Inspection on 22/11/06 for Nottingham Neurodisability Service Hucknall - Rosewood

This inspection was carried out on 22nd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Nottingham Neurodisability... 20/11/08

Nottingham Neurodisability... 08/02/06

Nottingham Neurodisability... 13/06/05

Nottingham Neurodisability... 31/01/05

Nottingham Neurodisability... 08/07/04

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

CARE HOME ADULTS 18-65 Nottingham Neurodisability Service Hucknall Rosewood Hankin Street Hucknall Nottingham Nottinghamshire NG15 7RR Lead Inspector Steve Keeling Key Unannounced Inspection 22nd November 2006 09:00 Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.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 Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.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. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nottingham Neurodisability Service Hucknall Rosewood Hankin Street Hucknall Nottingham Nottinghamshire NG15 7RR 0115 968 0202 0115 964 2747 Address 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) Four Seasons Homes (Ilkeston) Ltd Diane Eden Care Home 32 Category(ies) of Physical disability (32) registration, with number of places Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users accommodated at Nottingham Neurodisability Service Hucknall - Rosewood shall be within category PD The maximum number of service users accommodated at Nottingham Neurodisability Service Hucknall - Rosewood is 32 8th February 2006 Date of last inspection Brief Description of the Service: The Nottingham Brain Injury Centre, Rosewood Unit is a 32 bed care home for service users with moderate to severe physical disabilities who need full care with nursing. The home is situated just off a main road entering the town of Hucknall, on a bus route. Within half a mile radius there are shops, superstores as well as the town centre, leisure activities, market and the parish church. All rooms are located on the ground floor. There is a designated activities room and independent living skills kitchen. There are 29 bedrooms, including 3 double rooms, many with en-suite facilities and access to a garden area via a patio door from their rooms. The fees currently charged at the home range from £530.45 to £736.45 per week with additional payments of £20.00 per hour for one to one monitoring. Additional payments are required for Physiotherapy services, Occupational Therapy services, Clinical Psychology services and Podiatry services. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 6.5 hour period and involved one inspector. The main method of inspection was case note tracking, this is a method of selecting service users within the home and discussing with them their expectations and experiences of living within the home environment. On this occasion the inspector was unable to fully ascertain the views of the case tracked service users but comments from alternative service users were taken into consideration to inform the inspection process. The case tracking method also analyses the records of the service users to ascertain if the service users identified needs are being addressed appropriately within the home setting and that their safety and well being is being maintained. On this occasion two service users notes were case tracked. What the service does well: The pre-admittance assessments and care planning procedures within the home were generally effective in addressing the identified needs of the service users. Service users are encouraged to make independent decisions about their own life and take risks as part of an independent lifestyle. Service users benefit from the provision of a varied social activities programme, encouraged to interact within the local community and maintain appropriate relationships with family and friends. Service users are offered a healthy balanced and nutritious diet that is determined by the preferences of the service users. Service users receive personal support in a way they prefer and require and physical and emotional needs of the service users are met. Practices in relation to medicines management at the home are effective in maintaining the safety of service users. The home provides a comfortable and safe environment, which is well maintained, homely, clean and hygienic. The service users live in a well run home and are supported by an effective management structure. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 6 Recruitment processes utilised at the home promotes the safety of service users Staff receive appropriate mandatory training to promote the health and safety of service users. 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 Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 8 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 Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. We looked at outcomes for the following standards. 2 This judgement has been made using available evidence including a visit to this service. The pre-admittance assessments examined on the day of the inspection evidenced that the service users holistic needs were being assessed effectively. EVIDENCE: The inspector examined the case tracked service users pre admittance documentation and it was evidenced that service users are only admitted to the home following a holistic needs assessment performed by an appropriately qualified member of staff. Prospective service users, family and friends can visit the home prior to gaining residency to assess the suitability of the home it meeting the service users needs. Admission to the home only takes place if the service user or their representative together with the assessor are confident that the needs of the service user can be met at the home. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 10 The two case-tracked notes were detailed in identifying the specific needs of the service users and utilised a recognised assessment tool (Activities of Daily Living). The assessment documentation was clear, concise, signed and dated by the assessor. The assessment process can also utilise the skills of additional members of staff such as the homes Social Activities Coordinator to determine the service users suitability to gain residency at the home. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. We looked at outcomes for the following standards 6, 7, 9. This judgement has been made using available evidence including a visit to this service. The care planning procedures within the home was effective in addressing the identified needs of the service users. Service users are encouraged to make independent decisions about their own life The service users ability to take risks as part of an independent lifestyle is promoted. EVIDENCE: The manager of the home is currently updating the care-planning format. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 12 The revised core care plans are research based and are much more “user friendly” additional information, which is specific to the service users identified needs can also be documented within the revised core care planning format. Two service users files were seen on the day of the inspection. One set of care plans gave specific information to inform staff of the needs of the service user. The second service users care plans relating to mobility, personal hygiene, eating and drinking, moving and handling, elimination, dry skin and pressure ulcer prevention, required more details to inform staff of the needs of the service user. Furthermore an evaluation of the care plans had not been performed in October 2006. The deputy manager following a quality audit of the care plans identified the aforementioned shortfalls prior to the inspection. In identifying the shortfalls through effective quality auditing procedures, the deputy manager was addressing the issues effectively with the qualified nurse responsible for the formulation and review of the service users care plans. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.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): Quality in this outcome area is good. We looked at outcomes for the following standards 12, 13, 15, 16, 17. This judgement has been made using available evidence including a visit to this service. Service users benefit from the provision of a varied social activities programme at the home and within the local community. Service users are encouraged to interact within the local community. Service users can maintain appropriate relationships within family and friends. Service users rights and responsibilities are respected at the home Service users are offered a healthy, balanced and nutritious diet EVIDENCE: Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 14 The deputy manager, Social Activities Coordinator (SAC) and service users stated that the home provides a comprehensive range of social activities beyond the home immediate environment such as trips to the coast, cinema, theatre, local pubs and restaurants so as to promote service users interactions within the community. An examination of the homes activities room evidenced a wide selection of games, DVDs and art and craft materials, which service users can utilise as they wish. Service users also confirmed that significant events such as Christmas, Easter, Bonfire Night etc are celebrated at the home On the day of the inspection Thornton’s confectioners were visiting the home to provide an opportunity for service user to purchase gifts for the forthcoming festive season. Two service users spoken with confirmed that the social activities at the home are good and that staff at the home promote independence whilst respecting individual choice in relation to participation in social activities. The service users at the home also benefit form the specialised Independent Living Skills (ILS) room in which independent living skills such as cooking, laundry and ironing are practiced to promote the service users independence. An examination of the case tracked service users notes evidenced that the activities coordinator records social activities within the care planning documentation. Two service users spoken with stated that they have free access in and out of the building. One service user spoken with had just returned to the home, having been to the local shop. The service user also stated that he attends the local leisure centre to participate in circuit training, which he particularly enjoys. The deputy manager and a member of staff stated that the home operates an open door policy in relation to visitations so as to facilitate and maintain appropriate relationships with family and friends. A visitor to the home and service uses spoken with also confirmed the open access to the home and confirmed that the staff are always welcoming and friendly. In relation to protecting service users who develop intimate relationships the deputy manager could not evidence any policies or procedures to offer guidance to staff to ensure the safety of service users. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 15 The deputy manager stated that to promote the service users safety an assessment would be performed to ensure the service users could give informed consent in relation to intimate relationships. If informed consent were to be established issues in relation to contraception, sexually transmitted diseases and privacy and dignity would be discussed to ensure the safety of the service users. To promote the service users safety, the registered person should ensure that a policy is available to inform staff of appropriate actions to be taken should a service user develop an intimate relationship. The service users and a visitor to the home stated that the meals at the home are good. A four weekly menu is provided to the service users and service users spoken with stated that two meal options are available at lunchtime so as to promote the service users choice in relation to meal provision. On the day of the inspection a menu board was not on display in the dining room, as the display board had been utilised in another part of the building for an educational event. The registered person should ensure that the daily menu board is on display at all times to aid the communication process at the home in relation to meal provision. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.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): Quality in this outcome area is good. We looked at outcomes for the following standards 18, 19, 20. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in a way they prefer and require and the physical and emotional needs of the service users are met. Practices in relation to medicines management at the home are effective in maintaining the safety of service users. EVIDENCE: Service users were asked about the personal support and care they receive, and each said that they were quite happy with the way in which the care was delivered by the care staff at the home. Service user said that the homes routine is flexible and individualistic and that personal interventions are always performed in the privacy of the service users bedroom or in the bathrooms. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 17 One service user stated that he was mostly independent in relation to his personal hygiene and that he was happy that the staff at the home promotes his independence as much as possible. Records in the service users care plans relating to personal care detailed specific equipment and staff compliments required to ensure the service users safety whilst performing personal care. To further promote the service users emotional wellbeing regular service user meetings are performed at the home. The meeting are service user led and service users perform the roles of treasurer, secretary and chairperson. Service users spoken with said that the meetings are particularly useful as service users are informed of changes at the home and are able to contribute to developments within the home. At the time of the inspection no service users were responsible for the selfadministration of medicines. The deputy manager stated that should a service user wish to be independent in the administration of medicines a risk assessment would be performed. If the service users were deemed as being safe, the service user would be supported to be independent in relation to the self-administration of medication. The case tracked service users Medication Administration Records (MAR) charts were examined and it was evidenced that the MAR charts were filled out appropriately and did not have any gaps present. The temperature within the medication fridge had been monitored on a daily basis and the temperature within the medication fridge was within acceptable parameters thus ensuring medication degradation is inhibited. The medication cupboards in the medication room were locked and the temperature within the medication room is maintained at an appropriate temperature by a recently installed air conditioning unit. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.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): Quality in this outcome area is good. We looked at outcomes for the following standards 22, 23. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure in place, which is effectively distributed throughout the home to ensure that concerns and complaints are identified and acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: The person in charge was not investigating any complaints at the time of the inspection and the Commission for Social Care Inspection had not received any complaints appertaining to the service provision at the home. The “Statement of Purpose” which all service users are given on admission to the home contains a copy of the complaints procedure and the complaints procedure was also on display in the foyer of the home. The statement of purpose evidenced that the complaints procedure is clearly written, and is easy to understand, but did not evidence agreed timescales to respond to complaints. Currently the complaints procedure was only produced in one format and it is recommended that a number of formats including large print and pictorial Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 19 representations are made available to enable service users with impaired cognitive and sensory abilities to make a complaint or make suggestions effectively. The inspector discussed the complaints procedure with two service users and a relative visiting the home and it was established that they were aware of the complaints procedure and were confident that should they have any concerns or complaints the manager would addressee them effectively. The inspector examined the homes complaints book. The last complaint was on made on 31.07.06 and related to the slow response of a nurse when a service user used the nurse call button. The complaint was fully documented but the resolution/outcome was not evident in the complaints book. The registered person should ensure that all elements relating to complaints are fully documented which will include the outcome and actions resulting from complaints. Service users spoken with stated that they felt safe and protected within the home. An examination of the staff-training matrix evidenced that staff receive appropriate training in relation to the Protection of Vulnerable Adults (POVA). A member of the staff spoken with on the day of the inspection confirmed that training opportunities in relation to POVA takes place at the home and could demonstrate an acceptable knowledge of issues relating to POVA. An examination of the home documentation appertaining to the management of service users money evidenced that service users money is currently pooled in a joint account (interest free) in which individual names and corresponding monies could be evidenced. Regulation 20. - (1) Subject to paragraph (2), states the registered person shall not pay money belonging to any service user into a bank account unless the account is in the name of the service user, or any of the service users, to which the money belongs; and the account is not used by the registered person in connection with the carrying on or management of the care home. Regulation 20. - (3) The registered person shall ensure so far as practicable that persons working at the care home do not act as the agent of a service user. Following a discussion with the units general manager it was established that the service users money is maintained within a joint account as the service users do not have advocates who could manage the service uses money for them. To promote the financial wellbeing of the service users the registered person should liaise with the social services Adult Residential Services department to Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 20 ensure that the money of service users with impaired cognitive abilities are managed by an effective advocate whenever possible. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. We looked at outcomes for the following standard 24, 30. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe environment, which is well maintained and homely. Service users benefit from a home, which is clean and hygienic. EVIDENCE: The inspector performed a partial tour of the premises as part of the inspection process. The accommodation, which included service users bedrooms, and the communal areas they frequent were well decorated, comfortably furnished and maintained to a good standard. Service users spoken with stated that they were very satisfied with their bedrooms and communal living areas and confirmed that they are encouraged to bring small items of furniture and personal possessions such as family Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 22 photographs, televisions and stereos etc to personalise their individual bedrooms. One service user who has an interest in music had purchased a full drum kit, situated in the service users bedroom; he was able to peruse his interest thus promoting his choice and wellbeing. To ensure the safety of service users, the home has a security system on the front door so that all visitors to the home have to gain consent from a member of staff before entering the building. It was also evident within the foyer of the home that an “In and Out” board is utilised to adhere to fire regulations thus promoting the safety of service users and staff. The home also benefits from attractive gardens areas which are accessible to service users in wheelchairs to utilise in the summer months. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. We looked at outcomes for the following standards 32, 34, 35. This judgement has been made using available evidence including a visit to this service. An appropriate number and skill mix of staff were employed at the home to meet the service users needs. Recruitment process utilised at the home promotes the safety of service users. Staff receive appropriate mandatory training to promote the health and safety of service users. EVIDENCE: Staff employed at the home is in sufficient numbers to meet the needs of the 39 service users accommodated at the home. An examination of the staff rota evidenced that eight carers and two qualified nursing staff were on duty throughout the morning, throughout the afternoon period 4 carers and 2 qualified nurses were on duty and three carers plus one qualified nurse covered the night period. