Inspection on 29/11/07 for Little Ashmill RCH

This inspection was carried out on 29th November 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

Little Ashmill RCH 07/12/06

Little Ashmill RCH 08/12/05

Little Ashmill RCH 04/08/05

Little Ashmill RCH 30/11/04

Little Ashmill RCH 08/06/04

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

CARE HOME ADULTS 18-65 Little Ashmill RCH 21 Stanhope Way Great Barr Birmingham West Midlands B43 7UB Lead Inspector Bhag Jassal Key Unannounced Inspection 29th November 2007 10:00 Little Ashmill RCH DS0000043608.V351402.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 Little Ashmill RCH DS0000043608.V351402.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. Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Ashmill RCH Address 21 Stanhope Way Great Barr Birmingham West Midlands B43 7UB 0121 360 5842 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) Ashmill Residential Care Home Ltd vacant post Care Home 5 Category(ies) of Physical disability (5) registration, with number of places Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age Range 18-65 years Date of last inspection 7th December 2006 Brief Description of the Service: Little Ashmill is registered to care for five people between the ages of 18 and 65 who have a physical disability. The property is a detached house, which has been extensively modernised and refurbished to meet the needs of this service user group. It is situated in a residential area in Great Barr and has shops and a public house nearby. All service users have their own bedroom, which is provided with an en suite shower and toilet. All rooms are designed to be accessible to those using wheelchairs. There is a vertical lift to the first floor. The laundry is reached via an outside path and is therefore not accessible to the service users. Those using wheelchairs would be unable to prepare meals in the kitchen. Little Ashmill is comfortable and well equipped and because of its smaller size, achieves a homely atmosphere. The present Registered Individual Ms Salma Katrina Brown (on behalf of Ashmill Residential Care Home Ltd) has been operating this service since August 2003. The Acting Care Manager Mr Paul Courtney has been in his present post over 12 months and he is still to register as a Registered Manager with the Commission for Social Care Inspection (CSCI). Ashmill Residential Care Home Ltd makes their services known to prospective service users in the Statement of Purpose and Service Users’ Guide. The Inspection Report is mentioned in the Statement of Purpose and how a copy can be obtained. The care home charges (Fees) are reviewed annually and people who use the service are notified one month in advance. The only additional charges to people who use the service are for hairdressing, chiropody and Ring and Ride. This is clearly laid out in the home’s terms and conditions. The current fees charged at Little Ashmill range from £1,000. 00 to £1,200.00 per week. Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 5 Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This report is on a Key Inspection, part of which included an unannounced visit undertaken on 29th November 2007. This unannounced visit started at 10.00 am and lasted 6 hours and 25 minutes. The home had all the five places occupied. The judgements made within this report are based upon information supplied by the home, from interviews with staff, people who use the service and their relatives. During the course of inspection the assessment information and care plans were case tracked for 5 people who use the service. Medication administration was checked. Staff records were seen to check staff rotas, recruitment procedures and training. Various documents were seen in order to check compliance with health and safety legislation. A tour of the premises was also undertaken and observations of care practices and interaction between staff and people who use the service was also completed. Discussions took place with four members of staff and all the people living at Little Ashmill care home. The Acting Care Manager – Mr Paul Courtney was present throughout the inspection process. The Responsible Individual Ms Salma Katrina Brown was present briefly during the morning. All the information received from the care home was considered and discussed with Mr Courtney. What the service does well: Little Ashmill care home provides comfortable, warm and homely accommodation in a well-maintained building. People using the service have their own attractive bedrooms and they all have en-suite facilities. There is strong leadership at the care home, with the Acting Care Manager being very much involved in the daily “hands on” care of people who use the service. It is clear the people using the service are encouraged to make choices and that the home is proactive in seeking suitable activities, both within the home and the wider community. People using the service enjoy a number of trips out, which they help to choose. There is good choice of food available and people using the service are involved in the weekly menu planning and food shopping trips. Care is taken to ensure that nutritional needs are met. There are good links with local social and healthcare services. Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 7 The home communicates well with the families, friends and representatives of people who use the service and welcomes visitors. People who use the service say they are happy and content with living in a homely and caring place. One person summed up how he felt about Little Ashmill: ”I don’t want to move anywhere else, if I moved I would have to come all the way back again”. Another service user added that the staff are very good and caring people. What has improved since the last inspection? All 12 Requirements and all 5 Recommendations arising from the last key inspection dated 7th December 2006 have been addressed by the home. Five senior members of staff have completed their training in safe handling of medication. The procedures for the management of medication have been revised and updated to ensure the safety of people who use the service. The home now has an updated Complaints Procedure in place. This Procedure is included in the Service Users’ Guide and also made available in the home. The home’s Adult Protection Procedure has been revised and now is in line with the Walsall Social Services Adult Protection Procedure. A number of staff have received training in adult protection issues. The staff rota was seen during the inspection. The rota contained the details of the Acting Care Manager’s hours and the person who is on-call in the event of an emergency. The home now has a training and development plan in place and staff files contained an individual training and development assessment profile. A majority of staff have received the mandatory training in safe working practice topics. This training will help to ensure that they are improving knowledge and skills to meet the needs of people who use the service. Staff recruitment procedures and practices have improved and all the required checks and written references are obtained prior to the commencement of employment at the care home. All new staff now receives induction training in accordance with the Skills for Care standards and specifications. There has been further improvement in the quality of care plans at Little Ashmill and evidence that people who use the service have been involved in the development of the plans. Regular reviews have been taking place. A rolling programme of redecoration at Little Ashmill has been implemented. An extension to the premises is in progress and building work is scheduled to be completed in April/May 2008. People who use the service will benefit from the improved accommodation and facilities at Little Ashmill. Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 8 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. Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 9 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 Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 10 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): 2. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There are sound admission procedures in place, which include a phased introduction to Little Ashmill. This ensures, as far as possible, that the needs and aspirations of people who use the service will be met. EVIDENCE: There has been one new admission to the home in July 2007. There are good admission procedures in place. The home has a Statement of Purpose and Service Users’ Guide available. The Surveys confirmed that the information about the home is shared, and that people who live at the home are kept up to date with important issues. Full assessments were completed for everyone before they moved into Little Ashmill. A care plan is written based on the information from the assessments, when a person comes to live at Little Ashmill. All people using the service had been referred by Social Services and a proper assessment was carried out prior to their admission. There is a risk assessment in place for each individual service user, which is based on their specific needs and risks. It was evident that family carers’ needs and interests had been taken into account in care planning. Little Ashmill RCH DS0000043608.V351402.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 Good. This judgement has been made using available evidence including a visit to this service. People who use the service have an individual care plan, which sets out their needs and goals and how these are to be met. Care needs to be taken to ensure that these plans are clear and contain up to date information. People using the service are encouraged and assisted to make decisions about their daily lives. Any risks to individual people using the service are assessed. EVIDENCE: Care plans for five people were examined. Case tracking provides a view of how the home responds to diversity of needs and how this is being managed and supported. This is particularly evident where health needs and disability requires greater input and support from staff within the home. All people using the service have a Care Plan, which is based on the assessment information and covers personal, social support and healthcare needs. At Little Ashmill the home have developed their own care plan and separate health check sheet (see Standard 19). In addition to this, each service user has an “Essential Lifestyle Plan”, which is a Person Centred Plan Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 12 drawn up by the service user with the assistance from their social worker, their families, and all other interested parties, including staff from Little Ashmill care home. The Acting Care Manager stated that the care plans are reviewed on six a monthly basis by the Physical Disability Team. The Care Plans provide details to staff on the process of care needed for each individual. For example, how a particular person likes to be assisted with personal care. The care plans contain risk assessments. They also include a daily personal care plan and are checked on a weekly basis. There is a key worker system in operation. Each person is allocated a key worker to oversee his or her care. Each key worker builds a closer relationship so they gain more understanding and knowledge of individual needs, goals and wishes. There is evidence of key worker support and