Inspection on 26/02/07 for Liam House

This inspection was carried out on 26th February 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Liam House 23/05/07

Liam House 23/05/06

Liam House 05/12/05

Liam House 10/05/05

Liam House 22/11/04

Liam House 02/06/04

Liam House 01/03/04

Liam House 03/11/03

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

CARE HOME ADULTS 18-65 Liam House 13 Spencer Road Bournemouth Dorset BH1 3TE Lead Inspector Stephanie Omosevwerha Key Unannounced Inspection 26th February 2007 11:15 DS0000003956.V331206.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 DS0000003956.V331206.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. DS0000003956.V331206.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Liam House Address 13 Spencer Road Bournemouth Dorset BH1 3TE 01202 294148 01202 789983 liamhouse007@aol.com 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) Mr Marvin Charles Stephens Vacant Care Home 11 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (11) of places DS0000003956.V331206.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2006 Brief Description of the Service: Liam House is a home for adults of both sexes who have a learning disability. It is a large, semi-detached house situated in a central area of Bournemouth close to Boscombe and Bournemouth town centres. The home is conveniently located near shops and facilities and is not far from the sea. It has good access to public transport. Residents accommodation is provided in 7 single and 2 double bedrooms. Seven bedrooms are located on the first floor and two on the ground. The first floor also has 2 bathrooms with WCs and a separate WC. The ground floor has one bathroom with a WC. The communal space is located on the ground floor and consists of a lounge, separate dining room and kitchen. There is a small locked office where all the records are kept. Outside there is a small garden at the rear of the property that has a large storage shed, which contains the laundry facilities and 2 large freezers. The front of the property provides offroad parking. The home is staffed 24 hours a day, with 2 sleeping in staff at nights. Most residents attend day activities organised by different agencies outside the home although this is flexible and residents are also supported to spend time at the home. Current fees provided on 14/03/07 range from £450 to £1000 per week; dependent on individual care needs and if the provision of day care is necessary. Fees do not include personal items such as toiletries, hairdressing, cigarettes and sweets. For further information on fee levels and fair terms of contracts you are advised to refer to the Office of Fair Trading website www.oft.gov.uk. The home keeps copies of all inspection reports that are available in the office and can be seen by service users, relatives and professionals at their request. DS0000003956.V331206.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection of the home and took place over 5 hours. It was carried out as part of the planned inspection programme for care homes undertaken by CSCI and to address the requirements and recommendations made at the previous inspection. This inspection was a key inspection and therefore, assessed all identified key national minimum standards for care homes for adults (18-65). During the inspection various records and documents were sampled including service users’ care plans, health and safety records and staffing records. A tour of the premises was undertaken including all of the communal rooms and a sample of 3 service user’s bedrooms. The inspector was able to talk to 3 members of care staff who were on duty throughout the day. The proposed manager was also available throughout the day. The inspector met with all the residents on their return from their daytime activities and was able to speak to some residents on an individual basis and to the group of residents as a whole. Additional information received by the inspector prior to the inspection was also taken into account. This included previous inspection reports and any incident reported to the Commission under Regulation 37 of the Care Homes Regulations 2001. What the service does well: Service users benefit from a well-maintained environment that has appropriate lighting and heating. Furnishing and fitments are comfortable and domestic in appearance. Service users were observed to move freely around all of the premises. Service users have comprehensive care plans in place and their physical, emotional and social needs are well documented. These have been regularly reviewed ensuring any changes to resident’s care needs are noted and put into practice by members of staff. Clear written guidance is given to staff about how to manage conditions such as epilepsy, diabetes and ‘challenging behaviour’. Service users personal care and healthcare needs are well met by the home. Personal support is offered in a way that promotes service users independence and takes into account their likes and dislikes. Residents are supported to attend healthcare appointments, promoting their good health. Service users said they enjoyed the meals, which were varied taking into account individual preferences and offering healthy eating choices. DS0000003956.V331206.