Inspection on 15/07/08 for Naimo Care Home

This inspection was carried out on 15th July 2008.

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

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

Naimo Care Home 09/07/07

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 08/11/2008.

CARE HOME ADULTS 18-65 Naimo Care Home 31 Nanaimo Way Kingswinford West Midlands DY6 8TY Lead Inspector Linda Elsaleh Key Unannounced Inspection 15th July 2008 2:30 Naimo Care Home DS0000069614.V368147.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 Naimo Care Home DS0000069614.V368147.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. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Naimo Care Home Address 31 Nanaimo Way Kingswinford West Midlands DY6 8TY 01384 835001 01384 70250 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) Select Health Care (2006) Limited Miss Karen Jane Richards Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Learning disabilities (LD 3). The maximum number of service users to be accommodated is 3. 2. Date of last inspection 9th July 2007 Brief Description of the Service: Naimo is a three-bedded home registered to provide personal care for younger adults set in a residential area of Kingswinford. The home is approached via the road, down a number of steps, and therefore may not be suitable for a service user with mobility problems. Parking is available on the road. A small block of shops is within easy walking distance and there is a good public transport system. The design and location of the home blends in well with the local community. There are three single bedrooms, none of which are en-suite, located on the first floor and are accessed by service users via stairs. There is no lift available. There is a garden at the rear of the premises. The home should be contacted for information about the current fees for this service. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This unannounced inspection was carried out over two days in July 2008. The purpose was to assess the home’s performance against the key standards in the National Minimum Standards for Care Homes for Adults and report on the progress made to address previous requirements. The findings are based on the information received by us, Commission for Social Care Inspection (CSCI), examination of relevant records and documents kept at the home and discussions with the registered manager, staff on duty and people who live in the home. We received comments from people who visit the home about how think the service has developed. One person told us, “…the manager has been fundamental in altering the culture whilst supporting the staff and service users to do the same…”. Staff told us they feel well supported by the manager. These are two of the comments we received, “Our manager is there for support when we need it” and “…she works with us so any problems we have can be addressed…” Staff supported people living in the home to complete our survey. Overall, the comments were positive about the service. One person told us she was “very happy at the home” and another said she “…speaks to staff about things she is unhappy about.” Two people told us they would like to be supported “to go out a little more.” The atmosphere within the home was relaxed and friendly. People living in the home and staff told us they were pleased with the re-decoration of some of the rooms and the refurbishment of the kitchen. A tour of the premises found it to be suitably furnished, clean and tidy. The requirements made at the previous inspection have been met. What the service does well: The home provides people with a homely atmosphere where they are free to express their views and preferences. Care continues to be provided by an experienced and stable staff team who know people’s individual care needs and preferred routines. The home works closely with other agencies to ensure people’s needs being met. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 6 People are actively encouraged to participate in the day-to-day running of the home. Good systems remain in place for supporting staff to carry out their duties. 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. Naimo Care Home DS0000069614.V368147.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 Naimo Care Home DS0000069614.V368147.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 & 5 Quality in this outcome area is good. People living at the home are provided with information about the service in suitable formats. This information is periodically updated. The care needs and aspirations of individuals are assessed and suitable care plans produced to identify how the service will meet their needs. Contracts are provided to individuals in a user-friendly format. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose was reviewed in July 2007. Information about the staffing complement in the Service User Guide was last amended in June 2008. Both documents are available and produced in text and pictorial formats. The manager has been in post since May 2007 and has since been registered by us (CSCI - Commission for Social Care Inspection). The registered manager’s name and relevant qualifications and experience should be included in the Statement of Purpose. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 9 There have been no new admissions to the home. The manager arranged for the needs of the people living at the home to be re-assessed last year. This included personal care, healthcare and identifying and managing risks. Care plans have also been revised. During our last visit we discussed with the manager the need for staff to receive training in assessing people’s needs. During the last twelve months training has been arranged in holistic assessment of needs, principles of care and the role of the worker to enable staff to develop their skills in this area. Each person living in the home is provided with a written contract/statement of terms & conditions provided in user-friendly, pictorial, formats. Both documents are signed and dated by the individual and a representative of the home. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. People are encouraged to participate in the process for producing care plans that reflect their assessed and changing needs and personal goals. They are involved in discussions for identifying how their needs met and assisted to make informed decisions about how they wish to live their lives. The service regularly consults with people about different aspects of life within the home and provides them with opportunities to participate in the day-to-day running of the home. Risk assessments are produced to ensure the well-being of people living in the home are protected. They are supported to take appropriate risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 11 Care plans are produced in written and pictorial formats and, where applicable, additional guidance is produced for the support to be provided. For example, there is additional guidance on one person’s file for support with personal care, mealtimes and independent living skills. The home has a process for regular monitoring care plans. A monthly update checklist is completed to ensure all aspects of care are included in the process. The home works closely with the relevant health & social care specialists. Staff informed us of their concerns about one person. These concerns are recorded in the person’s file with details of discussions held with the individual and the agencies involved in the person’s care. A risk assessment has been carried out and guidance produced for staff on how to respond to specific behaviours. Regular meetings are arranged to monitor progress and review and update any guidance provided for staff. The following comment was received from a health care professional involved in these meetings, “The staff team have consistently sought advice and acted upon suggestions offered”. The files show formal reviews of the care plans for two people living in the home have been carried out during the last six months. These have involved the individual; their relatives/representatives and significant health/social care specialists. One person told us her family are very involved in ensuring she is well looked after. The third person’s file shows care plans are monitored by the home on a monthly basis. However, the records show the last review of her care plan took place in June 2007. The manager told us a review had recently taken place and minutes of the meeting have yet to be forwarded to them by the funding authority. The manager is advised to keep records of the outcome review meetings in order to demonstrate that any changes to care are made as agreed at the meeting and in a timely manner. The home has continued to work with individuals to further develop their communication passports. One person showed us the changes in her ‘passport’ and the photographs that had been added since our last visit. Staff told us the ‘passport’ for another person had improved communication between the home and the day centre she attends. This has led to a more consistent approach to meeting her care needs and personal preferences. We observed discussions taking place between staff and individuals about people’s plans for the day. The care plans show individuals are not restricted in making their own decisions about the lifestyle they wish to follow. Staff told us they support individuals to make informed decisions by discussing options and possible outcomes of the decisions they make. Two people living at the home told us they are regularly consulted about their individual care needs. One person said, “Staff tell me what to do”. The examples she gave were of situations where staff have provided guidance when supporting her to carry out tasks such as preparing a meal, washing and managing conflict with others. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 12 Regular house meetings are held to enable people living in the home to contribute to how it is run. The minutes show discussions about day-to-day issues and people being encouraged to express their views. Recently people living in the home and staff have discussed replacing kitchen crockery and equipment and how to improve the garden. We were shown photographs of shopping trips to purchase items that have been agreed at the house meetings. People living in the home and staff told us how much they had enjoyed these outings. The care plans identify the varying levels of support individuals need in different areas of their lives. For example, the home continues to meet with health & social care professionals to discuss concerns about one person’s behaviour. A short-term care plan has been produced for another person to ensure she receives appropriate support in her recovery from a major operation. In both cases risk assessments have been carried out and action identified to minimise risks. These are regularly monitored and, where applicable, amendments made. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. People are provided with individual programmes for their personal development and preferred activities. However, a monitoring system should be implemented to ensure activity programmes are followed and people have opportunities to participate in some additional/unplanned activities. Details of the support provided by the service to encourage people to follow their own routines and maintain contact with relatives are identified in the individual’s care plan. People are able to choose from a range of nutritious meals that meet their dietary needs and personal preferences. A pleasant environment is provided for them to enjoy mealtimes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 14 One person living in the home has had a major operation. She told us she did become frustrated in not being able to go out during her period of recovery, but praised the support provided by staff and other people living at the home. During this period a care plan was produced for meeting her needs. She has since made a full recovery and is happy now she is able to resume her normal lifestyle such as going shopping and to bingo. Another person attends a day centre during weekdays. As previously stated, communication between the home and the centre has improved. We observed a