Inspection on 16/10/08 for Manor Park Grove, 5

This inspection was carried out on 16th October 2008.

CSCI found this care home to be providing an Good service.

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

Manor Park Grove, 5 28/11/07

Manor Park Grove, 5 11/07/07

Manor Park Grove, 5 01/08/06

Manor Park Grove, 5 20/01/06

Manor Park Grove, 5 23/08/05

Manor Park Grove, 5 22/01/05

Manor Park Grove, 5 29/09/04

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 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Manor Park Grove, 5 Manor Park Grove, 5 Northfield Birmingham West Midlands B31 5ER     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kerry Coulter     Date: 1 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Manor Park Grove, 5 Manor Park Grove, 5 Northfield Birmingham West Midlands B31 5ER 01214765821 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Friendship Care and Housing Association care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Residents must be aged under 65 years Date of last inspection Brief description of the care home 5 Manor Park Grove is a bungalow located within a cul de sac. The home is close to local facilities to include the Great Park and Rubery town centre. Bus routes are within close walking distance. The home has parking facilities for two cars and there is also plenty of on street parking available. Up to four people can live at the home who have a learning disability. Each person is provided with a single bedroom that they can furnish and decorate according to their own choices. There is a large bathroom with assisted bathing facilities and a seperate shower room with a level access shower for people who may have mobility difficulties. In addition to a through lounge and dining area there is a kitchen, laundry room and small office. To the rear of the home is a pleasant garden. Copies of our reports about the home are available in the home on request. The service user guide, dated June 2008 stated that fees to live at the home are 1157.74 pounds per week but that these are negotiated on an individual needs Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 4 Brief description of the care home basis. Things such as transport, toiletries, activities and holidays are not included. The reader is advised to contact the home for up to date information about the fees. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out over one day, the home did not know we were going to visit. This was the homes key inspection for the inspection year 2008 to 2009. Prior to our visit taking place a range of information was gathered to include notifications received from the home and an Annual Quality Assurance Assessment (AQAA) completed by the manager. This provides information about the home and how they think it meets the needs of the people living there. Surveys were sent to health professionals and one person who lives at the home, however at the time of writing this report none had been returned. Care Homes for Adults (18-65 years) Page 6 of 33 Care Homes for Adults (18-65 years) Page 7 of 33 What the care home does well: What has improved since the last inspection? Staff have consulted people about their food likes and dislikes so that people can have their own menu of foods they like. Staff have supported people to attend the health checks they need to stay healthy. The home has obtained an assessment from an Occupational Therapist regarding peoples seating needs so that a new lounge furniture can be purchased that will meet peoples needs. Health and safety checks are done more often to make sure that people at the home and staff are safe. The fire risk assessment has been reviewed to make sure it is up to date and people are protected from the risk of fire. Care Homes for Adults (18-65 years) Page 8 of 33 Staff have received more training so that they have most of the knowledge they need to meet peoples needs. The views of care professionals and relatives have been sought to help the home know what people think they do well and what needs to be improved. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that prospective residents have the information they need to make a choice about whether or not they want to live there. Arrangements are in place to ensure that before people move into the home an assessment is completed to ensure their needs can be met. Evidence: It was observed that the Statement of Purpose and Service User Guide documents are readily available in the home. These documents had been updated and included all the relevant and required information. The service user guide was in an easy read format that included pictures. This gives the information about what the home provides to people who are looking to see if the home can meet their needs and whether or not they want to live there. One person spoken with confirmed that they had seen the guide. No new people have been admitted to the home for sometime, however the home now has a vacancy. The manager said that several people were interested in the vacancy Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: but that formal assessment had not begun. The manager said that visits to the home would be offered to see if the person liked the home before formal assessments took place. Discussion with the manager indicates that any potential new person would be fully assessed to ensure the home could meet their needs. As no one has moved into the home for some time a formal assessment tool is currently not available. This is something that that the Annual Quality Assurance Assessment says is going to be developed. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have most of the information they need to support individuals to meet their needs and ensure their safety and well being. The people living there are supported to make choices and decisions so that they live the life they choose. Evidence: The care provided to three people who live at the home was case tracked. Each person had an individual care plan, which generally detailed how staff are to support the individual to meet their needs and achieve their goals. Care plans stated the likes and dislikes of the person so that staff know what the person wants. Care plans detailed how staff are to support people to meet their communication, social, cultural, health, personal care, dietary and mobility needs. The care plans sampled were generally detailed in content although two were overdue for review to make sure the information was up to date. The manager said that it was planned to review the care plans soon but that staffing difficulties earlier in the year had delayed the reviews. Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: Care plans sampled had some good information about individuals diverse needs to include cultural needs. Evidence was available to show that review meetings are held with people who live at the home. Where appropriate, relatives of people who live at the home are invited to attend the review. Each persons records included individual risk assessments. These stated how staff are to support the person to minimise the risks in areas such as finances, night time support, choking, falls, sunburn, fire evacuation and manual handling. All risk assessments were detailed but as with the care plans some assessments were overdue for review to make sure the information was up to date. Members of staff were observed encouraging people to make choices about day to day matters, such as what to have for their packed lunch and what they wanted to do on that day. Some people who live at the home have difficulties in verbally communicating some of their choices and preferences. Staff described how choice was offered to people, for example by putting a choice of two breakfasts in front of the person so that they could choose the one they preferred. At the last key inspection a member of staff had sought peoples preferences to include food and clothing by completing a collage of pictures they have chosen reflecting their choices. The Annual Quality Assurance Assessment completed by the manager records that the home now intends to complete communication charts for people who do not use speech and to develop the use of objects of reference for one person. Care Homes for Adults (18-65 years) Page 14 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements for activities ensure that people living in the home experience a meaningful lifestyle. The people living in the home are offered a healthy diet to ensure their well being. Evidence: Each person who lives at the home has their own schedule of activities, this shows that most activities are undertaken on an individual basis rather than in a large group. Records and discussions with staff show that activities on offer include visits to the pub, cinema, markets, eating out, college, shopping, holidays, bowling, Cannon Hill Park and reflexology. One person supports Birmingham City Football Club, staff said he often goes to watch matches supported by a member of staff. Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: Activities on offer are generally culturally appropriate, for example one person goes to Cherish House twice a week. Cherish House is a Chinese community centre, the person gets a Chinese meal there and meets friends from the same culture. Another person regularly goes to an Irish club. One person spoken with said they were happy with the activities on offer and said that they were going out to a floristry class that day. When they returned with their flower arrangement they proudly showed what they had made to the staff on duty. Other people were out for part of our visit, one person went to their day centre whilst another went to Cherish House. The Annual Quality Assurance Assessment for the home records that it intended in the next twelve months to explore training opportunities for people via the People in Partnership organisation. It is also intended to make an application to receive copies for a talking newspaper. Care plans detail the support people need to maintain contact with family and friends. Discussion with staff and one person who lives at the home showed that people are supported to maintain contact with their family and friends by visits, telephone calls and sending cards. Where appropriate peoples relatives are invited to attend their review meetings. One person has relatives who find it difficult to visit the home so staff take the person to see them twice a month. One person told us that they were having a birthday party and that they have invited friends and neighbours to the party. Records show they have been supported to send out party invitations to people. Satisfactory food stocks were available and these included fresh fruit and vegetables. Food provided and menus are appropriate to and reflect the cultural background of the individuals who live in the home. Menus showed that meals on offer are varied and nutritious. Where people have special dietary needs due to having diabetes or dysphagia menus were seen to meet their needs. One person is sometimes reluctant to choose healthy option meals and records show that staff encourage them to try healthy options where possible. Discussion with staff indicates that the menus have recently been reviewed and new menus are due to be introduced that have been completed in consultation with people at the home.Each person will have their own individual menu. One person told us that they had sat down and talked with staff about foods they like and dislike to help agree on the menu. Daily records and discussion with one person who lives at the home shows that people are involved in doing the food shopping for the home. This includes shopping in places such as the Chinese centre in Birmingham so that culturally appropriate foods are available. Care Homes for Adults (18-65 years) Page 16 of 33 Care Homes for Adults (18-65 years) Page 17 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are usually recognised and responded to ensuring that their health is promoted. People who live at the home usually receive their medication safely and as prescribed by the GP. Evidence: Care plans indicated the degree of assistance required for personal care, this varied form very little such as prompting to full personal support. Sampled records for one person showed that staff had met with them to agree how they would like to be supported when getting up in the morning. Staff had paid attention to each persons personal care, people were wearing clothes in good condition suitable to their