Inspection on 28/07/06 for Malvern View

This inspection was carried out on 28th July 2006.

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 found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Malvern View 26/10/07

Malvern View 26/01/06

Malvern View 03/08/05

Malvern View 14/03/05

Malvern View 03/02/05

Malvern View 17/02/04

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 Malvern View Malvern View 573 Birmingham Road Lydiate Ash Worcestershire B61 0HX Lead Inspector Christina Lavelle Unannounced Inspection (& additional visit 11 August) 28th July 2006 11:15 th Malvern View DS0000041385.V301559.R02.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 Malvern View DS0000041385.V301559.R02.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. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Malvern View Address Malvern View 573 Birmingham Road Lydiate Ash Worcestershire B61 0HX 0121 453 7727 0121 453 7757 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) Malvern View (Lydiate) Ltd Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may also have a mental health disorder that is associated with their learning disability. Service users may also have a physical disability that is associated with their learning disability. 26th January 2006 Date of last inspection Brief Description of the Service: Malvern View provides accommodation with personal care for eight adults (men and women) who must be under sixty-five years of age. Currently the home has no vacancies and the service users are aged from thirty seven up to fifty nine, two of them are women. Service users must require care due to learning disabilities and may also have a mental health disorder or a physical disability associated with their learning disability. Service users can therefore have complex needs and also use behaviours that challenge the service. One stated aim of the home is to provide a homely environment in which continual encouragement, education and stimulation are the core elements of service users’ daily lives. Another aim is to help service users achieve their personal goals, to develop independence and integrate in the local community. Malvern View is situated on the outskirts of the town of Bromsgrove on the public transport route between Bromsgrove and Birmingham. There are local shops within a reasonable walking distance and the home also has two vehicles so that staff can transport service users to the nearest town at Bromsgrove (a few miles away) and take them on outings and activities that are further away. The home is a large, detached house in a residential area. The original part of the building has five bedrooms for service users, which has been extended to provide bedrooms for another three service users. All bedrooms are single and the three in the extension are bed-sits, with en-suite facilities. There is a large and secure garden at the rear of the house with a patio and an enclosed paved courtyard area at the front. Two sitting rooms, a separate dining room, one bathroom, two showers and four toilets are available for everyone to use. The current fee for the service starts at £1550.00 and is dependent on the needs of individual service users, as agreed between the provider and their funding authority. Items not covered by the fee (as indicated in the preinspection questionnaire), include hairdressing, chiropody, personal toiletries, newspapers & magazines and towards holidays that cost over £100 up to £350. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. These inspection visits are part of a key inspection of Malvern View. The main purpose of this inspection is to assess if the service is meeting key National Minimum Standards. The first visit was made unannounced over five hours during the day on a Friday. The second visit was arranged at the first visit so the assistant manager could be there to discuss relevant management issues and the findings of the inspection. This visit was two weeks later on a Friday afternoon and took four hours. A Pharmacist Inspector also visited the home and in about two hours inspected how medicines are managed in the home. Some time in the home was spent in the company of staff and service users, to observe their activities and how they get on with staff and each other. Only one service user was asked about their life at Malvern View privately in their bedroom, as due to their learning disability most service users’ communication and behaviour makes it difficult to obtain their views. Various records kept by staff at the home were also checked and most parts of the house looked at. Comment cards had been sent to the home for service users and their relatives or representatives before the inspection asking for their views of the home. Six were returned and their comments are referred to in this report. Several staff were spoken with on their own and asked how they got their job, about their training and support, the care service users receive, the home and their experience of working there. The assistant manager had also completed a questionnaire before the inspection giving helpful information about the home. Other evidence is obtained from all contacts between the home, provider and Commission since the last inspection. This includes events in the home that had affected service users and reports made by the provider following their monthly visits to check the home is being run properly. Two complaints had been raised with the Commission since the last inspection. Some allegations made were of serious concern in respect of service users’ welfare. Therefore the complaints were referred under Worcestershire inter-agency procedures for the Protection of Vulnerable adults, but the provider took immediate and appropriate steps to safeguard service users. An investigation followed and is continuing, although one matter was fully investigated and was not upheld. What the service does well: Malvern View offers service users a safe and comfortable home, which suitably meets their needs. The house fits in well with other houses nearby and is quite well decorated and furnished. Service users who wanted to have made their bedrooms nice and personal. The garden is a good size for socials and barbecues and the paved area at the front with its baskets of plants, a water feature, chairs and tables is safe and a good place for service users to sit in and have drinks etc when the weather is good. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 6 There is a friendly, lively atmosphere in the home. It was one service user’s birthday and service users and staff were all in the sitting room when this person happily opened their presents. They also had a birthday cake from the home. Most relatives are positive about Malvern View. Three comment they are very happy with the care their family member receives. Also that staff and management are supportive and they are made welcome in the home. Each service user has a care plan so staff should know all their needs and how to meet them. Staff make sure service users’ personal and health care needs are met properly. The plans also show how staff can help keep them safe and what staff can do to help when they are upset. Service users all have a special staff member who gives them some individual attention and tells other staff what they like and dislike. Staff support service users to have more active and interesting lives by taking part in activities in the home and community. They also encourage them to develop their social and life skills. Staff receive relevant training, that includes the needs and care of people with learning disabilities. Staff therefore have the knowledge, understanding and the skills to meet service users’ special needs and also to keep them safe. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Malvern View DS0000041385.V301559.R02.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 Malvern View DS0000041385.V301559.R02.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 at least once during a 12 month period. 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 these visits to this service. Thorough assessment and admission procedures are in place to make sure that service users needs would be appropriately met by the home. EVIDENCE: There have not been any new service users admitted to the home since March 2005. However a service user guide is available for prospective service users which is also provided in a suitable format with pictures and symbols so people with learning disabilities are more likely to understand it. It was confirmed in a previous inspection that there is an appropriate statement of purpose for the home, although staff were unable to locate service users’ contracts. It was previously confirmed staff did make sure that the person who was most recently admitted would be suitable for the home and their needs could be met before their placement was agreed. It was also good to hear from staff how this person has settled in well and is making positive progress in many ways. In view that one service user will be moving soon management discussed how they had already received a referral for a prospective service user. They had started an assessment of this person’s needs by visiting them at their current residence. They had also requested detailed information from their social worker and community nurse and would be visiting them again with care staff. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 9 The prospective service user and/or their family would next be invited to visit Malvern view and be given the information documents about the home. If this was all satisfactory and everyone was in agreement, a trial stay at the home of between 3-6 months would be arranged. A decision would not be taken about the placement continuing until their suitability and compatibility with other service users had been reviewed at the end of this period. This would involve all relevant people, including the service user to the extent possible. Malvern View DS0000041385.V301559.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Good care planning helps staff know service users’ needs and how to meet them properly. Possible risks are also assessed so any risks that could affect service users and other people’s safety are minimised. It would ensure there is a focus on each service user’s wishes and goals when a more person centred approach is fully implemented. Service users make choices and decisions in their daily lives and routines, to the extent they are able to. EVIDENCE: A sample of two service users care records were looked at in detail. They include an identity sheet with background information and their photograph. Ongoing records are kept of significant events in their lives and arrangements they (and/or their family) want on their death are specified. All service users have a plan of their care, based on their assessed needs and covering relevant areas, with objectives and how these will be met. The plans had appropriately Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 11 been reviewed by staff monthly and are reviewed more formally six monthly with families and relevant other people invited to be involved. Whilst plans are sufficiently detailed and cover all aspects of need the home’s care planning format should be more “person centred”, focussing on each individual’s wishes and goals and not so much on generic issues. Some staff have already received training on person centred planning and it is good that the intent was expressed to fully implement this approach in future. Keyworkers and a co-worker are allocated to each service user from the staff team. They confirmed they are expected to take a lead role in helping service users with their personal clothes and toiletries and keeping their bedrooms tidy etc. Also to arrange outings they like and health care checks and escort them to their appointments. Keyworkers are also expected to make a report on the events in service users’ lives each week covering their mood, behaviours, health issues and activities. They are involved in reviewing and updating their plans, with service users if possible. One service said she liked her keyworker and clearly valued their input. Service users’ care records include a general risk taking policy and overview risk assessments. Risk assessments specific to individuals, such as moving & handling, road safety and aggressive behaviour towards themselves and other people had also been carried out. Behaviour management plans specify who could be at risk and how any incidence of aggression should be managed by staff, using techniques such as diffusion and distraction. Restricted physical intervention procedures are in place for some service users, although rarely have to be implemented. They were set up in consultation with a Behaviour Therapist and there are written and visual guidelines available and all staff have to attend training sessions before they can use these interventions. Incidents of aggressive behaviour are fully recorded by staff with details of what was happening at the time, the behaviours used and outcomes. All reports made are checked by the manager and discussed and those involved given any support needed. Staff enable service users to make choices in their daily lives, to the extent they are able, such as when to get up, go to bed and whether to go out or not. Whilst not everyone could fully participate in decision making an external advocacy group facilitate service users’ monthly meetings to try and involve them and obtain their views about the home etc. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to this service. Service users receive support form staff to lead more active and interesting lives and mix in the community, to the extent they are able and wish. Staff also help service users maintain contact with their family and to make choices about their daily lives and routines. It is being ensured that wholesome meals are provided for service users, which they like and promote health eating. EVIDENCE: Each service user has an activity timetable and any activities they have taken take part in are recorded daily by staff. Staff said they aim to take service users out of the home every day if they want to, although clearly activities and outings can only be arranged when staff are available, especially as some service users need 1 to 1 support when out in the community. Others are reluctant to go out far or often, due to the nature of their disability. During the inspection some service users went out to a pub and others had been to town. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 13 Two service users are enrolled in life skills courses at college and attend three weekdays. Most other service users are not able to participate in work related or day services due to their special needs and behaviours. Regular activities some service users enjoy include visiting a snoezelen sensory facility, pottery and swimming. Staff also help them to keep themselves occupied whilst at home e.g. listening to music, doing puzzles and going out into the garden. Social events including barbecues and parties are arranged when service users’ families are invited and service users are encouraged to socialise if they wish. It was seen that outings often include small groups of service users and are not really very focussed on the individual’s interests and social needs. This was discussed with management, who are aware that activities do need to be more structured and “person centred” and intend to promote this approach. Those service users capable are encouraged to be independent and improve their life skills through doing household tasks, cooking etc. One service user said they make their own drinks and like to spend time in their bedroom, rather then be with others. Staff support service users to maintain links with their families. During these inspection visits one person was away at their relatives and another was transported by staff to visit their elderly parent for the weekend. Several relatives confirmed they are made welcome in home and are kept informed and feel well supported by staff and management. Regarding food provided by the home a menu is drawn up, which was seen to include a variety of wholesome meals. Staff said they try to use more healthy food products, and fresh fruit, vegetables, yoghurts etc were seen in the home. Staff are aware of service users preferences and particular dietary needs and provide alternatives to main meals accordingly. Staff always eat meals with service users and try to promote meals as a social occasion. Service users ’plans reflect that their healthy eating should be encouraged and some service users are having a low fat diet to help them reduce their weight. Records of weight are kept and showed there had been some success. This had helped to improve one person’s mobility and must promote their general well-being. Plans also give instructions for staff when service users have special needs in respect of their meals, such as their food needing to be cut up and them supervised when eating, due to possible choking. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including visits to this service; one made by the Commission pharmacist inspector. Service users are supported by staff to ensure that their personal, emotional and health care needs are being met properly. Service users receive medication from trained staff who understand medication management. The storage of medicines does require further review to ensure service users medicines are stored safely and correctly. Healthcare records of medicine requirements need to be up to date and easier to follow. EVIDENCE: Service users’ plans show the assistance they each need with their personal care, physical, emotional and psychological needs. Service users’ care records include details of health related matters i.e. their diet, weight and conditions such as epilepsy. It was good that one person’s diverse personal care needs arising from their ethnicity are taken into account and being met appropriately. Each person has a “My Health Action Plan” booklet as is now expected. They are used to ensure they receive regular and specialist health care check-ups at the usual frequency, or as their special needs require. The booklets also cover Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 15 all aspects of their general health and well being that need to be monitored, i.e. skincare, hearing, feet, nutrition, continence and mobility with any special needs and how they should be managed e.g. a low fat diet and use of skin oil. The medicine policy was detailed and reflected how medicines are handled in the home. The receipt, administration and disposal of medicine were recorded, however the date of opening of medicine containers was not recorded. The majority of the audits done were accurate. Staff have undertaken training on the safe handling of medication. A further six members of staff were going to have this medication training within the next two weeks Storage of service users medicines was not adequate. Medicine was stored in a freestanding metal cupboard next to a radiator in the office. There is an increased potential of the heat from the radiator, when switched on, affecting the efficacy of service users’ medicines. Extra medication (eye drops, inhalers and external creams) was inappropriately stored together in a separate smaller cabinet located on a wall in the office. External preparations (creams and ointments) were stored together with internal preparations with an increased potential of contamination between them. Two service users were prescribed a ‘when required’ medicine for behaviour control, however there was no detailed written procedure or assessment available in the care plan to inform staff under what circumstances that this medicine should be given. This means that service users healthcare needs could be at risk due to a lack of up to date and detailed records. It is good that on the final visit to the home that most of these requirements had already been met, in advance of the home receiving the written report. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Service users’ are supported to give their views of the service and appropriate steps are taken to protect them. EVIDENCE: The home provides a written complaints procedure, which is also in a format people with learning disabilities are more likely to understand. Most relatives said they are aware of this procedure and have no concerns about the service. Keyworkers aim to get to know service users’ preferences and they are then able to advocate better on their behalf. Service users’ meetings are facilitated by a local advocacy group so those able to can express their views, which are minuted and would be passed onto staff at the home. A complaint was made to the home recently from neighbours, regarding noise. Staff had been made aware of this and the situation is now being more closely monitored. Two complaints were also raised with the Commission since the last inspection making some allegations that are of serious concern for service users’ welfare. The concerns had therefore been referred under Worcestershire inter-agency procedures for Protection of Vulnerable adults. An investigation has followed, however the provider took immediate and appropriate steps to safeguard service users. One matter has since been fully investigated and was not upheld and another is ongoing. The home has policies & procedures relating to safeguarding vulnerable adults. Staff interviewed had received training on abuse and adult protection and understand their responsibility to protect service users and whistle blowing. Malvern View DS0000041385.V301559.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including these visits to the service. Malvern View provides accommodation that is safe and meets service users’ needs. Whilst overall the impression of the environment is homely and comfortable some aspects of the premises would benefit from upgrading to make it nicer for service users. A programme to complete the necessary work, with timescales, should be drawn up and actioned. The home is kept clean and good infection control is promoted. EVIDENCE: The property at Malvern View is compatible with nearby housing and gives service users an opportunity to be part of a local community. There are some facilities, such as shops and pubs, within a reasonable walking distance and public transport can be easily accessed and is sometimes used to provide an experience for service users. The home has a comfortable and well-lived in feel and although overall is in a reasonable state of repair and decoration, some areas have been damaged Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 18 and/or now look a bit shabby. This includes the dining room and the kitchen would also benefit from being refitted. Bedrooms are furnished and fitted to meet service users’ special needs e.g. one is sound proofed. Most service users bedrooms are well personalised (as they wish) and those able to hold their own key and lock them if they want to. Environmental Health Services had recently inspected food hygiene at the home’s instigation. Appropriate action was taken to meet recommendations made and were confirmed as satisfactory by an Environmental Health Officer. The home provides appropriate policies & procedures relating to infection control and staff confirmed that disposable gloves and aprons are provided for them to use. The house was seen to be clean and tidy and liquid soap and paper towels are provided in communal bathrooms, which is another means of promoting better infection control. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including these visits to this service. Staffing levels are sufficient to meet service users’ needs and staff receive relevant training to help them meet service users better and keep them safe. Their knowledge of service users’ special needs, and how to care for them, should improve if new staff had completed an accredited induction programme. Service users would be better protected from risk of unsuitable staff providing their care if the home operated more thorough recruitment procedures. EVIDENCE: Management and staff interviewed consider that sufficient staff are deployed to meet service users’ care needs, although at times greater flexibility and/or availability to meet their individual social needs would be of benefit. Staffing rotas confirmed there is always a minimum of five staff on duty during the day, (often six or seven) plus the manager’s 9-5 hours weekdays, with two staff on waking duty during the night. Staff are all expected to undertake the required health & safety training areas. They also receive training on care related topics, such as abuse awareness for vulnerable adults and in respect of service users’ special needs, e.g. autism, epilepsy and positive interventions for management of challenging behaviour. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 20 Further training sessions had been arranged so that new staff could undertake all this training and existing staff knowledge could be “refreshed”. It is also planned to introduce an anti-oppressive practice training session, which is a good way of promoting values and highlighting equality & diversity issues. The provider has a comprehensive induction programme in place that all newly appointed staff have to go through during their first six months. The home is currently negotiating locally to introduce a Learning Disabilities Accredited Training Framework programme (LDAF), which all new staff in care homes for people with learning disabilities are now expected to undertake. Staff interviewed had achieved an NVQ qualification and/or were doing a social care course at college and there is a programme of NVQ training. Staff said the team work together for the benefit of service users. Also that staff meetings are held regularly when they are able to express their views and discuss any plans to develop the service and prospective new service users etc. They feel communication within the team is good and a communication book and shift handovers help this process. A fairly new staff member described their recruitment and appointment. This appropriately had involved them completing an application form, attending an interview and the home obtaining a satisfactory CRB/POVA check before they started work at the home. Their induction had involved an introduction to the service users and staff and time spent with the assistant manager going through fire, health & safety and other relevant procedures. They had then worked with other staff until they had got to know the home’s routines and become familiar with service users’ plans/risk assessments. They are currently working through the home’s induction programme. A sample of staff records were looked at and it was noted the application form does not request a full employment history, and for any gaps to be explained, as is now required. In addition one person’s references were from a friend and a relative, which is not necessarily a creditable source. Whilst this person may have had few previous jobs an effort should always be made to obtain references from their most recent employer or from such as a college tutor or other person who has had a more professional relationship with them. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 The quality in this outcome area is adequate. This judgement had been made using available evidence, including these visits to the service. Whilst there is not a registered manager currently, the home is generally well run and temporary management cover has been arranged. There are processes to ensure that the quality of the service is monitored and continues to develop, for the benefit of service users. Appropriate action is taken by staff to ensure the home is kept safe so that service users and staff are safeguarded EVIDENCE: The registered manager had recently resigned and the first inspection visit was her last working day. Appropriate arrangements had already been put in place to oversee the home, until a new manager is appointed. A registered manager from another of the provider’s care homes had been seconded to the home for several months previously anyway. It was proposed this arrangement would Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 22 continue to support the home and assistant manager, however at the final visit it was confirmed the seconded manager would be submitting an application to register as manager in respect of Malvern View. Currently team leaders are responsible for taking decisions on each shift about service users’ activities and the allocation of staff to support them. They also oversee keyworkers and how they review service users’ plans and complete their monthly progress reports. The inspector was informed however that the delegation of duties to senior staff will be reviewed, including their allocation of specific responsibilities, in order to improve management effectiveness. There is a comprehensive quality assurance and monitoring system in place for the home. This involves monthly audits of all aspects of the service, carried out during the provider’s required monthly visits to the home. As part of this process any shortfalls are identified and an action plan made to address them. The operations manager for the providers’ company and seconded manager discussed their intent to review the way the home is operating currently and to produce an summarised annual development plan. This should be based on the views of service users and other stakeholders and will provide very helpful information for the Commission as part of the inspection process. Regarding the promotion of good health & safety in the home all staff are expected by the provider to complete all the mandatory heath & safety training topics i.e. fire safety, first aid, food hygiene and general health & safety. The pre-inspection questionnaire also confirmed that annual maintenance and servicing is carried out e.g. of the gas and electrical installations in the home. Records kept by the home showed that fire safety checks are undertaken by staff; COSHH and other risk assessments had been carried out and/or are in place and checks such as on water temperatures are regularly undertaken. There were no hazards observed in the environment during these inspection visits, and overall the home it is apparent the home pays due attention to ensuring the safety and welfare of service users and staff. Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 23 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 X Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales. No. Standard 1 YA20 Regulatio n 13(2) Requirement The date of opening of all medicine containers must be recorded in order to undertake a full medicine audit. It was confirmed this requirement was complied with on 11/08/06 Medicine must not be stored near to direct sources of heat e.g. radiator. It was confirmed this requirement was complied with on 11/08/06 Service users care plans must be kept up to date with healthcare needs including specific directions for medicine to be given on a when required basis. External preparations (creams and ointments) must not be stored together with internal preparations (Tablets, liquids etc.) It was confirmed this requirement was complied with on 11/08/06 All medicine must be labelled with the name of the service user. It was confirmed this requirement was complied with on 11/08/06 Staff employed at the home must submit a full employment history, (with any gaps explored and a satisfactory explanation given) before their appointment is confirmed. References must be from a creditable source including their most recent employer. DS0000041385.V301559.R02.S.doc Timescale for action 31/07/06 2 YA20 13(2) 31/07/06 3 YA20 13(2) 31/08/06 4 YA20 13(2) 31/07/06 5 YA20 13(2) 31/07/06 6 YA34 19 31/07/06 Malvern View Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 YA12 Good Practice Recommendations A more person centred approach to care planning should be fully implemented. This should help staff to focus more on the needs, wishes and personal goals of individual service users, in particular their social needs and risk assessments/behaviour management plans. The home should produce a planned renewal and redecoration programme for the premises, with timescales, that will address some parts of the environment that are in need of upgrading. The home should introduce LDAF-accredited induction training for all new staff. An application to register the newly appointed manager for the home should be submitted to the Commission as soon as possible. 2 YA24 3 4 YA35 YA37 Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN National Enquiry Line: 0845 015 0120 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 Malvern View DS0000041385.V301559.R02.S.doc Version 5.2 Page 27 - 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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