member of staff discussing the day’s events and what activities she had taken part in. The care plan for the third resident shows the support provided by the home has enabled her to increase her attendance at art & craft sessions and independent living courses. We spoke to a member of staff who accompanies her and she told us how pleased she was with the progress the person has made. An activity programme has been produced for each person. One of the reports we received about the monthly visits made to the home by the company shows an additional member of staff had been appointed for 15hrs per week. The purpose of the appointment was to provide more individual support to people in participating in activities. The manager told us the person has since left and the company has given approval for the home to use 7 hours per week from this post. We looked at the record of activities provided to one person over a 4-week period. During this period 4 activities had been provided by the home during weekdays and none had been provided during the last 2 weekends. Comments we received from people living in the home included, “…would like to go out a little more” and “there is not always enough staff on a weekend to do things…”. Staff reported, “We are trying to cover extra hours for service user activities ourselves. This is difficult at times [because] someone has to be in the house at all times”. Regular monitoring systems should be introduced to ensure activity programmes are followed and sufficient staff hours are available to deliver planned activities and allow for impromptu activities to take place. Annual holidays are agreed with people who live in the home. Two people said they had enjoyed their holiday year. The manager told us the other person did not wish to go away this year and enjoyed trips to Worcester, the Black Country Museum and walks and picnics with staff instead. Two people told us they are able to follow their own routines, such as choosing when to get up and when to bathe/shower. They also told us they have a good relationship with staff and appreciate the support and advice they provide. People have a key to their bedroom and staff respect the individual’s right to spend time alone in their room. There are no restrictions placed on people accessing communal areas or going into the garden. A health care professional told us the support for individuals to live the life they choose “is improving since the change of ownership”. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 15 Social and communication charts show contact people have with their relatives. Staff discussed how they provide support in maintaining positive relationships. The home does not employ ancillary staff. The staff team is support people to develop their cooking skills and are responsible for all other catering duties. We saw two people preparing their lunch with a member of staff and were told work continues to be done in introducing healthy eating programmes. Nutritional assessments are carried out. One person has diabetes for which she is prescribed medication. Her dietary needs are identified in her care plan and training in diabetes care has been provided to staff. Menus are produced in pictorial format and individuals are consulted about their choice of meals on a daily basis. Basic food hygiene training and refresher courses are provided for staff. The minutes of staff meetings show discussions are held about how people are to be supported to follow good hygiene practices in the kitchen. People have a choice of where to take their meals. This is usually served in the quiet lounge. One person sometimes chooses to sit at the table in the conservatory when they do not feel like socialising. The people living in the home told us they enjoyed their meals. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. The staff team are familiar with the personal and health care needs of individuals and provide support in accordance with their care plans and in the way they prefer. People’s health and well-being is protected by suitable arrangements and procedures for managing medication on their behalf. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff team continue to be familiar with the personal needs and preferences of the people they are supporting. Since our last visit the service has combined the upstairs toilet and bathroom creating more space. This has proved beneficial when assisting a person, whose mobility needs have changed, to get in and out of the bath when taking a shower. The individual told us that since her operation her mobility has improved and she no longer has difficulty getting in and out of the bath. The staff team are closely Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 17 monitoring the situation. The support to be provided to individuals in respect of their personal care is identified in their care plans. All people have access to routine and specialist healthcare services. One person had attended a dental appointment and was resting in her room when we arrived. Health care leaflets and information about medication prescribed to individuals are available to staff. Where applicable, regular meetings continue to be held to discuss how an individual’s health care needs may best be met. A health care professional who works closely with the home told us the staff team is “excellent at considering both psychological & physical health care needs”. All prescribed medication continues to be managed by the service. A written record of consent for this is available on their individual files. Training in the safe handling and administration is provided to all staff. A written medication policy and procedure is available in the home. These were last reviewed in February 2008 and each staff member has signed this document to confirm they have read and understand its contents. One person is prescribed medication to be administered “as required”. A protocol for administering this is available on her file. The medication administration record (MAR) sheets we looked at showed no gaps in recordings. Appropriate records are kept for medication received into the home and returned to the pharmacist. Staff complied with the home’s procedures when administering mid-day medication. The local pharmacist who carries out regular audits on the medication do not identified any concerns. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 18 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. People who live in the home feel their views are listened to and concerns are appropriately addressed. The home’s procedures and practices protect people from abuse and self-harm. The financial well-being of individuals will be more fully protected once the home has addressed a shortfall in its recording practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaint’s policy is included in the Statement of Purpose and Service User Guide and a copy is also available in the hall. People who live in the home are provided with a pictorial copy. We have not received any complaints about the service. The records kept by the home show they have received four complaints during the last twelve months. The home has taken appropriate action to investigate the concerns raised and reported back their findings. We were informed by two people they knew who to speak to if they had any concerns and one person told us they were happy with how the home is dealing with a concern they raised. Others said they had not raised any concerns with the home, but were aware of its procedure for dealing with complaints. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 19 Adult protection policies and procedures are available and contain a flow chart providing staff with easy-to-read guidance what action should be taken. Training is provided on adult protection issues. One member of staff has recently attended update training and arrangements are being made for other staff to attend also. There have been no reported adult protection issues or referrals. No concerns were raised during this visit. Dudley Appointee-ship Unit manages the finances on behalf of two service users and the personal allowance is managed by the home on their behalf. Another person often asks the home to look after some money for her so “it is kept safe”. The home keeps records of all monies they receive, transactions made on people’s behalf and monies returned to them. However, the individual records we looked at contained receipts and collective transactions for example, each person’s record had a receipt for taxi fares that was shared by all three people on different days. The manager showed us the record she keeps to ensure each person takes turn in paying for these journeys. We discussed the need to follow robust processes when managing money on behalf of people living in the home. She said the individual’s contribution to any future collective payments will be recorded separately on their records and on the same day the transaction takes place. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 20 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 & 30 Quality in this outcome area is good. A clean, tidy and safe home is provided for people to live in. The progress made in the implementation of the re-decoration and refurbishment programme has further improved their living environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The company’s handy person is available to the home to carry out minor repairs and a person is employed to look after the garden. The home does not employ any domestic staff. The care staff team undertake these duties and encourage people living in the home to participate. Our tour of the premises found it to be clean, tidy and homely. People who live in the home enjoy the use of the well-kept garden during fine weather. Since our last visit people have been involved in shopping for garden Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 21 ornaments and plants. One person told us she still likes to put out food out on the bird table. Communal areas accessible at all times and people are able to go to their own bedrooms whenever they choose. The communal areas consist of a front lounge, rear lounge/dining room and a conservatory. Supervision is provided to individuals, where assessed as required, in high-risk areas such as the kitchen and bathroom. A redecoration and refurbishment programme has been implemented. The work completed so far includes the re-decoration of hall, stairs and landing, new kitchen cupboards and the refurbishment of the rear lounge and upstairs toilet/bathroom. Work has also been carried out on the drains to eradicate the unpleasant odour in the conservatory. The home continues to use portable fans to control the temperature in the conservatory during hot weather. We were told plans for the refurbishment of this room include measures that will allow the temperature to be maintained at a comfortable level throughout the year. People living at the home showed us their bedrooms and told us they have their own door key. They said they choose their own colour schemes and soft furnishings. All bedrooms are situated on the first floor accessed via the stairs in the hall. Each room is personalised with items belonging to the individual and reflects their own personality and interests. A small office/staff sleep-in room is also located on this floor. There are systems and recording processes in place to ensure all domestic tasks are completed on a regular basis. There are suitable laundry facilities. Infection control procedures are available and training is provided. One member to staff told us she is due to attend infection control up date training this year. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 22 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): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good. A small team of dedicated, experienced and qualified staff provide care and support to the people who live in the home. However, staffing hours should be closely monitored to ensure this is sufficient to meet people’s needs and the management of the service. The home has suitable policies and procedures for the recruitment of staff to ensure the wellbeing and safety of people who live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to operate with a small stable staff team, all of whom are familiar with people’s needs, routines, likes and dislikes. The team is made up of a manager and three support workers. Occasional shifts are covered by a bank worker who is also familiar with the needs of the people who live in the home. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 23 Two members of staff have the National Vocational Qualification (NVQ) Level 2 in Care and one also has NVQ Level 3. One member has commenced Level 3 training. The manager has implemented a training programme for the year. The staff records we looked at show client-centred training attended this year include an introductory course to the mental capacity act, working with people with autism and people with diabetes, safe handling and administration of medication, protection of vulnerable adults and managing challenging behaviour. Arrangements are also made for staff to receive update training such as, first aid, fire safety and infection control. Training in equality and diversity is being planned. A visitor to the home commented, “the staff team are always willing to extend their knowledge and skills to effectively meet service users needs”. An audit of the staff recruitment files carried out by the current owners has been completed and records updated. Following our last visit the home increased its staffing by 15 hours per week. The person appointed left after a short period of time and the post remains vacant. The staff team continue to be flexible in their working hours. The manager’s working week is 24 hours direct care and 16 hours managerial duties. The records and comments we have received show there are shortfalls in the availability of staff. In our survey we asked people to tell us how they think the service could improve and the majority responded that staffing levels could be increased. This issue may be resolved by an appointment being made to the vacant post. However, the home is advised to closely monitor it staffing hours and the manager’s role against people’s current needs and tasks involved in managing the service. The manager continues to support staff by providing them with planned supervision sessions, annual appraisals and regular staff meetings. The supervision records we looked at show regular discussions are held about care planning, practice issues and training needs. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. People who live in the home have confidence in the manager and her ability to ensure their needs are met. Further development in the home’s quality assurance system will endorse people’s belief that their views are valued and underpin the home’s self-monitoring and development of the service. Suitable health and safety procedures are available and training is provided to staff to ensure people live in an environment where their safety is fully protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 25 The manager’s application for registration has been approved by CSCI. She has the relevant experience and skills for working in a residential setting with this client group and is in the process of completing the Registered Manager’s Award (RMA). She told us she feels supported by the staff team and by regular visits from her area manager. Reports are produced of the monthly visits made by to the home by the area manager to monitor the home’s performance. The majority of the manager’s working week involves providing direct care to the people who live in the home. As reported on the previous section of this report, this should be monitored to ensure she is able to effectively meet her managerial responsibilities. The home keeps good records of routine checks, servicing and inspections of appliances and equipment. The staff team is provided with training on health & safety matters. Accident records are appropriately maintained and, where applicable, the relevant agencies notified. The home has a quality assurance system for monitoring its own performance. This needs to be developed further. It is advisable that a monitoring system for assessing how effective the home is in providing a varied programme of activities be implemented. Also the home should produce report of its findings on its own performance and plans for developing the service. This should be made available to all interested parties. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 26 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 2 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 2. Refer to Standard YA1 YA6 YA14 Good Practice Recommendations The registered manager’s name, relevant qualifications and experience should be included in the Statement of Purpose. Records of the outcome of reviews should be kept available in the home to demonstrate care plans are updated in a timely and accurate manner. The activity programmes produced by the home should be regularly monitored to ensure people are supported appropriately to participate in their planned activities and has the capacity to provide some impromptu activities. People’s individual records of monies managed by the home on their behalf should include their contribution to collective transactions, such as when sharing a taxis, on the day of the transaction to demonstrate their financial well-being is fully protected. A more suitable system for controlling the temperature in the conservatory should be fitted in the conservatory as part of the refurbishment programme to ensure people’s DS0000069614.V368147.R01.S.doc Version 5.2 Page 28 3. YA23 4. YA24 Naimo Care Home 5. 6. YA33 YA39 comfort when using this room. Staffing hours within the home should be closely monitored to ensure there are sufficient hours to meet people’s needs and manage the service. The home’s quality assurance system should include a monitoring system for assessing how effective it is in providing varied activity programmes. A report of the home’s findings on its overall performance and its plans for developing the service should be produced and made available to interested parties. Naimo Care Home DS0000069614.V368147.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. 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