Inspection on 26/10/06 for Magdalen Close

This inspection was carried out on 26th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Magdalen Close 24/02/06

Magdalen Close 20/09/05

Magdalen Close 03/03/05

Magdalen Close 12/10/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Magdalen Close 1-5 Magdalen Close Clacton on Sea Essex CO15 3LS Lead Inspector Gaynor Elvin Key Unannounced Inspection 26th October 2006 13:00 Magdalen Close DS0000030726.V316589.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 Magdalen Close DS0000030726.V316589.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. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magdalen Close Address 1-5 Magdalen Close Clacton on Sea Essex CO15 3LS 01255 432951 01255 422784 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) www.essexcc.gov.uk Essex County Council Dennis Bateman Care Home 18 Category(ies) of Dementia (1), Learning disability (18) registration, with number of places Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 18 persons) One person, under the age of 65 years, who requires care by reason of a learning disability and dementia, whose name was made known to the Commission in March 2004 The total number of service users accommodated in the home must not exceed 18 persons 24th February 2006 3. Date of last inspection Brief Description of the Service: Magdalen Close is a local authority residential home, which provides accommodation, personal care and support for people with a learning disability. The property is located at the end of a Cull de sac in a residential area, on the outskirts of the town of the seaside resort of Clacton on Sea, Essex. The home is within walking distance to the post office, shops, pubs, GP surgeries, cinema, local theatre and the seaside. The home is made up of four separate houses, each providing more specific services, two units are for people with more complex needs, one for people aiming towards independence and one is a short stay care unit. Each unit is as domestic, unobtrusive and ordinary as is compatible with fulfilling their purpose and includes a kitchen, utility room, bathroom, lounge and dining area, individual bedrooms and a rear and front garden. Fees range from £62.45 - £1,300.00 per week. The home has two vehicles at their disposal managed by Magdalen Close Motor Vehicle Trust Fund (an independent trust independent of Essex Social Services). Residents (including short break residents) have the opportunity to become members and contribute a membership fee, thus providing savings on public transport. Alternatively residents are supported in arranging other methods of transport, although the cost is the responsibility of the individual. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 26th October 2006, over a period of six hours. All of the Key National Minimum Standards (NMS) for Young Adults and the intended outcomes were assessed in relation to this service during the inspection. The inspection process included reviewing documents required under the Care Home Regulations. A number of records were looked at relating to the residents, staff recruitment, training, staff rosters and policies and procedures. Time was spent talking to residents, relatives, the Registered Manager, the assistant manager and staff. This report has been written using accumulated evidence gathered prior to and during the inspection. Comment cards from 4 residents, 18 relatives of residents, 2 GPs, Social Services and Independent Advocacy Services were completed and returned to the Commission and views expressed are included within the contents of this report. What the service does well: What has improved since the last inspection? What they could do better: Overall the service is performing at an excellent level. All National Minimum Standards inspected met with minimum requirements and some exceeded minimum requirements and were rated ‘4’. The service recognises there is always scope for improvement and the manager and staff demonstrate a positive and pro active approach and is encouraged to continue to develop initiatives and recommendations in good practice. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 6 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. Magdalen Close DS0000030726.V316589.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 Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 4. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home operates a thorough pre-admission process, giving care and attention to ensuring the home is admitting individuals whose entire assessed needs could be fully met. The home promotes the opportunity to visit the home as an essential part of the admission process. Prospective service users are provided with all the information required to enable them to make a fully informed choice about where to live. EVIDENCE: The home has developed a comprehensive Statement of Purpose and Service User Guide, which is very specific to the resident group and considers the different styles of accommodation, support, philosophies and specialist services required to meet the needs of the residents. The information is in a format suitable to the needs of the resident, and their families, for example, appropriate language, pictures and power point (visual) and audio presentation. People who already use the service have been involved in the production of the information. All prospective residents receive a full comprehensive needs assessment prior to their admission, carried out by the manager and individuals are supported and encouraged to be involved in the process. The home endeavours to operate a graded admission policy of visits in progressive duration, covering Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 9 introduction and compatibility with other residents and orientation to the home and staff. The service is efficient in obtaining a summary of any assessment undertaken through care management arrangements, particularly in an emergency situation. Positive comments were expressed to the Commission by the Locality Operational Manager stating that all Social Workers within the team were very happy with the support received by service users and that the home responds well to crisis situations offering respite and emergency care provision. A complaint relating to the cancellation of respite care for a regular user of the service was received. The cancellation was unforeseen at the time, Magdalen Close responded to a crisis, agreeing to an emergency placement for an agreed short period but this was extended and the placement was used as an in house resource. The complainant was satisfied with the homes response, and feedback from the comment card received by the Commission indicated that Mr Bateman, the manager, was extremely prompt and helpful in an intermediary capacity with Social Services. The home has since taken a strong approach to ensure that respite is not to be cancelled and that Social workers must renegotiate arrangements with all parties in the interim response to emergency situations. Before agreeing admission the service carefully considers the assessed needs for the individual and the capacity of the home to meet their needs. Each resident is allocated a key worker and the use of advocates to support residents is strongly encouraged. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The care plans were focused on the individual and developed in partnership according to the individuals’ assessed needs, ability, development of skills and future aspirations. The home is totally committed to supporting all residents including those with limited communication or intellectual skills to make informed decisions, understand the range of options available to them and have the right to take responsible risks. Service users are supported in accessing participating in self-advocacy groups. independent advocacy and Information about residents was handled in accordance with the homes’ written policies and procedures and the Data Protection Act 1998. Records were secure and confidential. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 11 EVIDENCE: The care plans examined were developed in partnership with the resident, according to the individuals assessed needs, ability, development of skills, and future aspirations, following the principles of person centred planning. Excellent detail provided staff with a good understanding of how the resident is to be supported in achieving outcomes. The care plan is used as a working tool and is understood by the individual and all staff, ensuring appropriate, consistent and continued support, and can be used in an emergency by people who are not familiar with its content. Further initiatives were discussed with staff and management around the care planning process, and it is recommended that the plans also be produced in a format that the residents can more readily understand and take ownership of, further developing the total communication environment. The care plans indicated that individual risk was assessed on the basis of their vulnerability and that responsible risks are considered that may benefit the individuals’ development as part of an encouragement to support an independent lifestyle such as road safety awareness. The home responds promptly to unexplained absences by residents, according to written procedure and this is demonstrated in the reports of notified incidents received by the Commission in accordance with Regulation 37. The home reviewed assessment of risk and alternative or improved management strategies were initiated within care planning arrangements to reduce risk and prevent further incidents. From discussion and inspection of documentation it was evident that service users are supported to the best of their abilities to make decisions about their lives. Informal consultation with service users takes place on a daily basis. The service users were supported in accessing independent advocacy services when they were required and some service users participate in a self-advocacy group. Feedback received from the Independent Advocacy Services expressed that the organisation has always had a positive experience when working with the residents who live at Magdalen Close. Arrangements for supporting service users to access their personal allowances were found to be satisfactory. They were fully involved in the process of maintaining their own finances within an individually named high interest account. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 12 Policies and procedures were in place with regard to confidentiality and the manager indicated that staff were made aware of these during induction, and this issue was reinforced continually through supervision. Magdalen Close DS0000030726.V316589.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): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The service promotes the individual’s right to live an ordinary and meaningful life, both in the home and in the community appropriate to their peer group, and to enjoy all the rights and responsibilities of citizenship. Service users are supported to achieve their goals, follow their interests and be integrated into community life and leisure activities. Service users are offered a healthy balanced diet in accordance with preference and dietary requirements. EVIDENCE: The residents are accommodated in small groups within the home in selfcontained houses. The buildings are homely in appearance and service users have access to all areas except for the need to observe the right and privacy of each own bedroom’s. The communal gardens are utilised for organised Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 14 functions such as barbeques, and residents meet and chat with the other residents in Magdalen Close, including neighbours who also reside in the Close and receive support from other care providers. The service users accommodated at Magdalen Close have a wide variation of needs. The home continues to explore ways to achieve a good balance of inclusion and empowerment. A Total Communication environment is an aspect of the service continually developing to achieve a good standard and outcome for service users. New support and development approaches continue to be explored particularly for those service users preparing to move on to a more independent lifestyle. The homes Digital and IT equipment have been utilised for service users as an effective additional visual and aural learning tool for the development of simple independent living skills. Respite care at Magdalen House is for short duration of one to two weeks. Respite residents were supported to continue their usual programme of daily activities throughout their stay. Feedback from relatives of respite users confirmed continued access to day resource services was supported. The home provides opportunities for residents according to their assessed needs to attend learning work initiatives, colleges, resource centres and therapeutic services such as sensory rooms. All residents are supported either one to one with their key workers or in groups to access the cinema, theatres, meals out, evening clubs and football. The home has two vehicles at their disposal managed by Magdalen Close Motor Vehicle Trust Fund (an independent trust independent of Essex Social Services). Residents (including short break residents) have the opportunity to become members and contribute a membership fee. Alternatively residents are supported in arranging other methods of transport, although the cost is the responsibility of the individual. The home supports and recognises family and friendships as an extremely important factor for service users well being and encourages links. Family and representatives are always invited to reviews and staff support service users in maintaining contact by letter writing and telephone calls. One resident has been supplied with a speakerphone to enable regular contact to be maintained with family. Close relatives naturally wish to keep very engaged with the decision making process and feedback from comment cards received by the Commission from relatives were highly complementary indicating the home was inclusive and supportive. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 15 The home actively supports residents to be independent and involved in all areas of daily living in the home. This includes where appropriate, participating with the shopping, meal planning and meal preparation. The home, in line with recommended good practice, has developed initiatives to help ensure the residents are provided with a healthy nutritional balanced diet. In turn this has also helped to promote an awareness of a healthier lifestyle and well being particularly for those residents with healthcare needs or potential healthcare needs. Six staff attended a workshop prepared by the dietician and they are cascading the information to all staff. The home is in receipt of guidance from the dietician and the British Food Foundation giving clear information about different food groups and the recommended daily portions. Staff are supporting residents by providing informed choices and education about healthy eating throughout the menu planning, shopping and meal preparation process. Photo menu books have been improved to include individual photographs of food items, placed in groups such as meats, fish and vegetables to enable residents to pick their favoured items from each group ensuring a balanced meal. Magdalen Close DS0000030726.V316589.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, 20 & 21 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from the approach and support from carers who respond appropriately to their physical and emotional health needs. The arrangements for care planning in this home are good, providing a person centred understanding of the individual and how they prefer assessed personal, health, emotional and social care needs to be met. EVIDENCE: Personal support, in the way the resident prefers, is reflected admirably within individual care plans. Clear information gained in partnership with the service user, developed according to assessed needs; precisely details choices and preferences with regard to personal support and how the service user is to be supported by care staff to achieve outcomes. The key working system is linked to the care planning process. Interaction between the service users and staff was observed to be very respectful and supportive throughout the inspection. Staff were observed to Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 17 consult with service users about their opinions and assisted appropriately to make choices and decisions. The level and style of communication between the carers and service users was reflective of good practice. The service users clearly enjoy the company of the staff and spoke positively about them. Healthcare arrangements were sampled and found to be well-organised and appropriate records maintained. Service users have their own GP and follow ordinary life principles, as appropriate. Feedback received by the Commission from two local GP surgeries indicated satisfaction with the care practice provided at Magdalen Close. They felt that staff demonstrated a clear understanding of the care needs of the residents, medication was appropriately managed and specialist advice is received and incorporated into the residents’ plan of care. One GP commented ‘ I believe the staff provide excellent and exemplary care to the residents worthy of commendation’. From discussion with management and a recently bereaved resident it was evident that staff recognised and supported the emotional needs of the resident as they presented in his grief. The resident praised a group of staff who had provided a close and supportive relationship with him in such a short time since his recent admission due to the loss of his parents, his main carers. Exercise is considered within the healthy living initiative as well as healthy eating. Walking to the local shops for fresh produce is encouraged as an option to going out of town by transport to collect a weekly shop from the supermarket. The healthy living initiative is part of the care planning process to promote well-being and achieve outcomes particularly for those residents with current and potential health problems such as overweight, diabetes and high blood pressure. Good practice initiatives were discussed with the manager in relation to Health Action Planning, a Department of Health initiative to promote well being and identify healthcare needs for people with learning disabilities. The initiative highlights an awareness to identify, record and report additional information, occurrences and observations in the individuals’ physical and mental health and identify any slow deterioration that may otherwise go unnoticed. The gathered information is recorded and may be used in partnership with the GP in annual health checks and medication reviews. The homes Administration of Medicines policy contained the relevant information for staff to follow for the receipt, recording, storage, handling administration and disposal of medication. Staff had successfully completed the combined Essex County Council and NHS medication workbook ensuring appropriate knowledge and skills for safe practice and responsibility in medication administration. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 18 Current residents did not retain, administer or control their own medication, although the manager indicated that some respite residents might do so within a risk management framework. The home is not registered to provide nursing care and endeavours to offer continued care for those residents whose needs can be appropriately met with the support of Community Healthcare professionals. Feedback from health and social care professions indicate that the staff take appropriate decisions when they can no longer manage the care needs of the resident. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a comprehensive and accessible complaints and adult protection policy and procedure. EVIDENCE: The complaint and adult protection policies and procedures remain the same as seen at previous inspections. The complaint procedure is comprehensive and reflective of current good practice, highlighting the importance of complaining or making suggestions for improvement. An alternative version, in pictorial format, more suited to residents needs is provided and explained to each resident. As previously mentioned in the content of this report, one complaint was received by the home since the last inspection. The focus of the complaint was about booked allocation management by the Locality department and did not relate to care practice. The complaint was managed appropriately, according to procedure and to the satisfaction of the complainant. Records demonstrated details of complaint, action taken and outcome. Feedback from GPs, Social Workers and Independent Advocacy stated they had not received any complaints about the home and that they were satisfied with the overall care provided to the residents in the home. Feedback from residents and their relatives/representatives indicated a high awareness of the homes complaints procedure and that they have not had any Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 20 cause for a complaint to made. Relatives spoken with confirmed that they felt comfortable to discuss any concerns and felt they were listened to, and the manager and staff addressed their concerns. A letter of compliment to the home, from a Trident student attending Magdalen Close for a short duration in a school placement scheme, stated that Magdalen Close provided her with good experience and understanding of care and support provision, valuing peoples rights and promoting diversity. An outstanding compliment received from a young teenager. The home had an Adult Protection policy and procedure in place, including Whistle Blowing, which complied with the Public Disclosure Act and the Department of Health guidance ‘No Secrets’. Staff had received individual copies of the Essex local guidelines, informing of the appropriate procedure to alert Essex Vulnerable Adult Protection Committee in response to a suspicion, allegation or evidence of abuse. Update in staff training with regard to Protection of Vulnerable Adults and Challenging Behaviour is required. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 21 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, 25, 26, 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes premises are suitable for its stated purpose; accessible, safe, clean and well-maintained meeting residents individual and collective needs in a comfortable and homely way. EVIDENCE: The four individual houses are in keeping with the local community, domestic and unobtrusive, offering access to local amenities, local transport and relevant support services. The home is designed to provide small group living where residents can enjoy maximum independence in a discrete noninstitutional environment. The kitchen and laundry are designed to enable and promote involvement of residents in domestic tasks and as part of developing or maintaining self-help skills. Bedrooms enable privacy and have locks on the doors; residents have keys to their rooms unless a risk assessment indicates otherwise. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 22 The home has a planned maintenance and renewal programme for the upkeep of the properties and internal redecoration of the properties was evident. The manager and staff are currently decorating rooms in their own time, required for new admissions or those in urgent need of attention, due to long delays in the process by the Local Authority. When rooms are to be re decorated the residents are supported to express their personal choice and participate in the decorating process if they wish. The home has specialist equipment and adaptations needed to meet individual residents needs such as an assisted bath with electronic chair for the purpose of comfortable and safe bathing of the residents and safe assistance for staff in moving and handling. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had adequate staffing arrangements to meet the service users needs. The staff team are diverse and demonstrate a thorough commitment and understanding of the particular needs of the service users. The home supports a commitment to develop staff knowledge and skill but is not supported adequately by its training provider. Robust employment procedures were followed to help ensure residents are protected from abuse. Service users benefit from staff that are well supported. EVIDENCE: Staff spoken with during the inspection presented as confident and knowledgeable about service users. They demonstrated a clear understanding of their roles and responsibilities, based on accurate job descriptions and specifications. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 24 The home is staffed according to the residents assessed needs. Additional agency staff familiar to the home are employed to provide additional support hours, usually for particular individuals admitted for respite with specific high support needs. Some feedback from relatives indicated that at times the home seems short of staff, but this is never to the detriment of the residents. Further discussion indicated that this is possibly due to holidays. A sample of staff files were inspected to ascertain compliance with regulatory requirements relating to recruitment, job induction, training and supervision. Learning and development needs were identified in Personal Development Plans, which are then managed by the organisations training and development team. Whilst the manager is committed to developing a trained, skilled and competent staff team; it is disappointing to see the home is not supported adequately by Essex County Council in the provision of identified staff training requirements. The staff files contained reference to training courses undertaken by individuals during their employment. Whilst there has been a comprehensive range of basic training provided by the authorities training provider, the staff training audit indicated that there were significant omissions or failures to provide sufficient training in the staff group as a whole in mandatory training and updates. For example seven staff required basic food hygiene and seventeen staff members required update to ensure compliance