Inspection on 17/10/06 for Long Eaves

This inspection was carried out on 17th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Long Eaves 15/06/07

Long Eaves 18/01/06

Long Eaves 30/07/05

Long Eaves 04/03/05

Long Eaves 28/07/04

Long Eaves 30/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Long Eaves 40 Stafford Avenue Clayton Newcastle Staffordshire ST5 3BJ Lead Inspector Mr Berwyn Babb Key Unannounced Inspection 17 October 2006 09:30 Long Eaves DS0000005112.V313234.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 Long Eaves DS0000005112.V313234.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. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Long Eaves Address 40 Stafford Avenue Clayton Newcastle Staffordshire ST5 3BJ 01782 630375 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) staffsordave@choices.ha.co.uk Choices Housing Association Limited Mrs Jackie Furniss Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 January 2006 Brief Description of the Service: Long Eaves is registered to care for five adults with learning disabilities. It is one of a group of homes managed by the Choices organisation, which is a provider of care for people with learning disabilities in North Staffordshire. Long Eaves is one of a cluster of six homes whose management is overseen by a Principal Officer. It is situated in Clayton, a residential area of Newcastleunder-Lyme. It is located close to a range of amenities and is on a public transport route. The home is a dormer bungalow with a single storey extension to the rear. All bedrooms in Long Eaves are single occupancy (though none have ensuite arrangements) and are located on the ground floor. They are serviced by both a dedicated walk-in shower room, and a domestic bathroom, and a separate toilet. The living accommodation and facilities are domestic in style and design. The Dormer is used to accommodate the office, and the staffs sleep in quarters. There are private gardens to the front and rear, including a seating and barbeque area to the front. There is limited off-road parking in the front driveway. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection for 2006/07 was conducted from mid-morning to early evening on Tuesday the 17 of October. The Registered Care Manager was on duty together with her deputy, with one support worker assisting them in the house, and another providing transport/Escort to a gentleman who was out shopping. A nursing student was also present in the house gaining work experience as part of her placement. One gentleman was suffering from a very heavy cold, which was affecting his whole demeanour adversely. Staff were observed as being particularly sensitive to his needs. The other residents continued with their planned and chosen routines, one of them returning from his input at a local hospice, where he was advising them in producing documents that would be more accessible to people with a learning disability. After a mid-morning drink he was back out again, this time assisting some less mobile residents from another home during their weekly trip to the supermarket. After a communal lunch of rolls, salad, cold chicken, savoury snack, and cheese, one resident retired for his regular afternoon lie down, another watched a film in the residents lounge, a third busied himself on his hobby in his own room, and the others used this time from our import into this inspection. The home was clean, warm, comfortable, and welcoming throughout, reflecting good programs of maintenance and decoration, with a display of knowledgeable and sensitive support from those employed to work there, to allow those who lived there to have the best quality of life that they could. What the service does well: What has improved since the last inspection? Since the inspection on the 18 of January this year, new carpets have been provided in the residents lounge, and in the bedroom of one gentleman. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 6 The shower room has also been fitted with new flooring, this being of the nonslip variety. A new display cabinet has been received for use in the residents lounge 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. Long Eaves DS0000005112.V313234.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 Long Eaves DS0000005112.V313234.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Documents relating to the last person to be admitted to the home demonstrated that there needs and their personal choices had been assessed fully. EVIDENCE: In addition to the confirmation made by the care manager, that all residents received full community care assessments prior to them being considered for the admission to the home, the care plan of the most recently admitted resident was reviewed. This contained a copy not only of that assessment, but also of the notes made by the care manager at the time, of the ability of the home to meet those needs and choices that had been recognised. There was also a copy of the licence agreement that is the contract of each resident with a home, and this covered all those things set out in the standard. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 9 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. Residents had extensive persons centred care plans, and these demonstrated the necessary import to allow them to take risks, and to fulfil those decisions that they had taken about their lives. EVIDENCE: Evidence to support this judgement was taken both from the discussion forward/interaction with the men themselves, from discussion with management and staff of the home, and from minute study of one sample care plan, and more general reference to some of the others. This can be summarised as follows: Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 10 The plans sampled demonstrated care planning based on the assessed and changing needs and personal goals of the individual resident. They contains details of personal choice, and of risk assessments that had been undertaken and used as a basis for input designed to increase their activities and choices, rather than to restrict them. Discussion with one resident confirmed what was documented in that it was his choice to have a nap at a lunch, and with another that he had moved to the home because