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: As a result of this inspection one requirement and three recommendations have been made. A further requirement is outstanding from the previous inspection. The main concern is that the home does not have a registered manager. This is necessary to ensure the effective long-term running of the home and make sure the improvements made to meet regulatory standards are sustained. DS0000003956.V331206.R01.S.doc Version 5.2 Page 7 No formal system of supervising staff is in place. Whilst staff told the inspector they felt well supported in their roles, it is important to provide regular, recorded sessions to ensure they have adequate time to reflect on their work. Supervision also gives the opportunity to reinforce the homes aims and objectives, provide professional guidance and identify any training and development needs. The inspector also recommended that staff have opportunities to attend specialist training courses linked to the needs of service users living in the home such as the Learning Disability Award Framework induction and foundation units and other courses relevant to service users such as Makaton, sensory loss and diabetes. The format of some of the risk assessments that the proposed manager has implemented is limited. The inspector recommended that clearly identifying the risks specific to each individual and giving specific action points as to how to manage these would ensure service users were not unnecessarily limited and provide staff with clearer guidance. A draft annual plan has been produced based on feedback from service users and staff, however, this would benefit from further development to take into account other aspects of service such as maintenance of the environment and staff training and development to give a more comprehensive picture about future improvements. 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. DS0000003956.V331206.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 DS0000003956.V331206.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): 1, 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Previous evidence indicates professionals assessments of service users needs were carried out prior to admission to ensure the home could provide appropriate care. Improvements have been made in the information available to service users to make it more easily understood ensuring service users are clearer about the terms and conditions of living in the home. EVIDENCE: There have been no new admissions to the home since the previous inspection. Evidence from previous inspections has indicated appropriate admission procedures were followed with liaison with the relevant professionals to obtain care management assessments and plans prior to admission. The inspector was shown a copy of the new Service User guide, which has now been produced in a more accessible format. The proposed manager said he would also liaise with carers or involve advocacy services if necessary to ensure prospective applicants had the information further explained to them. DS0000003956.V331206.R01.S.doc Version 5.2 Page 10 A sample of residents’ contracts was also viewed. These have also been produced in a more accessible format and clearly identify the service user’s room in a plan attached to the contract to make sure residents are clear about the room they are to occupy. DS0000003956.V331206.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): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Detailed care plans are in place providing staff with good information about individual support needs. These have been regularly reviewed ensuring any changes to resident’s care needs are noted and put into practice by members of staff. Positive changes have been made to ensure residents have more choice and opportunities to make decisions in their daily lives. Consideration had been given to managing risks in the home. However, more detailed assessments would ensure service users were not unnecessarily limited and provide staff with clearer guidance about the actions they needed to take. DS0000003956.V331206.R01.S.doc Version 5.2 Page 12 EVIDENCE: A sample of 2 residents’ personal files was examined as part of the inspection. Care plans have previously met the standard and are detailed containing information on all aspects of residents’ care including health needs, communication, personal care, community access, mobility, money management, domestic tasks, social, leisure and recreational activities and relationships and sexuality. Plans also contained clear guidance to staff about the support required e.g. how to deal with ‘challenging behaviour’. Both service users’ care plans had been reviewed in October 2006 and any changes to care plans had been recorded. The proposed manager stated he was trying to ensure residents had increased opportunities to make decisions in their daily lives. Examples of this included more flexible menus and providing staffing during the day so service users could on occasions choose to stay home from their usual day services. Observation during the inspection showed that one service user choose to have a sandwich instead of the evening meal as she had been on a cookery course that day and had made a cooked lunch. The proposed manager was also liaising with a local advocacy group and providing residents with information about this service. Service users finances have now been sorted out so that they all have individual accounts and withdraw their contribution to their residential fees on a monthly basis. A sample of service users’ financial records was checked and these were found to be up-to-date and accurate with receipts kept of all transactions made. There was evidence that consideration had been given to the management of risks in the home. Individual assessments had been made on a number of issues of service users’ files. In addition the proposed manager had reviewed these in October 2006 and set up further risk assessments to ensure all residents had assessments on their abilities to self administer medication, manage their finances, have their own set of keys and access the community. The inspector recommended that further detail would improve the quality of these assessments by clearly identifying the risks specific to each individual and giving specific action points as to how to manage these. DS0000003956.V331206.R01.S.doc Version 5.2 Page 13 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): 12, 13, 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. All residents were engaged in suitable daytime activities and the home was exploring ways to be more flexible in order to offer service users greater choice. The home has good access to the local community and residents are able to use the local facilities and amenities. The home welcomes visits from family and friends and service users are supported to maintain their personal relationships. Service users were able to exercise individual choice