encouragement to make sure that people who use the service are fully involved in the reviews of their care plans. Staff said they are aware of the plans and follow them to guide their practice. Assessment information seen gave information on the individual person’s ability to make decisions and choices. An Advocacy Service is available locally and this service is used if required by people living at Little Ashmill. People who use the service are assisted to participate in their preferred individual activities. For example, one service user is supported to attend a local Day Centre. All people using the service have their own Bank Accounts and are supported in the management of their finances. The home does not act as appointee or agent for any of the people who use the service, this is being handled either by the families of people who use the service, Social Services or, in one case, by the Court of Protection. Risk assessment is carried out prior to admission and risks are reviewed at the same time as the care plan. None of the people currently using the service would wish to go out alone and are always accompanied for all outside activities. Little Ashmill RCH DS0000043608.V351402.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. People who use the service have opportunities to take part in a wide range of appropriate activities. The involvement of family and friends is encouraged. People who use the service are encouraged to make choices and to be involved in the daily life of the home if that is their wish. There is good choice of food available and people using the service are involved in shopping and choosing the menus. EVIDENCE: A range of activities is promoted for people who use the service, both in-house and within the local community. These activities include shopping trips to Sutton Coldfield, Kingstanding, Walsall and Birmingham Shopping Centres. Outings are also organised for pub lunches, theatre and cinema. The indoor activities include knitting, birthday and festive parties, drawing, listening to music, watching DVDs/Videos. Ring and Ride is used for some trips out by people who use the service and they also have access to Little Ashmill’s minibus, when it is available. All people living at the care home are on the electoral register. Any staff time with people using the service for activities Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 14 outside the home are recognised by the Registered Persons as part of staff duties. Everyone is given the opportunity to take part with events arranged to suit people’s abilities. Staff said that opportunities are discussed regularly with people who use the service through their weekly meetings. Planning activities, menus, and any other issues within the home are discussed. Activities are now recorded in the individual dairies and provide evidence of people’s lifestyle, but there were still some gaps where no social and leisure activities have been recorded as taking place. Staff at Little Ashmill care home, as far as possible, to help people who use the service maintain links with their families and friends. Families and friends are welcome to visit whenever they wish. One service user visit her parents and stay overnight with them. The home has a clear policy with regards to intimate personal relationships. At the time of inspection the extension work was in progress at the home and gardens and patio areas were not accessible to anyone. The site was made safe in the interests of health and safety of all people who use this care home, including staff and visitors. Rules on smoking, alcohol and drugs are clearly stated in the contract/terms and conditions of residency. There is 4 weekly menu in place. The Acting Care Manager stated that people who use the service can choose whatever they wish to eat and staff will prepare that meal. People who use the service usually go food shopping with staff from the home. Health or medical needs and requirements of people using the service are taken into account and everyone’s particular needs and requirements are catered for. Records showed the varied and nutritional meals that are provided and alternative meals where these have been chosen. It was noted that service users who needed assistance to eat were helped in a sensitive and discreet way. The kitchen was clean and in good order and ample stocks of food were seen, including fresh fruit and vegetables. Fridge and freezer temperatures are taken daily. The temperature of the cooked meats was now taken daily. Little Ashmill RCH DS0000043608.V351402.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. Details of individual personal and healthcare needs are clearly identified in the care plans and health action plans. The detail informs staff on how care is preferred and makes sure that support is provided in a consistent way. Little Ashmill has a medication policy and procedure for staff to follow to ensure that all medication is administered and stored safely for the protection of everyone who uses the service and staff. EVIDENCE: Each person has a health action plan included with their care plan, which sets out how their health needs are to be met. People who use the service have a health checks sheet, which details: medical history, medication, category of physical disability, communication, mobility, skin, toileting, mental health, health screening, sight and dental care. People using the service all attend the same GP Practice and some service users are regularly visited by District Nurses. Where possible, people who use the service are supported to manage their own medication. Little Ashmill care home continue to be proactive in obtaining medical and specialist medical advice for people who use the