with good practice. This is particularly important as all staff employed contribute to the food preparation and cooking in the individual houses. Training and update is also required for staff in risk and conflict management to ensure competence in their ability to manage situations prior to using SCAPE, an introduction to the concept and philosophical way of management and self-protection when presented with challenging behaviour. Staff requiring moving and handling training and update were required by the organisation to attend allocated sessions centrally despite the fact that the home employs a senior carer, accredited as a moving and handling instructor. Concerns were raised with regard to service specific issues relating to the environment and the assessed needs of individuals, staff would benefit if they were able to tackle environment and equipment, and service specific issues within their own working area in a training session. At the time of inspection, the total workforce having attained a National Vocational Qualification in Care (NVQ) was 13 out of 31. Four staff are currently being supported by Essex County Council to attain NVQ, and the manager had demonstrated initiative in accessing training where able and had acquired a further 6 places for staff to commence NVQ through Profit for Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 25 Learning and utilised the free training resources in healthcare issues provided by the Primary Healthcare Trust. The staff files were organised and each contained a completed and signed pro forma incorporating details relating to the staff member required by regulation. The pro forma evidenced that an appropriate level of vetting had taken place during the recruitment process and the appropriate records had been seen and approved by the Registered Manager as some of the information required by regulation is held centrally in the organisation of the Local Authority. Residents are supported by independent advocates to be involved in the recruitment process, including devising their own questions, which are important to them and having the opportunity to put the questions to the prospective new staff member and having their opinions taken into consideration. The staff felt well supported by the manager and senior carers. Day-to-day contact was maintained and most issues were discussed as they arose. Recorded formal supervision was provided albeit infrequently. The senior carer and the manager advised that an informal approach to supervisions was also taken and this was not recorded. Staff meetings were used for consultation training and the involvement of staff in the development of the service. It was evident that the majority of the staff team demonstrated enthusiasm and innovation, welcoming positive change and were not discouraged by some reluctance displayed by a few. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users benefit from having a positive, innovative and effective management approach in place, dedicated to raising standards and quality outcomes and a management style that is open and encouraging. The home acts upon the outcomes of consultation with the person who uses the service and their families. The service users benefit from well maintained and accurate record keeping. The service users are protected from potential harm by the health and safety measures taken by the service. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 27 EVIDENCE: The Registered Manager, Mr Dennis Bateman has successfully completed NVQ level 4 in care and the Registered Managers Award. The manager continues to demonstrate a positive and pro-active attitude towards the development of the home. His approach to planning and practice; encourages development and change for positive outcomes for the residents, staff and the aims and purpose of the home. Staff spoke well of the support they and the residents received from the manager. The last inspection highlighted the progress in the introduction and implementation of an effective quality monitoring and assurance system to look at service provision, care practice and outcomes for service users. An audit framework was used to examine standard objectives in relation to communication and participation; looking at communication methods and formats, staff training and effective communication, meeting service users assessed communication needs, objectives and outcomes. The process audit looked at the services being delivered and the audit of outcome assessed the benefits achieved by the service user. The results were formulated and carried forward to inform future service development. During this inspection the home has demonstrated the enormous progress the manager and staff have made towards achieving the objectives identified in the quality assessment process. The inspector looks forward to the continuing cycle of quality audit and continuing development of an excellent service. Records were sampled at random. Of those examined, all were found to meet regulatory requirements and National Minimum standards. The service was able to demonstrate that health and safety measures were current and that management systems were in operation. There were no obvious health and safety issues noted at the time of the inspection. There appeared to be clear lines of accountability both within the home and to external management. Reports from the registered provider on the conduct of the home are received monthly by the CSCI in accordance with Regulation 26. Training issues need to be addressed to enable the home to sustain its current position. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 28 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 4 2 4 3 3 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 3 LIFESTYLES Standard No Score 11 3 12 4 13 4 14 3 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 4 4 4 3 3 3 3 Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 29 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 YA6 YA19 Good Practice Recommendations Residents would benefit from care plans produced in additional formats suitable to their needs. Residents would benefit further from Health Action Planning linked with person centred planning to identify and record occurrences and observations over a period of time that may otherwise go unnoticed in identifying healthcare needs for people with learning disabilities. Magdalen Close DS0000030726.V316589.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Magdalen Close DS0000030726.V316589.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. 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