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 24 An examination of staff files and a discussion with the manager evidenced that the homes recruitment policies are followed effectively thus ensuring the safety of the service users. The recruitment documentation of the last two members of staff employed at the home was checked and found to be satisfactory. Both staff members had undergone appropriate Protection of Vulnerable Adult checks together with Criminal Record Bureau (CRB) checks and had provided two written satisfactory references. The homes documentation relating to the recruitment process was well organised and clear. A service users spoken with stated that he is involved in the recruitment process at the home and is invited to be part of the recruitment panel. The service users stated that the inclusion of service users in the recruitment process provides the opportunity for service users to asses the suitability of potential employees. All new staff members received an induction programme that normally takes six weeks to complete. Currently the same induction package is supplied to all staff irrespective of the qualifications or profession. The unit manager stated that the induction process is currently being reformatted to provide a discipline specific induction process to ensure that all grades of staff can be assessed as competent in performing their duties at the home. An examination of the staff training documentation and a discussion with the deputy manager at the home confirmed that the training opportunities were appropriate in ensuring the safety of service users and staff. An examination of the training records evidenced that training is provided in relation to Moving and Handling, First Aid, Health and Safety, Infection Control and the Protection of the Vulnerable Adult. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 25 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): Quality in this outcome area is good. We looked at outcomes for the following standards 37, 39, 42. This judgement has been made using available evidence including a visit to this service. The service users live in a well run home and are supported by an effective management structure. A range of health and safety documentation was examined and demonstrated that the service users safety is protected and promoted EVIDENCE: The manager at the home attended an interview at the Commission for Social Care Inspection on the 4th August 2006 and was assessed as having Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 26 appropriate experience and qualifications to perform the manager’s role at the home. Service users and staff paid particular praise to the manager at the home saying that she was professional, approachable and that the service provision has improved significantly since the manager commenced employment. It was evident that the manager is committed to improving the service provision at the home through effective quality auditing methods in relation to medication management, care planning processes, infection control monitoring and staff training to ensure that policy is translated into practice. It was evident that the homes manager ensures that policies and procedures are readily accessible to all staff at the home to ensure that staff have an appropriate reference resource to promote the health and well being of the service users. A staff member stated that she felt supported by the manager at the home and stated that her supervision sessions were particularly useful and supportive and that the manager’s feedback in relation to work practices is effective. The manager in ensuring that the service users views underpin developments in the home continues to promote an effective consultation process in the form of monthly service user meetings. An examination of the minutes of the meetings evidenced that service users are encouraged to provide an agenda for discussion which could include any topics pertinent the service provision at the home. As mentioned earlier in the report the service user meetings are service user led and service users at the home perform the roles of chairperson, treasurer and secretary. To establish that the health and safety of service users is promoted at the home a range of health and safety documentation was examined It was evidenced that the home is maintained to a good standard throughout and it was determined that appropriate precautions are taken in relation to the control of Legionella contamination, the testing of fire fighting equipment and fire alarms and the maintenance of equipment designed of aid mobility such as wheelchairs, hoists and baths. The maintenance technician employed at the home also performs hot water outlet checks on a monthly basis so as to minimise the risk of scolds, internal and external environmental checks to ensure the safety of the service users. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 27 The maintenance technician maintains excellent records appertaining to the all the aforementioned issues; the documentation was clear, concise and very well maintained. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000058988.V319798.R01.S.doc 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Version 5.2 Page 29 Nottingham Neurodisability Service Hucknall Rosewood No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA22 Regulation 22 Requirement The registered person shall ensure that all elements relating to complaints are fully documented which will include the outcome and actions resulting from complaints. Timescale for action 05/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA15 Good Practice Recommendations The registered person should ensure that a policy is available to inform staff of appropriate actions to be taken should a service user develop an intimate relationship, so as to promote the service users safety. The registered person should ensure that the daily menu board is on display at all times to aids the communication process at the home in relation to meal provision Currently the complaints procedure was only produced in one format and it is recommended that a number of formats including large print and pictorial representations are made available to enable service users with impaired cognitive and sensory abilities can make complaint or make suggestions effectively. DS0000058988.V319798.R01.S.doc Version 5.2 Page 30 2 3 YA17 YA22 Nottingham Neurodisability Service Hucknall Rosewood 4 YA23 The registered person should liaise with the social services adult residential services department to ensure that the money of service users with impaired cognitive abilities are managed by effective advocacy services. Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Nottingham Neurodisability Service Hucknall Rosewood DS0000058988.V319798.R01.S.doc Version 5.2 Page 32 - 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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