and had freedom of movement in the home. Increasing service users participation in household routines had provided further opportunities for developing independent living skills. Service users enjoyed the meals, which were varied taking into account individual preferences and offering healthy eating choices. DS0000003956.V331206.R01.S.doc Version 5.2 Page 14 EVIDENCE: Suitable daytime activities were recorded on service users files and these included day centres, college courses and work placements. The proposed manager said he was working towards giving residents more choice of day time activities and was hoping to staff the home to accommodate service users staying at home for the day if they wished. Discussion with service users on their return from their daily activities confirmed they were happy with their individual arrangements. The home currently provides day time care for one service user during the week. Observation on the day of the inspection showed the service user was taken out shopping with a member of staff and they also had lunch out. Service users spoke about accessing a range of facilities in the local community including shops, post office, banks, leisure centres, pubs, cafes and beaches. The home has good access to public transport and service users confirmed they could catch the bus to the local town centres with staff support. The proposed manager said that residents were now taken on more outings in the local community and could visit nearby shopping centres in Bournemouth, Boscombe and Poole. To facilitate this the staffing rota had been adjusted so that 3 staff were sometimes on duty over the weekend to give more flexibility and choice for going out. There was evidence that personal relationships were supported and details of relatives were recorded on service users files. The proposed manager had been contacting relatives to let them know they were welcome to visit the home and as a result of this one resident’s sister had now started to visit the home. Service users were also encouraged to visit and spend time with their families, although not all service users had relatives living locally. A service user who had moved out of the home was being encouraged to maintain contact with some of the residents he had close friendships with and visits the home on a regular basis. Observation during the inspection evidenced that service users had unrestricted access to all communal areas of the home. On their return from day centre activities service users choose whether to spend time in the kitchen, dining room and lounge or in the privacy of their bedrooms. Staff were seen chatting and interacting with the service users. Service users responsibilities for housekeeping tasks were identified on their care plans e.g. “X is a capable assistant in the kitchen, can dry up and tidy bedroom”. There was further evidence that residents had increased opportunities to take part in household routines and rotas for domestic duties had been devised to promote this. A suggestion box had been placed in the dining room so residents could put forward any new ideas and residents’ meetings were being held on DS0000003956.V331206.R01.S.doc Version 5.2 Page 15 approximately a monthly basis. These were now being organised and chaired by one of the residents. A member of staff had responsibility for catering in the home. The proposed manager said service users were consulted about their preferences when drawing up the menus and that service users were involved in shopping and meal preparation. Records of menus showed that a varied and balanced diet was offered and that special dietary needs were met. An alternative choice was offered if residents didn’t like the main meal. Service users told the inspector they enjoyed the food in the home. DS0000003956.V331206.R01.S.doc Version 5.2 Page 16 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. Personal support is offered in a way that promotes service users independence and takes into account their likes and dislikes. The home provides good guidance to staff about residents’ healthcare needs and appropriate support is provided by professionals to ensure residents’ physical and mental well-being. The home’s system of administering medication is satisfactorily managed promoting service user’s good health. EVIDENCE: Personal care needs were well documented on service users’ care plans. These included information on washing, oral hygiene, hair care, shaving, continence and dressing, giving staff clear guidance about individual support needs. Discussion with service users confirmed they were generally happy with the support they were given. Staff spoken with demonstrated a good understanding of resident’s care needs and said personal preferences were taken into account. DS0000003956.V331206.R01.S.doc Version 5.2 Page 17 Service users plans contained detailed information about their health needs including their physical and mental health. G.P. details were clearly recorded and all visits to healthcare professionals were noted. Clear written instructions were available to staff on how to care for particular conditions e.g. monitoring mental health and a protocol from managing diabetes. Advice was also included about when to seek professional advice e.g. referral to psychiatrist and contact details for the district nurse. The proposed manager told the inspector they were continuing to ensure residents kept medical appointments and were supported to attend these. For example, one resident had recently had to go to hospital to have his wisdom teeth taken out, another resident had had a recent mental health assessment and appropriate equipment had been provided to one resident to facilitate his walking following an OT assessment. The medication cupboard was checked as part of the inspection. The home has a locked cupboard in the office and uses a monitored dosage system. A sample of records was checked and these were found to be up-to-date and accurate. None of the residents have been assessed as able to manage their own medication, although some take responsibility for their medication when they are out at their day-time