. Named workers and residents undertake monthly reviews of the life skills plan and update them to reflect any changes and assess the progress made towards achieving their personal goals. Staff consulted were very knowledgeable about the individual needs and preferences of residents and were observed following the guidance recorded in residents care plans. A resident who is aged over 25 years holds their own personal planning book in their bedroom. This was written by the resident and contained information about them and what their personal goals and aspirations were that they wish to work towards. The standard of daily recording was good with a clear account of actions and events that had occurred, these were written in a style that was respectful and non judgmental. The home has a developed system in place for enabling residents to take responsible risks as part of an independent lifestyle. For example core risks faced and posed by residents are assessed and any control measures put into place to help manage or reduce risks. Residents confirmed that they were able to make choices about most aspects of their daily lives. A resident said “I can do anything whatever I want to do but I have to tell the staff”. Another resident did not like having to attend evening life skills sessions, after they had been at college. This was fedback to the manager and it was agreed that this situation should be made clear in the homes literature to ensure residents have the information they need to make an informed choice about whether into move to the home. One resident’s individual plan provided guidance on how to help them make decisions when their verbal communication is not clear. A range of ways was seen of how well residents are involved in the running of the home with regular meetings and consultations. There is a chores list, which contains the household chores that each resident is responsible for undertaking. A resident was observed receiving their post unopened and being told that if there was anything that they did not understand when they opened it they could seek guidance from staff. There is a pay phone, which is located outside the office in a corridor, which affords little privacy. Instead residents use their own mobile phones, which they use to keep in contact with their friends, relatives and with the home while they are out independently. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11 12 13 14 15 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Central to the ethos of the home is providing opportunities for residents to maintain and develop social independence, communication and living skills. Residents’ lives are enriched by being supported to access a wide range of opportunities for occupation and leisure. Resident’s benefit by being supported to maintain relationships with their families and friends. Resident’s dietary needs are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. EVIDENCE: Each resident has a varied individual daily programme, this involves considerable organisation to ensure that all residents receive the necessary support to meet their assessed needs and achieve their daily activities. Residents consulted could not recall any examples when an individual activity Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 13 has been cancelled for any other reason than by choice. This is to be commended considering the complex daily logistics of ensuring residents follow their own individual programmes. Residents undertake various college courses at further education centres, largely chosen by themselves. In addition, residents attend life skills lessons held at the organisations, headquarters development centre, which is an approved as a satellite centre by Sussex Downs College. These courses are tailored towards the individual needs of residents and include numeracy, literacy, information technology and home economics. Some courses lead to formal qualifications. A resident aged over 25 years undertakes some voluntary work. Much thought has gone into providing the learning environment, that best suites the residents learning style. For example a residents attends an education centre at a working farm in order to undertake practical learning. Residents also attend groups on relationships and sexuality where there is an opportunity to talk about this subject with an independent advocate. These groups were set up and are commissioned by the home in order to support resident’s knowledge of their rights and responsibilities. This practice is to be commended. Residents are provided with individual weekly social and leisure money, which they have to budget, as part of life skills training. Residents spoke of the many leisure activities they are involved in, including, Swimming, bowing, dancing, football, basket ball, cinema, walking, youth clubs and social clubs. Staff and residents were in the process of planning an indoor skiing outing. In addition large group outings are occasionally arranged with the organisations other home. A relative said that their relative is “kept busy and has a real sense of achievement undertaking independent activities”. The home has its own transport enabling residents to access a wide range of leisure amenities. It was reported that there is currently a shortage of drivers but staff said that they worked around this by using public transport as part of training for independent lifestyle. Care plans describe the significant others for each resident with most residents relatives and friends taking an active role in their lives. Staff spoke of how they supported resident to maintain regular contact with people that were important to them. This included letters, telephone calls and visits. A resident spoke of the friends that visit them from the organisations other home for dinner parties each week. Relatives said that they can visit whenever they want but invariable phone in advance as residents are often out or busy. There is an organisation newsletter, which a relative said was an excellent idea as it kept them updated on what was happening. All relatives consulted felt that there was a very good standard of communication with them. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 14 The daily routines of the home are largely determined by residents individual programmes with good planning evident to ensure that these are being followed. All residents consulted mentioned some flexibility in their daily routines and respect for their personal freedom and lifestyles. During the inspection residents were observed to move around the communal space freely, choosing which rooms to be in and what level of company they wanted to enjoy. Residents were able to choose when to spend time on their own, and can do so in their own bedrooms. A cook prepares the main evening meal. Currently one resident plans and cooks their own meals as part of an independent lifestyle. They said that they could eat whatever they want and receives guidance on healthy eating and cooking as part of their personal development. Staff said that the menus are planned weekly following discussion with residents. Residents spoke of taking it in turns once a week to choose their favourite meal. Lunch is spontaneous with residents able to choose and make their own from available stocks. Resident’s individual preferences were observed to be respected. In addition to the main kitchen there is a smaller kitchenette area where residents can make snacks and prepare their own pack lunches. Residents were observed helping themselves to the contents of a fruit bowl displayed. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 and 20 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Residents receive flexible, consistent, dignified and sensitive support to meet their personal, emotional and health care needs. Good medication practices are in place, which safeguards residents and ensure that their medical needs were being addressed. EVIDENCE: Each resident has a named worker, which helped to ensure that residents received consistent support and care. Staff demonstrated a good understanding of the named worker role and had a good knowledge of residents support needs. Resident’s plans contain clear guidance for staff on the support needed to meet the needs of residents and help them achieve their individual goals. Staff were observed providing dignified and sensitive support in a relaxed and friendly manner and in accordance with residents individual plans. The consensus of residents was that personal support provided was consistent with their individual wishes and which respected their privacy. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 16 Clear guidance is provided for staff on the health needs of residents. Records showed that there is regular input from health care professionals, when needed. Some residents, as part of an assessed need, independently attend their own medical appointments. Residents confirmed that where they have requested medical intervention then staff have arranged this promptly. As this is the first inspection of the home, medication practices were inspected by CSCI’s pharmacy inspector. Their comments are as follows: Written policies and procedure on medicine management support staff to handle medicines well. The storage arrangements for medicines are secure and record are kept of all medicine movement. Administration of a prescribed medicine was observed which a resident prompted. Residents are encourage and supported to manage their own medicines following a documented risk assessment and signed consent forms. This is recorded on the medicine administration record chart. Although there is some documentation around bought medicines in the care plan when Residents purchase over the counter medicines, a more detailed clear guidance document on these medicines would help staff manage this medication with a common approach. Staff handling medicines received basic Training on medicine management. This was delivered by the local council and also by in-house care manager. There is an expectation that training should be external, ongoing, regular updates, and competence skills accessed. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. An effective complaints procedure and appropriate adult protection policies, staff training and good practices protect the rights and interests of residents. EVIDENCE: There is an accessible complaints procedure for residents, their representatives and staff to follow should they be unhappy with any aspect of the service. This includes pictures of who to go to if a resident wanted to make a formal complaint. Residents were confident to approach the inspector and were articulate in their feedback regarding their positive experiences at the home. All residents consulted said they felt happy to approach any member of staff with any concerns. A resident said that they would use the resident’s handbook to find out whom to make a complaint to. The manager stated in information submitted both before and during the inspection, that there have not been any complaints about the service since it opened. All relatives consulted said that they did not have any concerns and if they did, felt able to approach any member of staff. The home has written policies covering adult protection and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. Staff consulted with showed a clear understanding of their roles Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 18 and responsibilities under adult protection guidelines and had undertaken adult protection training. The home supports residents to manage their own personal finances as part of their life skills development. Individual arrangements are in place for the collection and banking of personal monies, depending upon the individual needs of residents. Residents consulted with understood their own arrangements for the collection of their personal monies and felt that they could largely spend it on what they wanted. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 26 27 28 29 and 30 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a homely, clean, well maintained and decorated environment. Resident’s bedrooms are decorated and furnished to a high standard and in accordance with their individual preferences and needs. EVIDENCE: The home is a recently converted domestic dwelling located in a residential area close to Hove station. The standard of maintenance and décor is high with much effort made to ensure a domestic style environment. Resident’s bedrooms are highly individualised reflecting their tastes and preferences. A resident said that the best bit about the home was their own bedroom as they had all of their belongings in it. Bedroom doors are fitted with locks, the manager said that residents are provided with keys. Residents said that staff respected their personal space this included knocking on bedroom doors and waiting for permission to enter. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 20 Communal space consist of a lounge and a conservatory used as the dining room. There is a small enclosed garden which surrounds half of the property. The manager spoke of their plans to further develop this space for residents to be able to use during the clement weather. There is currently major building works being undertaken on the adjoining property. At the time of inspection this was creating some noise. Staff and residents said that they did not find this too disturbing and said that this would not last for too much longer. There are sufficient number of toilets located around the building, with all bedrooms providing shower ensuite facilities. The home is not designed to offer a service to people with physical disabilities and the stairs and other access arrangements would make it unsuitable for residents with significantly restricted mobility. Residents currently do not need any specialist equipment. All areas of the home were observed to be clean with a high standard of hygiene maintained. Residents are responsible for cleaning their own bedrooms. A resident said: “The only place that is mostly dirty is my room but I can clean it up!” a relative said “jean Marshall house is always fresh and always clean”. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 34 35 and 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a stable, well-supervised, trained and enthusiastic staff team that know them and who are employed in sufficient numbers as is necessary to meet their needs. EVIDENCE: It was observed throughout the inspection that staff understood their roles and had good planning skills. Staff had a clear understanding of the purpose of the service and how their role contributed to the achievement of this. Staff consulted with spoke knowledgeable, respectfully and professionally regarding residents and demonstrated much commitment towards the home and enthusiasm towards supporting residents. The staff team is reflective of the gender and age mix of residents. Most of the staff have worked at the home since it opened, which enabled residents to be provided with stable and consistent support. All persons consulted regarding the home spoke positively about the staff. A sample of comments by residents regarding staff include: “Really like the staff Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 22 my keyworker is “nice”; “great”; “friendly”; “they always treat me well” and “they always listen to me and help me”. A relative spoke of a review that they had recently attended which they felt had been a positive experience as the staff member was knowledgeable and professional at all times. Another relative said that the staff are “really nice, helpful and friendly and felt that their relative has bonded really quickly with them. Staffing levels vary each week in accordance with residents individual programmes and college term times. Staff consulted with felt that staffing levels were currently sufficient to undertake their role effectively and spend individual time with residents. Resident consensus was that there was always sufficient staff for them to get the support they needed. A senior member of staff said that they felt confident that with further admissions to the home the staffing level would be increased accordingly. In information submitted to the Commission as part of the inspection process, the Manager stated that currently half of the staff team have completed National Vocational Qualifications to at least NVQ Level 2. In addition many staff hold higher qualifications in a variety of subjects. Recruitment is undertaken jointly with the organisations other home. Good planning was noted in the recruitment practices to ensure that there was sufficient numbers of suitable trained staff ready when the home was opened. The manager reported that recruitment documentation is held at the organisations head quarters and could therefore not be viewed at the time of inspection. Instead the manager was asked to confirm that the recruitment practices followed for three staff selected by the inspector had undertaken all of the necessary checks in order to safeguard residents. The organisation has consistently maintained high standards of recruitment in its other service. It was evident that training is highly valued by the organisation with much good practice and administration evident to ensure that staff have all of the mandatory training necessary to work safety with residents. In addition staff undergo regular specialist training to support their work with people who have learning disabilities. This is to be commended. Staff spoke of the comprehensive induction programme that they undertook prior to them commencing work with residents and the home opening. Staff said that they receive regular supervision with a senior staff member regarding their performance, conduct and training needs. All staff consulted said that they felt well supported by the manager and senior staff to undertake their roles and felt able to approach them for advice and guidance. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 23 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): 37 38 39 42 and 43 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Resident’s benefit from an experienced and established manager who ensures a clear ethos and values of the home that enables staff to provide good quality care to residents. A range of regular health and safety checks helps to ensure the health and safety of residents and staff. EVIDENCE: There was clear evidence available that the home is managed effectively with a strong sense of leadership and direction being provided. The registered manager who is the organisations managing director and founder, delegates most of the day to day running of the home to senior staff who showed a good level of competence and understanding. The registered manager visits the Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 24 home most days with staff saying that the manager was always accessible. The manager has many years managerial experience and currently overseas the organisations other home. Staff consulted with said that the manager “never fails the residents” and will listen to new ideas and allow staff to put forward their point of view. A resident said that the manager “is very kind”. There are several mechanisms in place for the home to obtain feedback on the quality of the services provided and whether it is achieving its aims and objectives. This includes weekly residents meeting and a monthly audit of services undertaken by an ex member of staff. The manager also spoke of their plans to send out feedback questionnaires to residents, parents and health care professionals in the near future. Written guidance is available for staff on issues related to health and safety. In addition there is a health and safety committee for the organisation which residents are invited to join to discuss and monitor health and safety practices. Records submitted by the manager prior to the inspection stated that all of the necessary servicing and testing of health and safety equipment had been undertaken. Systems are in place to support fire safety, which included: regular fire alarms and emergency lighting checks, maintenance of fire equipment and fire drills. Staff undergo training in fire safety and fire safety notices are displayed in a pictorial format for ease of understanding. The manager reported that a fire risk assessment has been undertaken, by a consultant fire safety officer, which records significant findings and the actions taken to ensure adequate fire safety precaution in the home The manager reported that the recorded monthly visits by the registered provider have not been undertaken for several months. It was discussed that monthly audit visits completed by an ex employee fulfils the majority of this legal obligations but needs some minor review to ensure that all areas as listed under Regulation 26 are being completed. Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 4 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 3 x 3 x x 3 3 Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations That the homes literature makes clear the different types of programmes /services offered for the under 25 years and the over 25years and the arrangements for life skills lesson being held in the evening. To access external medicines training for staff who handle medicines. This should be on a regular basis and competence skills assessed. 2 YA20 Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Marshall House DS0000068102.V326467.R01.S.doc Version 5.2 Page 28 - 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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