he was having difficulty with the stairs at his previous home. There were notes about something called Perception Meetings (which inquiry revealed to be a monthly session where each man sat down with the deputy manager to discuss their level of satisfaction with the service, and any concerns that they might have) and the care manager said that these were being transcribed onto audio-tape so that he had access to this information in a form that he could use, and keep to listen to whenever he felt like it. During the next interaction with this resident, in response to the inspector’s prompts he said: I like having it on tape, I listened to my tapes when I want to. At one point during the day a discussion took place between a resident and his personal support worker about where he would like to go for his holiday next year. He said: I must think about it, yes, I will think about it today and then I will let you know. Further evidence of choice came from the recording of likes and dislikes, and the inspector verifying these with two men, especially in relation to their favourite foods, the time they spent out of the home, when they wanted to get out or go to bed, and the choice of what they did outside the home. Consideration of changing circumstances that affected the men was reflected in the review of the first point of contact for one of them, where his elderly parents had moved a long way away, and a cousin in another suburb of Newcastle had agreed to act in Loco Parentis. It was possible to observe the distinction between the level of support being provided in relation to the outcome of individual risk assessments, and the differing abilities in various fields. First one gentleman went out shopping with a driver/escort, whilst another was able to undertake a measure of sheltered employment without supervision from the staff of this home. There was also evidence of individual choice being exercised in relation to receiving Holy Communion, and the sharing of personal information to create Life History records, both in written form, and (currently in the process of being developed) in a computerised form that will enable it to be transferred to a DVD for the residents to view whenever and wherever they want. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 11 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. Residents were seen to be taking part in activities that suited their age and their choice, to have good links with the local community, to retain contact with relatives and friends, to be treated with dignity in the home, especially in the promotion of their independence, and be enjoying nutritious and attractive meals that balanced a healthy diet for their assessed needs, with their individual choice of favourite foods. EVIDENCE: A long discussion took place between the inspector, the Care Manager, and her deputy about attempts that had been made to find appropriate employment for two of the men who had expressed an interest in working. They reported the disappointing outcome of their contacts with an organisation set up to assist disabled people in finding work, as it transpired that their remit was agerelated. (This was prior to the recent legislation outlawing such discrimination) Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 12 Apparently their work was more with school leavers, than with two men one of whom was over 60, and the other over 70. Tim, the deputy manager, is continuing to pursue opportunities through both the job centre and local employers, but so far without success. Some of the resident’s gain therapeutic earnings for jobs they do for the providers, and as these did not affect their other state benefits, they thought on the whole that this would be better for them anyway than gaining cash in one hand, only to lose it out of the other. During the day one resident exercised his choice to go into the town with his support worker/escort in order to buy some new slippers, visit his bank, and have lunch outside the home. Another resident was away from the home at the outset as he was contributing time to an exercise being undertaken by the Douglas Macmillan Home. They have been setting up a bereavement care group, and he has been assisting them to ensure that the documents are as accessible as possible to anybody with a learning disability. This resident return to the home for lunch, and then went out with some residents and staff from another home, to assist with their weekly shop at the local supermarket. This was as part of a therapeutic earnings scheme operated by the providers, and his presence, as the person who pushed the trolley, enabled more residents from that home to participate in the activity of them would otherwise have been possible. Reference to the Person centred care plans, especially for resident x, demonstrated regular contacts with members of his family, the fact that he had chosen what food he would like hats and meal to celebrate his imminent birthday, and the list of his preferred activities (as well as a record of what he had done each day) and the preliminary arrangements that have been made to enable him to go and visit his mother in the Isle of Wight. The care plans also provided evidence of the precise detail of any communication aid being used by the men (Makaton and Moon being two methods noted at this time), together with an explanation of any private vocabulary that each man might use, for example, Hurt being an indication of the desire for a bowel movement. The inspector and all staff present joined in the majority of the men for a lunch of chicken and salad rolls, cheese, and savoury snacks. The gentleman who was not very well struggled to finish his portion, and was treated with respect, dignity, and support by his carers so that he was not rushed. As noted previously, both conversation and reference to care plans provided information about the likes and dislikes of the men in relation to food, and the care plans in discussion with staff demonstrated the import of appropriate professionals to give advice on diet. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 13 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, 20, and 21. Quality for this group of residents in this outcome area was good. This judgement has been made using available evidence including a visit to this service. The support and guidance offered to residents was seen to be sensitive and to meet with their approval, the records showed an extensive understanding of their health care needs and how these were met, staff were trained in the administration of their medication, and time had been spent recording choices relating to death. EVIDENCE: Evidence in care plan and of advice being sought from the clinical nurse specialist in the visual impairment, following which she did an assessment on one man identifying that he had a reversible condition. Her advice regarding the use of contrasting colours to help this man distinguished things was based on her tour of the environment, and this was documented in the care plan, and evidenced through observation around the home in such things as highlighting around his doorway and the serving hatch between the kitchen and the dining area, and exchanging the white toilet seat for a dark coloured one that would stand out from the lightly coloured flooring and tiles. The home had also Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 14 obtained different coloured plates on which to serve differently shaded foods, light plates are dark food and dark plates for light food. Following his operation to correct his eye, several of his care plans had been reviewed to reflect the improved ability across a whole range of activities as his renewed sight enabled him to become more independent and engage in activities to a much greater extent. Care plans also revealed a host of pertinent information about various aspects of the life and conditions of the resident, and with one resident showed an enormous expansion in his quality of life following a review of the form in which his medication was administered, an action that had resulted in a far better compliance with the prescribed release times of each drug, and hence, an enhancement of the result being sought by their original prescriber. The change in behaviour that this had brought about allowed him not only to do more things, but to be more independent in all the things that he did. Other parts of the planned were concerned with maintaining nutritional adequacy, choice of what was wanted on the next birthday, choice of where he wanted to go for his next holiday, and a very sensitive and detailed description of what he wanted to happen when he died. There was also a record of each man receiving an annual O K health check. The administration of medication was planned and delivered on an individual basis. The two of the gentleman this meant that the staff retained full control of the management of their prescribed medicines, but the others enjoyed varying degrees of responsibility for this task themselves. One gentleman was undertaking a programme of education designed at eventually enabling him to be self-sufficient, and he appeared to gain considerable satisfaction from showing the inspector the cabinet in his room (with appropriate lock) where his medications were kept. One of the other men managed his own topical creams and gastric suppressant, leaving the management of his analgesics to appropriately trained members of staff. (Records showed that all staff in this house had been trained and approved to administer medication). The remaining gentleman administered all his own medication from the appropriate cabinet in his room, with (currently) staff monitoring the remaining stock each day, to ensure that no under or overdoses had been mistakenly consumed. The relevant risk assessments concerned with this issue were a clear indication that programs of education and training were being enacted to enable residents to enlarge the number of things that they did for themselves, and only in the most unpropitious circumstances where they had been used to restrict a residents activities. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 15 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 was good. This judgement has been made using available evidence including a visit to this service. Residents were being protected by staff who were aware of all the issues surrounding abuse, and of their needs to assist these men to make any concerns they had known.. EVIDENCE: In relation to the comment in the last report concerning providing relatives with a copy of the complaints procedure, the Care Manager stated that this was done in February 2006, and pointed to personal care records where this had been documented. The inspector undertook a formal interview with one of the support workers, during which she demonstrated an awareness of many forms that abuse could take, and of the almost inexhaustible list of people who might be able to do something to one of her residents against their wishes. Her replies were immediate and instinctive, and would take to demonstrate a genuine concern for those whom she was charged with caring for. She also gave very reassuring answers to the action that she should take in a variety of scenarios that were put to her, and the importance of promoting the protection of the vulnerable adults at Long Eaves. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 16 In response to questions concerning the complaints procedure, she submitted that for some of the residents staff would have to use accumulated knowledge of their usual demeanour and non-verbal ways of expression, in order to determine that something was concerning them. She suggested that once a resident had alerted a member of staff to there being something wrong, then in the first instance the carers on duty would seek to advocate for them, bringing in independent advocates if an amicable solution could not be readily found to the cause of their complaint. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 17 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, and 30. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. The environment was judged to be comfortable, safe, and homely for the residents, and their bedrooms are suited to their needs, as were the communal spaces and service areas of the home, with planned programmes of decoration and renewal, and attention to the elimination of odours. EVIDENCE: The inspector undertook a cursory visual examination of the home from the exterior, and judged that it appeared to be in a most satisfactory condition with no evidence of any maintenance work being needed. As detailed in the opening summary in the home is a dormer bungalow that was not purposebuilt for its current use, and therefore does not stand out from the other housing stock among which it is situated. There are no notices all other stigmatising marks to indicate that it is a care home. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 18 The boundary is made of a mixture of shrubs, and the Care Manager stated that she had requested that these be trimmed. Metal ornamental gates opened and out onto a sloping driveway laid in ornamental bricks, where up to five cars could be part of road. Further ornamental gates to the rear of the property gave access to a back garden that was laid to lawn and shrub, and was well maintained. There was a storm porch protecting the front door (both in good quality UPVC) and this opened into the inner hall where the walls were hung with many pictures of the residents in various poses and locations. To the right of the door was set of stairs leading to the staff office/sleeping in quarters, at the foot of which was located a communal toilet. The dining area on the other side of the hall had a substantial table and upright chairs were all the residents could eat together if they so desired, and there were also easy chairs on the other side of the room. Here, as elsewhere in this home, the residents were protected from the danger of burning themselves on the radiator has by the provision of metal guards, and there was a large serving hatch connecting this room with a kitchen. Next to the kitchen there was a separate lounge, and this was very comfortablely furnished with leather upholstered settees for both two and three people, and with two single chairs. The door of this room (a which is a fire door) was being kept open with a wedge, and it will be a requirement of this report that fire doors should only be kept open with a device that will allow them to close automatically in the event of fire. Those bedrooms that were visited not only displayed comfortable furnishings and the individual natures of those gentlemen who occupied them, but also their individual choices in respect of the level of heating provided, one man asking to have his window left open so that he could keep cool. This person had his own private telephone line, and he had decorated the speed dial buttons with a picture of the person that he would be able to call by pressing that particular button. He was pleased to show off his wardrobe, which like the whole of his private environment was immaculately tidy. In another room, the residents had many pictures of his parents, and he had an appropriate extra wall mounted fan heater, because unlike his neighbour, he had started to feel the cold. He also liked the occasional bottle of whisky, and had his own optic mounted on his windowsill, a reminder of the fact that his parents had for much of their lives been public and is. The domestic style bathroom had ceramic tiles from floor-to-ceiling, and following comments made by a previous inspector, much work had been done by both residents and staff to make suitable decorations that had taken away the clinical feel of the room, and making them more homely place in which to enjoy the warm soak. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 19 The laundry was clean and tidy, with impervious flooring and walls that could be easily wiped down, and the substantial washing machine was furnished with a program that would allow for the sluicing of any item that becomes soiled, and also with a boil program. Systems were in place to keep clean and dirty washing separate, and each man had his own marked plastic container to ensure that his clean laundry was kept separate from that of everybody else. Cleaning and decorating programmes were seen for all the regular maintenance of the home, and know well odours were encountered at any point during this inspection. In summary the home was well furnished, well maintained, and both comfortable and clean throughout. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 20 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 was good. This judgement has been made using available evidence including a visit to this service. Residents were being supported by a staff group with a 100 record of NVQ training to level 2 and above, and were benefiting from recruitment policies and procedures aimed their protection, and a staff training programme covering all mandatory subjects, and the particular needs of people with a learning disability. EVIDENCE: During the afternoon the inspector conducted a formal interview with a member of the support staff covering the following four areas: abuse, an intimate caring task, getting this job, and the management ethos of the home. In discussing her recruitment she was able to confirm and equal opportunities legislation had been followed and that she had responded to situation vacant notice in the local newspaper. After an initial telephone contact she had been sent an application form and request for the names of two referees. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 21 Having been given an interview date, she then initiated her Criminal Records Bureau check, and came to meet the residents and staff of the home where it was intended that should she be successful, she would take up the vacant position. She received a phone call the day after the interview telling her that she had been successful, and arranging for her to have a week long induction at the companys headquarters in King Street Newcastle. After that she spent her first week in the home with somebody showing her the ropes at the beginning of her six-month probationary period. She confirmed that she had both a written contract and job description, and that she was receiving payment as agreed. She stated that she had found the induction training most useful, and confirms that she had received the following mandatory and good practice training: the management of actual and potential aggression fire moving and handling first a food and hygiene personal safety medication abuse and good practice training as follows: Core values