activities and this is appropriately risk assessed. A consent form signed by the service user giving permission for staff to administer their medication was observed on the files that were case tracked. All members of staff have completed a course in medication awareness and 4 members of staff have completed a course in emergency aid. There is further information available in the home for staff to refer to about medication that is administered to service users. DS0000003956.V331206.R01.S.doc Version 5.2 Page 18 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. A satisfactory complaints procedure is in place and service users can access advocacy/professional support to ensure their views are listened to. The home has appropriate guidance for staff about the protection of vulnerable adults, and training has been provided to ensure staff have knowledge of the correct procedures to follow. EVIDENCE: The home has a satisfactory complaints procedure that is available in a format accessible to residents. This is displayed on the notice board in the dining room. Further information about how to make a complaint is included in residents’ personal contracts that are set out in an accessible format. The proposed manager has liaised with a local advocacy group and information about this service is available to residents so they can access this support if necessary. Residents were able to articulate their views to the inspector and were aware they could speak to other professionals e.g. care managers about any concerns that they had. No complaints had been logged since the previous inspection. The home has policies and procedures concerned with the protection of vulnerable adults. These included Adult Protection and Prevention of Abuse, Dealing with Aggression and Whistleblowing. Staff have to read the policies DS0000003956.V331206.R01.S.doc Version 5.2 Page 19 and sign to confirm they have understood them. Since the last inspection, all members of staff have undertaken training in the protection of vulnerable adults. DS0000003956.V331206.R01.S.doc Version 5.2 Page 20 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained providing a comfortable and safe environment for those living there, working there and visiting. The home is clean and hygienic with appropriate procedures in place for controlling infection. EVIDENCE: A tour of the premises was carried out as part of the inspection. All communal areas were viewed including the lounge, dining room and kitchen. The inspector observed the premises had suitable lighting and heating. Furnishings and fittings were well maintained and domestic in appearance. A sample of service users’ bedrooms was seen. These had been clearly personalised to the occupant’s taste and had plenty of space for personal possession. Residents told the inspector they liked their bedrooms and were happy with their living environment. DS0000003956.V331206.R01.S.doc Version 5.2 Page 21 On the day of the inspection the home was seen to be very clean and tidy with no offensive odours. The home employs a domestic assistant who works Mondays to Fridays and is responsible for keeping the home clean. There are separate laundry facilities in an outside storage shed. Appropriate procedures were in place to prevent the spread of infection and equipment such as gloves and aprons was available. All staff have had training in infection control. DS0000003956.V331206.R01.S.doc Version 5.2 Page 22 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): 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff have the experience and skills to meet service users needs ensuring service users feel confident they will be appropriately supported. The home is now carrying out the required checks when recruiting and vetting members of staff ensuring residents’ welfare is properly safeguarded. Good progress has been made in staff training to ensure they have the relevant skills and competencies for working in a residential care home. Consideration now needs to be given to the more specialist needs of service users living in the home to inform the future training needs of the staff team. A formal system of supervision needs to be introduced into the home to provide staff with regular opportunities to meet with their manager and evaluate their work. DS0000003956.V331206.R01.S.doc Version 5.2 Page 23 EVIDENCE: The home has a small team of 6 members of care staff and a domestic and there have been no changes in the staff team since the previous inspection. There is a mix of male and female staff and age groups. All staff have some previous experience, some have experience in a nursing environment and others in care homes for the elderly or domiciliary care work. There are currently four members of staff who have achieved an NVQ qualification or equivalent. A further member of staff is to commence NVQ Level 2, meaning the home has met the target of having 50 of care workers qualified in the home. Observation of practice showed staff were approachable and appeared comfortable with the residents. Service users told the inspector they liked the staff. There was a breach of recruitment procedures at the previous key inspection. This requirement was addressed at a random inspection of the home carried out on the 8th November 2006. At this inspection the inspector found one member of staff had been employed since the last inspection. Records were checked and found to contain all the necessary documentation required by legislation indicating the home was now following much more robust recruitment procedures. No further members of staff had been employed since this inspection, however, the proposed manager said he was currently in the process of recruiting a new member of staff and was ensuring all documentation was in place including a POVA first check and 2 written references prior to them commencing employment in the home. The proposed manager went through the home’s training plan with the inspector. Gaps in individual members training had been noted as well as an analysis of the whole team’s training needs. The home had made good progress towards addressing any