Inspection on 13/04/07 for Montfort Fields 12

This inspection was carried out on 13th April 2007.

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

Montfort Fields 12 22/05/09

Montfort Fields 12 03/02/06

Montfort Fields 12 06/10/05

Montfort Fields 12 02/03/05

Montfort Fields 12 21/09/04

Montfort Fields 12 25/02/04

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 Montfort Fields 12 Kington Herefordshire HR5 3AT Lead Inspector Christina Lavelle Key Unannounced Inspection 13th April 2007 12.00- Montfort Fields 12 DS0000024682.V328768.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 Montfort Fields 12 DS0000024682.V328768.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. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Montfort Fields 12 Address Kington Herefordshire HR5 3AT 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) 01544 231030 01544 231030 www.macintyrecharity.org MacIntyre Care Mrs Lindsay Joy Ross Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two service users with physical disabilities in addition to their learning disability may also be accommodated. 3rd February 2006 Date of last inspection Brief Description of the Service: The service provider (McIntyre Care) is also a registered charity and runs many day & residential care services for children and adults with learning disabilities. The registered manager of 12 Montfort Fields is Lindsay Ross but she currently is on a secondment for six months as an area manager for McIntyre Care. During this period one of the home’s senior support workers (Trudi Stead) is acting as the manager of the care home (head of service). Macintyre Care makes six promises to service users in its mission statement: To listen to and treat service users with respect. To help keep service users safe, healthy and fulfilled. To enable service users to make decisions about their lives. To encourage and challenge service users to achieve their ambitions. To enable service users to take their place in the community. To speak up for service users when they want them to. Montfort Fields provides accommodation with personal care for five adults (men and women) who are aged under sixty-five. Service users all need care due to learning disabilities and two service users also have a physical disability. Service users all have profound disabilities and so have high levels of need, which is reflected in the home’s staffing levels. The property is a modern, detached house located in a residential cul-de-sac in the market town of Kington. It is within walking distance of the town’s shops and facilities and the home has two vehicles to provide transport further afield. Service users have single bedrooms and three are a very good size, although none have en-suite facilities. The two ground floor bedrooms are adapted for people with physical disabilities, who may be wheelchair users. For everyone’s use there are bathrooms with shower facilities on both floors and a separate toilet on the ground floor. The downstairs bathroom is assisted for people with physical disabilities. The home has a lounge, dining room and a substantial conservatory with patio doors to the garden. The garden is large, with decking and a summerhouse, providing a very pleasant and safe area for service users. Information about the home is provided in a statement of purpose and service users’ guide. The guide is available from the home and is in a suitable format for possible service users. The current fee for the service is from £56,000 up to £111,000 a year. Additional charges are made for transport costs, holidays, chiropody, hairdressing, toiletries and some recreational activities. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of Montfort Fields. This means that all the Standards that are most important for adults that live in care homes were checked. This visit to the home was made without telling staff and service users beforehand. Time was spent with service users in their sitting room. It was difficult to speak to them about what they think about living at the home because of their disabilities. The acting manager discussed how the home is being run, staffing and service users. Also any changes to the service since the last inspection. Two support workers were asked individually about their training, experience and service users’ care and lifestyles. Five service users’ relatives and three health or social care professionals who are involved with the home had sent in comment cards with their views. Their feedback is referred to in this report. Various records kept by the home and the premises were looked at. There was useful information in a questionnaire the manager completed before this visit. All other information received by the Commission about the home is also considered. This includes reports made by a McIntyre manager following their monthly visits to check how the home is being run. There had not been any complaints made about the home or issues raised relating to vulnerable adults. What the service does well: The home would only offer care to someone if it could meet all their needs. Possible new service users always visit and try out the home before moving in. Service users all have a care plan, which they and their family help to make. Plans make sure staff know all their needs and goals and how they can offer support to meet them. Service users all have busy lives and go out a lot. Staff help them take part in activities they like and encourage them to make choices about their lives. Service users are respected by staff and receive good personal and heath care. Their families are made welcome in the home and kept informed and involved in their care. Relatives’ comments include “The service provided is excellent. I cannot fault it in any way”. They all feel the care at the home is very good. Montfort Fields is an ordinary house, which has helped service users be part of the community. The home is in a good place close to Kington and is very homely and comfortable. Staff make sure the house is fresh, clean and tidy. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 6 There is a stable staff team and so staff and service users know each other well. There are enough staff and they receive a lot of training. This means they understand service users needs and how to support and keep them safe. The home is very well run and managers have necessary skills and experience. Staff receive good support and work well together. The team is committed to making sure service users have a lovely home, good care and interesting lives. 