age, culture and gender. Records show that people are supported to go to the hairdressers and barbers regularly. One person told us they were going to the hairdressers soon to have their hair done ready for their birthday party. Records sampled included individual health action plans. This is a personal plan about Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: what a person needs to be healthy and what healthcare services they need to access. Records sampled of the people who live there showed that other health professionals are involved in the care of people to ensure that their health needs are met. Where people had been unwell records showed that appropriate health advice had been sought. Records also showed that people had regular check ups with the dentist, optician and chiropodist where appropriate. One person has been assessed by the Speech and Language Therapist (SALT) as having dysphagia (swallowing difficulties). Guidelines said this person needs to have a soft diet with foods cut up. Staff spoken with were aware of this. The manager said that the SALT was visiting that evening to assess if the person was safe to take their medication in tablet form. One person regulary attends the weight clinic so that their weight is monitored to make sure they are healthy. The two other people at the home were discharged by the clinic a few months prior to our visit, this was on the understanding that the home weighed them monthly. The manager said this had not yet been implemented but had been discussed at the last staff meeting and would be done. One person at the home has diabetes, records showed that they had been unwell due to this and that the home had taken them to hospital. The hospital had advised that daily blood glucose monitoring should be done and the home has started to do this. The GP has put in place a basic protocol for staff to follow that tells staff what the safe range for the blood glucose levels are. However, discussion with the manager and staff shows that staff have yet to receive training in this procedure. Staff have had a recent talk from a diabetes nurse but this did not cover monitoring blood glucose levels. Staff need to be trained to ensure reading taken are accurate and that it is done safely. Discussion with the manager and records show that the GP has been approached to refer the person to the diabetic clinic, the manager said he would try and arrange staff training via the clinic. Medication is stored in a locked cabinet. The home retains copies of prescriptions so that staff can check the correct medication has been received from the chemist. Staff who administer medication have been trained to do so. Medication competence assessments are completed for all staff who administer medication, this includes observation of staff giving medication and staff having to complete questions on medication practice. The pharmacist who supplies medication to the home had recently completed an audit of medication practice and their report said that there were no problems. Medication administration records (MAR) were sampled and found to be in generally Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: good order. Medication administered to people had been signed for and where people had not had their medication the reason for this was recorded. A photograph of the person was attached to their MAR so that any new member of staff would not get confused and give medication to the wrong person. Where people are prescribed medication on an as required basis guidelines signed by the GP were available so that staff know when to give this medication. Where handwritten ammendments had been made to the MAR chart these were signed for and appeared to be accurate. The manager was however reminded that handwritten ammendments should be checked and signed by two staff to reduce the risk of any errors. Unfortunately one person who lived at the home has passed away since the last inspection. Records showed that staff visited the person in hospital before they passed away. Discussions with the manager and staff indicate that staff and people who live at the home attended the persons funeral. The home also ensured that the persons friends at the day centre and their past home knew about the funeral so they could attend if they wanted to. A wake was held at the home following the funeral and was attended by friends and family. Staff spoken with felt that it had been dealt with sensitively and people had received the support they needed. Care Homes for Adults (18-65 years) Page 20 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints procedure, which ensures peoples views are listened to and acted upon. Arrangements are sufficient to ensure that the people living in the home are protected from abuse, neglect and self-harm. Evidence: The complaints procedure is included in the service user guide and was also on display so that visitors to the home are made aware of the procedure. The procedure is in an easy read format that includes pictures so making it easier for people who live at the home to understand. The Annual Quality Assurance Assessment completed by the manager stated that a system for people to complain without the homes staff being involved is in place by posting a card to a senior manager. We have not received any complaints about this service in the last 12 months. The home has a log book for complaints received, this showed that the home had not received any direct complaints since the last key inspection. Since the last inspection there has been an allegation made about a member of staff who works at the home. We were informed of the allegations and the home also reported it to social services as an adult protection matter. Action taken by the home was in line with adult protection procedures. A member of staff spoken with said they would be confident in reporting any concerns to the manager as he listens to what people say. Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: Staff training records and discussion with staff showed that they have received training in the Protection of Vulnerable Adults (POVA) so they know how to identify different types of abuse and what to do if abuse is happening so they can protect the people living there. Some staff have also had training in the Mental Capacity Act. This came into force in April 2007 and is about assessing each persons capacity to make decisions so it is important that staff know about this. Further training is arranged for staff who need it in early 2009. One person who lives at the home is assessed as bruising easily, they also have a history of scratching themselves. Care plans and risk assessments have been completed and record where bruises usually occur, guidance is given within the plan of areas of the body where bruises would cause concern. The financial records for three people were sampled, receipts were available for all expenditure. Staff check monies at the handover of each shift to ensure that the money is still there and any money taken out for people to spend had been calculated properly. Care Homes for Adults (18-65 years) Page 22 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall the home is maintained in a comfortable, clean and tidy condition so that people benefit from a homely environment that generally meets their needs. Evidence: The home was seen to be generally well maintained, homely, comfortable, clean and free from odour. Satisfactory hand washing facilities were observed in the bathroom, laundry and kitchen. The home has a combined lounge and dining area, which is the only shared space available. Some areas of the decor is now looking a little tatty but discussions with staff and the manager indicate that plans are in place the room to be redecorated and carpeted. Since the last inspection the manager has arranged for an occupational therapist to assess peoples seating needs and their report has recently been obtained. The manager said it is intended to purchase new lounge seating in line with the recommendations from the report. There is no communal space for people to receive visitors, take part in activities of have space away from other people other than the lounge/ diner. This is not ideal. Last years development plan for the home indicates that funding for a conservatory was to Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: be sought. The manager said that as yet, no funding is available. At the last inspection the kitchen was observed to have no blind at the window, one staff had raised a concern that the neighbours could look straight in. A blind has now been fitted so that peoples privacy is respected. Bedrooms seen were generally well decorated according to individuals tastes, interests, age and gender. They contained many personal possessions. At one persons review meeting it had been agreed that their bedroom would be redecorated as they would now prefer a different colour scheme. The manager said this had not been done this year due to lack of budget. The manager should ensure this is done as soon as possible so that the person is not too disappointed. Observation of the home and discussion with staff indicates that people have the specialist equipment they needs. A level access shower is available to assist people who have mobility needs to be as independent as possible. The bath has an electric bath chair so that people who have mobility difficulties can have a choice of having a bath instead of a shower if they wish. Discussion with the manager indicates that a new bed is to be purchased for one person whose current bed has been identified as not meeting their continence needs. Care Homes for Adults (18-65 years) Page 24 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a staff team that can support them to meet their individual needs and achieve their goals. People are protected by the homes recruitment practices. Evidence: Since the last inspection the home has had some staffing difficulties with some staff leaving, some on long term sick leave and another on maternity leave. The home let us know about the staffing difficulties they were having and about the arrangements they had made to ensure the home was adequately staffed. In recent months more new staff have been employed and the home is not so reliant on agency staff. During the visit staff were observed to give support with warmth, friendliness and patience and treated people respectfully. Staff have the opportunity to undertake the Learning Disability Qualification and National Vocational Qualifications. As many of the staff team are new the home does not have as many staff with these qualification as before. However staff are being encouraged to undertake this training. Staff spoken with during the visit demonstrated they have good knowledge of peoples needs. We spoke with the manager and staff about staffing arrangements in the home. The Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: manager said that new staff had been recruited and that the home had about seventy staff hours still to fill. One new staff was due to start the following week. Staff spoken with said that there had been some staffing difficulties but that there had always been enough staff on duty to meet peoples needs. One staff said that although agency staff had been used they were regular so that they got to know people well. One staff said that the staffing in the home was now much improved. We looked at the staff rota and this showed that there were enough staff to meet peoples needs. At night there is one waking staff and during the day there are a minimum of two staff on duty. However, there is usually three staff on duty between 10am and 4pm so that people can undertake their chosen activities. Recruitment records for six new staff were sampled, these showed that robust checks are done before staff start work to include obtaining references and a criminal record bureau check. This reduces the risk of unsuitable staff being employed to work with the people living there. The annual quality assurance assessment for the home records that is intended to explore how people at the home can be involved in staff recruitment in a meaningful way. Sampling of records and discussion with staff shows that a programme of training is in place so that staff receive the training they need to meet peoples needs. Staff have training that includes safeguarding adults from abuse, food hygiene, manual handling, medication, diabetes, first aid and health and safety. Discussion with the manager and training records show that