service. Staff Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 16 from the home accompany people who use the service to any health appointments, such as Doctors, Opticians, Dentists and out-patient appointments. Regular checks and monitoring is being recorded in health action plans. This is good practice that helps to ensure that health care and support is provided in a personalised way. There is an improvement in the level of recording and information available in the care plans to advise and inform staff. All people using the service have their own bedrooms and all personal care giving takes place in private. It is not possible at all times to provide intimate care by a person of the same gender for male service users. However, now the home has employed two male members of staff to address this issue to some extent. All people using the service have the technical aids they need to assist their independence. Specialist support is available from community based healthcare professionals. Staff were observed providing support for people using the service in a respectful way, making sure that each person’s dignity and self-esteem was important. All the people who use the service present during the inspection, were able to communicate their views of the home, and they appeared to be comfortable and at ease in their surroundings. None of the people using the service take charge of their own medication, although all have a lockable facility in their bedrooms if they wish to do so. Medication is stored in a locked cupboard in the Manager’s office. The mobile medication trolley is also stored in the same facility after use at an acceptable temperature. Only one service user is prescribed controlled drugs at present. A check was made of the medication and accompanying record sheets, which appeared to be satisfactory. A medication policy and procedure is in place and provide guidelines to follow should any medication error occur. Additionally, procedures advise that errors are to be reported to the Commission for Social Care Inspection (CSCI). The staff training records showed that five senior carers have completed their training in safe handling of medication. The Acting Care Manager stated that the remaining members of staff who as yet have not received this mode of training will do so shortly. The home has a homely remedies policy and staff obtains the consent of the GP if any homely remedies (such as paracetamol) are to be used. Little Ashmill RCH DS0000043608.V351402.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. People who use the service are protected from abuse. They have access to easy to understand information about how to complain and staff support people to express their views and any concerns they may have. There are suitable procedures in place for the management of complaints. EVIDENCE: There are suitable and updated procedures in place at Little Ashmill care home to respond to any allegations of abuse and for managing any complaints made about the service provided. A copy of the local Adult Protection procedures is also available. The Complaints Procedure, which has been revised and updated is also available in the Service Users’ Guide, a copy of which was seen during the visit on the notice board in the main entrance hall. Staff support people who live at Little Ashmill care home should they wish to make a complaint. A survey conducted during the summer 2007 showed that people are aware of the complaints procedure and that no complaints have been received. The CSCI has not received any complaint about the service since the previous inspection in December 2006. The home’s Adult Protection Procedure has been revised and updated and is now in line with the Walsall Social Services Adult Protection Procedure, a copy of which is available in the home. It is the home’s policy that physical restraint is not used. The home also have a Whistle Blowing Policy and members of care staff on duty at the inspection were aware of their responsibilities with regard to the Protection of Vulnerable Adults. The majority of staff have received training in Adult Protection issues and the Acting Care Manager stated that those members of Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 18 staff who as yet have not received this mode of training will do so shortly. This training is also part of induction training for new staff. The home takes charge of some monies on behalf of people using the service. An inspection of these monies showed very clear records and evidence of regular audits. People’s benefits are paid into their bank accounts and they are taken to bank to withdraw monies to pay for their contributions towards the fees at the home and for their personal needs. This can include money for clothes, toiletries and some leisure activities. Little Ashmill RCH DS0000043608.V351402.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 and 30. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People who use the service live in an attractive, clean and comfortable home. Most risk assessments are in place to ensure a safe and secure environment for people using the service. EVIDENCE: A tour of the home was conducted. Little Ashmill was found to be clean, comfortable and warm at the time of the inspection. The building has been designed to specifically meet the needs of people with a physical disability. All the bedrooms have en-suite facilities including a sink and a shower. There is wheelchair access to all communal areas, but at present the people using the service are unable to use laundry and kitchen, as neither are accessible to wheelchair users. However, the Acting Care Manager stated that these issues will be addressed by the current extension building work in progress, which is scheduled to be completed by April/May 2008. Throughout the home there are a number of items of equipment to assist people who use the service. These include a vertical lift, an assisted Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 20 bathroom, en-suite shower, a call system and lower light switches. There is storage and charging facilities for wheelchairs. Flashing light fire alarms have been provided in rooms where people who use the service are hard of hearing. People who use the service spoken to said that they are happy with their bedrooms. There is a very pleasant, landscaped garden to the rear of the property, which people who use the service say was much enjoyed during the summer months. There are policies and procedures in place for the control of infection, dealing with spillage, safe handling and disposal waste. The temperature of the hot water supply in the communal bathroom on the ground floor was tested to be above 50 Degrees C and in the hot water outlets in the bedrooms was also above 43 Degrees C, which is the recommended maximum. The Acting Care Manager stated that this matter will be addressed by the next morning and also will confirm this in writing to the CSCI the next day. All the radiators in the home are appropriately safeguarded to protect the people who use the service. The Acting Care Manager stated that the new extension to the existing building will include – a bedroom with en-suite facility – shower, disabled WC and sink, store room, laundry room, sluicing facility, staff room, service users’ multipurpose room and a conservatory next to the existing main lounge. The extension building work is scheduled to be completed by April/May 2008. The people using were very excited about the new facilities to be made available soon. Little Ashmill RCH DS0000043608.V351402.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): 32, 34 and 35. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff on duty with the right skills and knowledge to meet the needs of people who live at Little Ashmill. Staff are well supported and work together to provide consistent and good quality care. Staff receive relevant training to help them to meet the needs of people who use the service. The home’s recruitment policy and procedures make sure that suitable staff are employed. EVIDENCE: The information provided by the home and staff rotas for the month of November 2007 available on the day of inspection indicated that the home is adequately staffed. At the time of the inspection (10.00 am) the Acting Care Manager was present at the premises and four service users were also present at the home, and one of these service users was ready to go to the local community centre. Another service user had been out staying overnight with her parents. She also returned to the home in the early afternoon to join the other people using the service. There are always one senior carer and two carers or two senior carers and a carer on duty throughout the day and two night carers on wakeful duty and either the Acting Care Manager or a Senior carer is on–call in the event of Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 22 emergency. The staff rotas were seen during the visit. The Acting Care Manager’s hours are supernumerary. Specialist services are available from the community based healthcare professionals. Now the staff group does reflect gender and ethnicity composition of the people who use the service. Staff meetings are now held regularly, and all staff receives their formal supervision meetings on a bi-monthly basis. Staff were observed to have a good rapport with people who use the service. The people using the service were served with tea and biscuits during the morning and a selection of sandwiches at lunchtime. The main cooked meal is taken at teatime. The people using the service were listening to music, doing drawing and colouring, and then in the late afternoon watching T.V. Staff on duty were seen sitting with the people using the service supporting/ supervising them with their respective activities, and communicating with them using a variety of methods, to suit the individual service user. Staff are to train in British Sign Language in the New Year. The files of 4 members of staff were seen in order to check recruitment processes and practice at the home. All files contained all the required recruitment documentation, including a completed application form, two written references, CRB disclosure and a photograph of the staff member. All staff receive their terms and conditions of employment. The Acting Care Manager now has developed a training matrix for the staff team as a whole and this was seen during the visit. There is dedicated training budget. The staff training records showed that all five senior carers have completed their accredited training in safe handling of medication. Staff have taken part in a number of relevant training courses, including dealing with discrimination, Epilepsy, mental health awareness, managing a diabetic patient. However, staff also need to receive training in equality and diversity issues to increase their knowledge of the background of the people they care for at Little Ashmill. Two senior carers and a carer have completed their NVQ Level 2 and three senior carers and one night carer have completed their NVQ Level 3 qualifications. A majority of staff have completed their mandatory safe working practice topics training. The Acting Care Manager stated that those members of staff who as yet have not undertaken this mode of training and NVQ Level 2 training will do so shortly. The Acting Care Manager stated that he was now requested staff to sign an agreement to take part in all required and mandatory training. The induction process also includes new staff being supported by senior staff to familiarise themselves with the home, people who use the service, health and safety matters. All new staff also receive an induction training to Skills for Care specifications and standards. Now each member of staff have an individual training and development assessment and profile on file. Little Ashmill RCH DS0000043608.V351402.