shortfalls and all staff had now completed courses in fire training, medication awareness, protection of vulnerable adults and infection control. Most staff had also completed courses in health and safety and emergency aid. One member of staff who had the main responsibility for preparing the food in the home had completed a course in food hygiene. The proposed manager stated he was continuing to address any gaps in training and arranging courses as appropriate. Now most staff have completed mandatory training, the inspector recommended that consideration be given towards specialist course linked to service users needs such as the Learning Disability Award Framework induction and foundation units and other courses relevant to service users such as Makaton, sensory loss and diabetes. Although no new staff had joined the team since the previous inspection, the proposed manager showed he was aware of the new common induction DS0000003956.V331206.R01.S.doc Version 5.2 Page 24 standards and had designed an in-house programme for new staff that incorporated these, which he showed to the inspector. The proposed manager said that he was available for staff to consult with on a daily basis and provided informal support to the staff team. No formal system of supervision is in place. Whilst staff told the inspector they felt well supported in their roles, it is important to provide regular, recorded sessions to ensure they have adequate time to reflect on their work. Supervision also gives the opportunity to reinforce the homes aims and objectives, provide professional guidance and identify any training and development needs. DS0000003956.V331206.R01.S.doc Version 5.2 Page 25 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, 39 and 42. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home needs to have a registered manager in post to ensure progress towards meeting regulatory requirements can be sustained and provide security for the long-term effectiveness of running the home. The home has sought feedback about the quality of service from the residents and staff and this is included in an annual plan. More comprehensive detail is needed about other aspects of service delivery to ensure the plan sets out a full range of aims and objectives for future development. Practices in the home promote and safeguard the health, safety and welfare of the residents. DS0000003956.V331206.R01.S.doc Version 5.2 Page 26 EVIDENCE: The home does not currently have a registered manager. A proposed manager is in post but an application to register has not yet been received by CSCI. It is important that an application is forwarded to CSCI in order to ensure consistent management of the home and sustain the progress that has been made towards meeting regulatory requirements. The proposed manager has set up a quality assurance system to monitor certain aspects of care provided and questionnaires had been given to all residents in October 2006. Further feedback had also been obtained from residents’ meetings and staff meetings. A draft plan had been produced based on the views of the service users and staff, and this was shown to the inspector. Future aims and objects to improve the quality of the service included negotiating with a member of staff from the local day centre to come into the home to do work on total communication and purchasing a new washing machine to make it easier for residents to do their own laundry. The inspector recommended that the plan would benefit from further development to take into account other aspects of service such as maintenance of the environment and staff training and development to give a more comprehensive picture about future improvements. The inspector examined records that showed that the home was meeting the requirements of other agencies such as Dorset Fire and Rescue Service and Environmental Health Department. Certificates were in place demonstrating that equipment and facilities were regularly serviced and maintained. A fire risk assessment was in place and staff carry out weekly visual checks on equipment. A record of fire drills and fire training records are kept. The home had policies and procedures relating to health and safety practices. The proposed manager confirmed his awareness of relevant legislation and certificates were in place showing staff had attended various training courses in safe working practices. DS0000003956.V331206.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 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 1 X 2 X X 3 X DS0000003956.V331206.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA36 Regulation 18 Requirement The registered person must ensure staff working in the care home are appropriately supervised. The registered person must appoint a person to manage the care home and provide the Commission with the relevant details. (This requirement was made at the previous inspection with an original timescale of 01/08/06.) Timescale for action 30/06/07 2. YA37 8 01/05/07 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 YA9 Good Practice Recommendations It is recommended that further detail to risk assessments would improve the quality by clearly identifying the risks specific to each individual and giving specific action points as to how to manage these. DS0000003956.V331206.R01.S.doc Version 5.2 Page 29 2. YA35 3. YA39 It is recommended that consideration be given towards staff attending specialist courses linked to service users needs such as the Learning Disability Award Framework induction and foundation units and other courses relevant to service users such as Makaton, sensory loss and diabetes. It is recommended that the home’s annual plan would benefit from further development to take into account other aspects of service such as maintenance of the environment and staff training and development to give a more comprehensive picture about future improvements. DS0000003956.V331206.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000003956.V331206.R01.S.doc Version 5.2 Page 31 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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