arrangements are currently being made for staff to do epilepsy and dysphagia training. This is needed as many staff are quite new and have not yet done this training. One new staff spoken with said that they had an induction to the home and they thought it covered most things. They said they had the opportunity to attend lots of training at the home. Staff spoken with said that they had regular supervision and felt supported in their role. Regular staff meetings take place so that staff are updated with peoples changing needs and are aware of policies and procedures in the organisation. Care Homes for Adults (18-65 years) Page 26 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements ensure that the people living in the home benefit from a generally well run home. Evidence: The manager is registered with us and is experienced in working with individuals who have a learning disability and has previous management experience. The manager has achieved the level 4 National Vocational Qualification in care and also the Registered Managers Award. Discussion with the manager indicates he has kept himself up to date with training. The annual quality assurance system for the home records that the manager has recently completed further management training which included managing staff disciplinary, recruitment and performance management. The manager has ensured that requirements made at the last inspection have been met. Whilst the home has undoubtedly experienced some difficulties in 2008 due to staffing shortages the manager has worked hard to ensure outcomes for people are good. Staff spoken with described the manager as supportive and prepared to listen to Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: people. A representative from FCH, the Provider visits the home monthly and writes a report of their visit to ensure the home is being well managed. Sampling of the reports shows that the views of people who live at the home and staff are sought as part of the visits. Internally, staff complete a variety of audits to include medication, health and safety, activities and infection control to ensure good standards. It is an improvement that the home has now started to send out questionnaires to health professionals and relatives of people at the home to get their views on how the home performing. The home has received several questionnaires back, all but one are positive in their comments. It is recommended that the manager collates the comments into one report and uses the outcome to highlight what could be improved. Systems are in place to help ensure the home is safe for the people who live and work there. Fire records showed that a risk assessment is in place so that the risks of there being a fire are minimised as much as possible. This had been reviewed as recommended at the last inspection. Staff had regularly had fire safety training. An engineer regularly services the fire equipment to ensure it is well maintained. Regular fire drills are held so that the people living there and staff know what to do if there is a fire. Staff regularly test the fire equipment to make sure it is working. It is good that a simple version of the fire procedure in pictorial form is on display to help people know what to do if a fire occurs. The temperature of the water is regularly monitored to ensure it will not pose a risk of scalding to people. It is good practice that staff also complete a weekly visual check of the building to ensure it is safe. Certificates were available to show that equipment had been serviced and was safe to use, this included gas and electrical installations, the hoist and the assisted bath. General risk assessments were seen to be in place for the premises, but as identified at the last inspection some of these need to be reviewed to make sure all the information is up to date. Where new risks had been identified such as the use of portable heaters then risk assessments had been completed. At the last inspection some staff manual handling practice that we saw was unsafe. At this inspection we did not see many examples of manual handling due to people being out on activities. However practice witnessed was safe. Training records show that most staff with the exception of some very new staff have received recent manual handling training. Care Homes for Adults (18-65 years) Page 28 of 33 Care Homes for Adults (18-65 years) Page 29 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 12 Arrangements need to be made for staff to receive training in monitoring blood glucose levels. This will ensure that staff are safe to carry out this procedure and results of monitoring are accurate. 13/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Care plans should be updated at least six monthly to ensure staff have up to date information on how to meet peoples needs. Risk assessments should be updated at least six monthly to ensure staff have up to date information on how to keep people safe. Peoples weight should be monitored monthly as sudden weight loss or gain can be a sign of ill health. Arrange for decoration of persons bedroom where it has been previously agreed that redecoration will take place, to ensure the person is not disappointed that the agreement has not been met. 2 9 3 4 19 25 Care Homes for Adults (18-65 years) Page 31 of 33 5 28 The home has a combined lounge and dining area. There is no alternative communal space for tenants to receive visitors or take part in activities or have space away from the other service users. Consideration should be given to the provision of extra space, for example a conservatory. Brought forward from previous inspections. Increase the numbers of staff who have national vocational qualifications in care so that people are supported by staff who are suitably qualified to meet their needs. The results from questionnaires sent to professionals and family should be collated into one report to highlight where the home could make improvements for the benefit of people at the home. The general risk assessments for the home should be reviewed to make sure the information is up to date and people are protected from unnecessary risks. 6 32 7 39 8 42 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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