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, 39 and 42. 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 managed and staff received the leadership and support they need. People using the service can be assured that the home is run in their best interests and, in most respects, the home promotes their health, safety and welfare. EVIDENCE: There is currently an experienced and competent Acting Care Manager in post at Little Ashmill. Mr Paul Courtney has worked for five years at the Company’s larger care home in Birmingham, latterly as Deputy Manager. Mr Courtney has been Acting Care Manager at this care home over a year and he has just submitted an application to register with the CSCI as a Registered Manager. He is currently undertaking his RMA qualification and he is hope to complete this course by the end of December 2007 and then he is to commence training Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 24 for his NVQ Level 4 in Care. Mr Courtney also takes part in periodic training with the staff group to update his knowledge and skills. The Responsible Individual – Ms Salma Brown - carries out an audit of the home on a six monthly basis. Quality Assurance monitoring questionnaires are sent to people who use the service, their relatives, staff and visiting social and healthcare professionals. This feedback information is analysed, which informs the care home’s annual development plan. The last audit report for the period of January to June 2007 has been produced and made available in the home. Overall the feedback was positive. A member of staff stated “I like working here”. The relatives’ response was positive and mentioned “the new sofa in the lounge is much welcoming and good to see use of sunshades in the garden”. One of the service user said “we can do more of social activities”, “not interested in most of them, not most of the times”. The home has addressed this issue raised by a service user, and now a wide range of social and leisure activities are offered to all people who use the service in accordance with their preference and capacity. Equality and diversity for people who use the service were seen to be promoted throughout the care home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. The home keeps records to show that health and safety of people who use the service is promoted and protected. There is Fire Risk Assessment in place. Evidence was seen of regular maintenance of gas central heating system, emergency lights, the electrical system and equipment. The water system is checked each year for legionella. All accidents, injuries, incidents of illness or communicable disease are recorded and reported to CSCI as appropriate. Records seen show that fire alarm system tests take place each week and that last fire drill took place on 20 August 2007. Fire fighting equipment is also serviced once a year. New members of staff receive induction training in safe working practice topics and then full training is also provided. The staff training records showed that majority of staff have received their mandatory training in safe working practice topics. Staff have now commenced their infection control training. The Acting Care Manager stated that all those members of staff (including new staff), who as yet have not received mandatory training, including refresher training in safe working practice topics (e.g. moving and handling, food hygiene, first aid, health and safety, fire safety, and infection control/COSHH) would do so shortly. The Responsible Individual is also fully aware of this matter. People using the service spoken with were very complimentary about the Acting Care Manager and staff in the care home. They looked at ease in their presence. Little Ashmill RCH DS0000043608.V351402.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 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 2 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 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 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Little Ashmill RCH DS0000043608.V351402.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. 2. Refer to Standard YA35 YA35 Good Practice Recommendations All staff should receive Equality and Diversity training as a matter of good practice. A system should be put in place to ensure that all those staff, who as yet have not received training in safe handling of medication, all safe working practice topics, protection from abuse and NVQ Level 2 can do so as early as practicable to ensure that people who use the service are further safeguarded from any risk of harm or abuse. Records should be maintained of all the social and leisure activities participated in by the people using the service and these should be incorporated into their individual care plans. A system should be put in place to ensure that the risks of scalding from hot water supplies are assessed and that action is taken to minimise any unnecessary risks that are DS0000043608.V351402.R01.S.doc Version 5.2 Page 27 3. YA13 4. YA42 Little Ashmill RCH identified. This is to ensure that the safety of people who use the service. Little Ashmill RCH DS0000043608.V351402.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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. 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