Record keeping Communication What is Learning Disability? Sexuality the management of medication Containment Of Substances Hazardous to Health Food and Hygiene Bereavement. When describing how she would bathe a resident she covered the essential health and safety issues, as well as addressing his privacy and dignity, and respecting any choices that he was able to make. Her account also considered ways to promote his independence, as well as maintaining a constant verbal exchange with him, and allowing him safe time in private to enjoy a good soak. When considering the ethos and management style of the home she was able to state that supervision was a real, living, and two-way process, and that it was received at least six times a year. She further stated that her senior managers were always open to approaches by staff who wanted to talk about something that concerned them, and were willing to share their own knowledge to the benefit of others. When asked, she considered that the style Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 22 of management would best be described as being inclusive, transparent, and open. The she was then asked if she would agree to her staff record being examined, and following her agreement to this, all those areas that she had confirmed verbally, were corroborated by the written record. The staff rota was triangulated against the dependency levels of those residents currently in the home, and it was found that there were sufficient staff on duty to meet their assessed and emerging needs. This was further confirmed by observation that at no time during this inspection were staff rushed or not able to meet any request made of them, in spite of the extra work that resulted from the process of the inspection itself. The inspector was delighted to find the all seven of the carers who are employed in various capacities in this home have NVQ to a level 2 and above, and that the deputy care manager has now completed NVQ level 4 (the care managers award). Following up on the requirement of the previous report that staff records should include evidence of Criminal Records Bureau checks, and details of any disciplinary action taken, an examination of the staff records revealed the dates and outcomes of any CRB checks, and the fact that no disciplinary action had been taken against staff in the previous inspection period. Long Eaves DS0000005112.V313234.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 was good. This judgement has been made using available evidence including a visit to this service. The home was seen to be managed by somebody who was both experienced and qualified, who used to various quality of assurance tools to obtain the views of the residents, and strove to see that their health, safety, and welfare, were both promoted and protected. EVIDENCE: The Registered Manager had at least two years experience in her current position, and was both a first line nurse, and a holder of the NVQ level 4 care managers award. She was able to demonstrate their commitment to ongoing training. Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 24 She was supported by a deputy who had also obtained the care managers award, and to whom she had delegated tasks that were appropriate to his position. The home had recently completed a quality audit which was made available to the commission for social care inspection before this inspection began, and a principal officer of the providers visits her home on a monthly basis and sends a copy of her report to the inspector. The scope of obtaining feedback on the services provided had been extended at the suggestion of a previous inspector, and questionnaires had been sent out with the copies of the complaints procedure that were distributed in February 2006. There was a year on year development plan, and this included a three-year rolling programme for the complete redecoration of every part of the interior of the house. As indicated previously, a fire door was found wedged open in the sittingroom, and this will be the subject of a requirement at the end of this report detailing that where a fire doors are open, this should be using an instrument that will ensure that they fully close automatically in case of fire. No other concerns were raised about the health, safety, and welfare of the residents, either from observation during the tour of the environment, or from a review of the records howled in the office which showed that fire drills were held once every three months, the means of escape in time of fire and the emergency lighting were tested every week, that the fire alarms were tested every week, and that each evening a check was made around the house to ensure that the were no obvious dangers of fire, such as smoking materials in bedrooms, 40 electric sockets, or electrical appliances (bin. (This night he check also includes ensuring that the security of the home has not been breached, in that all windows and doors are closed and where necessary locked, and that intruder alarms activated. Certificates confirming appropriate servicing were seen for the gas appliances dated 2/5/06, and for the hoisting equipment dated 8/7/06. In reviewing the care plans risk assessments were seen to be in place to promote the health, safety, and welfare of each individual, and arrangements for the Containment of Substances Hazardous to Health were felt to be adequate. Long Eaves DS0000005112.V313234.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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 4 27 3 28 2 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 4 4 X 3 X X 2 X Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 26 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. 1 Standard YA42 Regulation 13 Requirement The registered person shall ensure that no fire doors are kept open by wedges, and that any that are required to be left open, are retained by a device that will ensure they closed automatically in case of fire. Timescale for action 20/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Long Eaves DS0000005112.V313234.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Long Eaves DS0000005112.V313234.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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