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. The summary of this inspection report can be made available in other formats on request. Montfort Fields 12 DS0000024682.V328768.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 Montfort Fields 12 DS0000024682.V328768.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 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Suitable information is available to help prospective service users decide if they might like to live at Montfort Fields and if the home could meet their needs. Thorough assessment and admission procedures are in place to make sure the home would be able to meet the needs, wishes and goals of new service users. EVIDENCE: Appropriate information documents are provided for the home, including a statement of purpose, service users guide and terms & conditions of residence. The relevant documents are also produced in a format which has symbols and photos and so is likely to be easier for people with learning disabilities to understand. Service users all have a copy of the service users’ guide. Although there has not been a new service user for years it is confirmed with the acting manager that the assessment and admission process for prospective service users would be carefully managed. Staff from the home would always meet them to fully assess their needs, having received a copy of a community care assessment made by a social worker from their funding authority. Visits to the home, overnight stays and a trial stay would be arranged to ensure they fit in with existing service users and their needs can be met. A review meeting would then be held after the trial, involving the home, service user and their representatives, to decide on the suitability and continuation of the placement. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. Service users’ plans show all their current needs and goals, so helping to make sure they receive the support they want and need. Service users are encouraged to make choices in their lives to the extent they are able. Relevant risks are also assessed and service users supported to take reasonable risks to enhance their lifestyle, whilst any possible risks to their safety and welfare are minimised. EVIDENCE: One service user’s care records were looked at in depth and another’s checked briefly. They include relevant background information, their photograph, a pen picture, and a map with people who are important to them. Each service user has a detailed care plan that is drawn up in an appropriately “person centred” way. Plans therefore show their wishes and goals as well as their needs, with actions needed to meet their personal goals specified and any outcomes. Each person’s likes, dislikes and preferred daily routines are outlined and there are pictures and photographs reflecting their hopes, dreams and fears. Service Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 10 users have a copy of their plan in their bedroom, although their involvement in drawing up the plans is somewhat limited because of their learning disabilities. It is clear that the staff team are very aware service users’ needs and wishes must always be put first and foremost. Support staff are allocated to certain service users as their link workers. They spend more individual time with them and take a leading role in making sure their needs are met, such as obtaining toiletries and clothes and maintaining contact with their family. Linkworkers are also fully involved in drawing up and reviewing service users’ plans. They get to know and understand service users’ needs and wishes and advocate on their behalf. Link worker meetings are held six weekly when their allocated service users’ plans, care and activities etc are reviewed. The home formally reviews plans and risk assessments six monthly. An annual person centred planning meeting is also held with service users’ parents and relevant people and their funding authorities arrange a placement review each year. Detailed daily records are kept by the home for service users describing life events, their behaviours, moods, health problems and activities taken part in etc. They provide very helpful information about service users’ ongoing lives, their health, welfare and progress and show their plans are being followed. Each service user has a communication profile including an assessment of their verbal, non-verbal, receptive language, opportunities and needs. They also show if they use a sign language such as makaton & signalong, and the home has guidance and information available if so. McIntyre’s communications officer is soon to help staff reassess and update these profiles and staff have attended a communication workshop. There are various symbols staff use with some service users to enable them to make choices in their daily lives and routines. The home plans to extend the use of pictures and objects of reference for such as menu planning, which will be another positive development. In respect of equality and the diverse needs of service users it is evident that care is provided in an individualised way. Whilst the current group have no particular needs relating to ethnic or cultural issues and they all have profound learning disabilities, the acting manager confirms that gender issues have been considered. The home has accommodated one service user’s family’s request for same sex personal care and they also ensure that male staff always work with a female support worker when providing personal care for the women. Relevant risk assessments are carried out and included in plans showing that staff are taking appropriate steps to keep service users safe, whilst promoting their rights to lead a normal lifestyle. Some risk assessments relate to general areas such as moving & handling, bathing, financial management and within the home environment. There are also individualised protocols to help staff manage service users’ particular behaviours and medical condition such as epilepsy. They show the staffing and other support needed, to enable service users to go out and take part in activities in the community for example. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. Service users are enabled to take part in a wide range of activities, which they enjoy and that also help them develop their social and life skills and integrate within the community. Their rights and individuality are respected and they are supported to maintain links with their families. The home provides varied and wholesome meals that service users like. EVIDENCE: Service users’ interests and social needs are detailed in their plans and there is clearly an emphasis on individualised activities. It is also evident that meeting social needs and enabling service users to take part in activities and go out in the community is prioritised by the home. Staff consider one of their main roles is to facilitate their activities and they work flexibly to provide appropriate support for each person’s needs. Rotas are organised so that individual trips out with two support staff (including linkworkers) are also regularly arranged to such as a sports club, for meals out, theatre visits and sailing. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 12 Whilst most service users find it difficult to attend day services, and would be unable to have a work placement because of their disabilities, they go out often. They take part in activities including horse riding, swimming, sessions at a Jacuzzi/therapy pool, trampolining, bowling and a social club for people with learning disabilities. They also go shopping and use other facilities in Kington. Today one service user was horse riding; others out shopping, for a walk and a small group went out for a picnic, as it was nice weather. When at home activities include helping with household tasks, aromatherapy sessions, games, a trampoline and the home has art materials. Some activities are regular but it is good that if service uses become less able to cope with them and/or do not want to, that staff are continually seeking new opportunities to widen their life experiences. They are currently checking out a farm project for one person. Service users were observed to move freely around the house and garden, although staff were always close by to monitor them and interacted with them in a caring, respectful way. Although service users are not able to take a very active role in cooking or household tasks staff try to involve them as much as possible, even if this is just watching. All the service users have family input and they also advocate for them. Staff help to ensure close links are maintained and provide transport and escorts for visits if necessary. Service users’ relatives’ feedback confirms they are made welcome in the home and are kept involved and informed in their care. They are all very satisfied with the overall care provided and the progress they have made and feel they are settled and happy living at Montfort Fields. The home is also well accepted within the local community and staff and service users are often invited to their neighbours parties and barbecues. Regarding food provided in the home staff say they aim to always cook fresh and home made meals. Menus show meals to be wholesome and varied and they include pasta and rice, salads, and a mix of meat, fish and vegetarian dishes. Staff draw up a set menu but individual’s choices are respected and alternative meals are given and recorded in their daily files. Food stocks were seen to include healthy options such as wholemeal bread and cereals, low fat yoghurts, fresh fruit & vegetables and salad stuff. Each service user has their particular needs in respect of food detailed in their plan with guidance for staff as to any assistance or oversight needed and when for example food needs to be cut up. One person requires a special diet, which staff monitor closely. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Service users receive appropriate support with their personal care. Staff also make sure their health is carefully monitored and that they have routine health care checks and input from health care specialist as and when needed. Service users’ medicines are managed safely in the home on their behalf. EVIDENCE: Service users’ plans detail any support they need with their personal care, with guidelines to staff about their daily & night time routines and at mealtimes, with checklists of care received. It is good that individual’s rights are respected and there is a statement agreed by relevant people on service users’ behalf regarding their personal care and preferences as to the gender of their carers. Service users were all seen on this day to be well presented and appropriately dressed, in accordance with their age, activities planned etc. Detailed information is available relating to each service user’s medical history, condition and their current health and medication. Any health care input they receive is recorded and there is detailed guidance for staff about any particular conditions e.g. epilepsy, with management plans. Staff keep records of any incidence of seizures and have received training on epilepsy. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 14 One relative comments “My daughter’s health issues have continued to hinder her from day-to-day. However staff have become so knowledgeable now that intervention has lessened dramatically thanks to their diligent, responsible care”. It is clear the acting manager and staff know when and how to refer service users when specialist input and support may be needed. Link workers also make sure they have regular routine health care checks. GPs confirm they are consulted appropriately by the home; that there is always a senior to confer with and that their advice is incorporated in the service users’ plans. One GP commenting that “The team there is providing wonderful care”. Records are also kept of all aspects of health related care service users have received, including chiropody, dentist and for their mental health. The home is planning to set up Health Action plans (HAPs) for individual service users. HAPs meet with Department of Health guidance for people with learning disabilities as they help to ensure that their health is monitored; any problems identified and their good health is being promoted. They can also help to show that their special health care needs are recognised and understood and that service users are being supported to stay healthy through preventative as well as routine and specialist health care input. Regarding service users medicines service users have all been risk assessed by the home in respect of them self-administering, which none of them are able to manage. Appropriate policies & procedures are in place for management of medicines in the home and for when medicines can be administered “when required”. The storage arrangements in the home are suitably secure and well organised and keys are kept safely by staff. Administration and other records, e.g. when medicines have to be disposed of are being maintained appropriately and good stock control allows on audit trail of medicines received and in the home at any time. Monthly stock checks and other audits are also carried out. Staff responsible for medication have undertaken relevant training. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Service users’ relatives would feel able to express their views and concerns on their behalf, with confidence they would be listened to and dealt with properly. Robust systems are in place to manage complaints and protect service users. EVIDENCE: The home provides an appropriate complaints procedure and there are also policies and procedures for safeguarding vulnerable adults, including whistle blowing. McIntyre designate their Service manager as the Complaints Officer for care homes, however if they cannot resolve a complaint an Appeals Panel would be set up by a senior person or managing director of the organisation. Managers are also expected by McIntyre to provide in-house instruction for their staff teams in respect of all these procedures annually. Service users relatives confirm they are aware of the complaints procedure but have never needed to make a complaint. There have also not been any concerns raised with the Commission or home since the last inspection and no issues arising relating to the safety of vulnerable adults. Staff receive training during their induction, and then the regular updates on adult protection, and the team have also attended a training session taken by Herefordshire Protection of Vulnerable Adults co-ordinator. Staff interviewed are fully aware of all these procedures and say they would be proactive in reporting concerns. However they are confident that the home’s culture and ethos would never allow poor practice and are clear about their responsibility for protecting service users. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 16 Service users financial affairs are being appropriately managed by the home. They have all had risk assessments carried out in respect of their monies etc., and they are unable to use their money without support. A McIntyre Director is appointee for service users’ Benefits and they can use their personal allowance as they choose. Service users all have a current bank account and staff ensure, in consultation with their relatives when necessary, that money is spent on their behalf for their benefit and that records and receipts are kept. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. Montfort Fields provides accommodation that suitably meets service users’ needs and offers them a safe, clean, very homely and comfortable home. The accommodation is decorated, furnished, equipped and kept to a high standard. EVIDENCE: Montfort Fields is in a good location being in a quiet residential cul-de-sac that is within walking distance of the shops and facilities of Kington. The property is an ordinary modern, detached house that is very homely and comfortable. The house was found to be clean, tidy and fresh throughout and is furnished, decorated, equipped and being maintained to a high standard. One relative comments that “Staff always make huge efforts to ensure the house is a home; bright, modern with amazing commitment, even in the garden” Since the last inspection the sitting rooms, both bathrooms and two bedrooms have been redecorated and look very nice. There is plenty of communal space for service users, including the large, pleasant and secure garden. It is good that plans are being considered for a sensory room in the grounds. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 18 Service users all have single bedrooms that are well personalised and they choose the colours etc. They are able to use their bedrooms as their private space as and when they wish. Attention is clearly paid to maintaining good general health & safety and food hygiene in the home. There are policies & procedures on all aspects, including infection control and staff have undertaken all the mandatory training. There are also protective gloves and aprons available; suitable laundry facilities and arrangements made for the disposal of soiled waste. Montfort Fields 12 DS0000024682.V328768.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. Service users continue to be supported by a stable, competent and effective staff team who know them well. Staff are appropriately trained and supervised. Thorough recruitment procedures are in place, which should help to ensure that only suitable staff are working at the home, for service users’ protection. EVIDENCE: The staff team comprises seventeen support workers, two relief staff and three seniors; one of whom is currently designated as acting head of service. Rotas show there are always at least three support staff deployed throughout the working day (and often more) with one staff waking and another sleeping in at night. Staff are deployed flexibly to facilitate activities out in the community. There have been no staff changes since the last inspection and staffing levels are more than just adequate to meet the individual needs of service users and undertake other home related tasks. This stability is good for consistency of care and staff and service users clearly know each other very well and have a good rapport. The staff team’s obvious commitment to meeting the aims of the service and promoting good quality care for service users is commendable. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 20 One relative comments “We have every confidence in X being looked after by excellent staff at Montfort Fields” and other relatives are also positive about the staff approach and care provided. Regarding staff appointment there has been no new staff at the home for over two years. However it was previously confirmed that McIntyre have thorough recruitment procedures in place. The processes that would be followed should a staff vacancy arise were discussed with the acting manager. This confirmed prospective staff would be required to complete a detailed application form and attend an interview. Also that when appointed a new person would never start work at the home before a satisfactory Criminal Record Bureau (CRB) check and two written references had been obtained. One current staff member’s records included a checklist showing satisfactory references and a CRB check had been received and when; which a registered person should verify. The induction of newly appointed staff includes them having to complete a comprehensive induction programme produced by McIntyre. They then move onto induction training, which is accredited especially for people who work in care with people who have learning disabilities. They are also expected to work for a probationary period before their appointment is confirmed. The staff team are well trained and all but one permanent staff have a National Vocational Qualification in care. They have undertaken all mandatory health & safety topics and also received training related to care and the special needs of services users e.g. adult protection, person centred planning, communication and epilepsy and the manager has attended a session on interview techniques. It is good that the home has a training plan for the coming year showing dates “refreshers” will be needed and other new training such as sexuality & personal relationships. Staff interviewed are clearly knowledgeable about the care of people with learning disabilities and are very aware of and understand service users’ conditions and individual and special care needs. Staff and the manager all receive individual supervision and their sessions are recorded and staff also have an annual appraisal. Staff interviewed feel well supported both as an individual and a team. Team meetings are held regularly and they feel their views are listened to and actioned and that management is open and supportive. Communication within the team is very good and the team work together and put the service users “first and foremost”. They can request any training they feel they need to meet service users’ social and other needs and so have opportunities to develop their skills and knowledge. Montfort Fields 12 DS0000024682.V328768.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. Service users benefit from a home that is being well run by experienced and qualified managers. The management and staff team ethos and approach, and their working practices, promote service users individuality, safety and welfare. Systems are in place to monitor and review the quality of the service, resulting in a plan for its continual improvement, based on what service users want. EVIDENCE: The Commission was appropriately informed about the proposed six-month secondment of the registered manager to an area manager post for McIntyre and appropriate arrangements have been put in place to cover the home. The senior who is designated as acting head of service is suitably experienced and qualified and is working four days a week covering management tasks. During this time she is receiving additional support from the home’s area manager. Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 22 The manager has responsibility for the day-to-day running of the home and overall budgets and service users’ accounts. The other seniors provide support and supervise the support staff. One senior is also responsible for medicines and the other senior is the home health and safety representative. This person’s role includes undertaking monthly audits, regular safety checks, and having an overview of the fire log to ensure that the specified tests and checks are carried out. Senior staff meetings are held six weekly and McIntyre has just started to arrange senior support workers meetings and are looking at their role. This inspection provides evidence that the home is still very well run and it is observed there is and open and positive management approach. The provider organisation is also very supportive to the home and staff team. Monthly heads of service meetings are held and mandatory conferences, covering topics such as “positive management” and one planned soon is on financial management. The home has implemented the provider’s comprehensive Quality Assurance and Monitoring (QA) System. Part of this process includes monthly unannounced visits by the provider’s representative, as is required under the Care Home Regulations, to check how the home is being run. McIntyre have produced a new visit report format, which provides full details of current staffing, training, service user occupancy, service user and staff interviews and their observations. They also check records such as service users’ monies, care plans; complaints; medication and look around the environment. This results in an action plan, with dates for completion of actions and by whom. There is an annual service development plan produces which is also based on views of the home obtained form relevant other people. Progress to meet all the specified actions in these plans are always reviewed in the home’s monthly team meetings. Regarding health & safety staff undertake all the necessary training topics with regular refreshers. Information received from the home and/or records kept show that a fire drill has been arranged recently; weekly fire tests are carried out; bath temperatures are checked daily and an external check for compliance with Legionella has been undertaken. In addition the portable bath appliances are serviced regularly and the home has COSHH risk assessments and suitable arrangements for the disposal of soiled waste in place. There were no safety hazards identified during this visit and regular health & audits are being carried out. It is evident staff understand their responsibility to promote the health, safety and welfare of service users and their particular vulnerabilities due to their profound disabilities. Their working practices promote safety in the home and any possible risks to the health and welfare of both service users and staff are being identified and minimised. Montfort Fields 12 DS0000024682.V328768.R01.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 3 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 4 25 4 26 X 27 3 28 4 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 4 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 3 4 X X 3 X Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NA STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered persons 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the registered provider to consider carrying out. No. Refer to Standard Good Practice Recommendations Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Montfort Fields 12 DS0000024682.V328768.R01.S.doc Version 5.2 Page 26 - 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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