Inspection on 19/12/07 for Nottingham Neurodisability Services Aspley

This inspection was carried out on 19th December 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Nottingham Neurodisability... 07/07/08

Nottingham Neurodisability... 28/08/07

Nottingham Neurodisability... 29/08/06

Nottingham Neurodisability... 06/12/05

Nottingham Neurodisability... 23/05/05

Nottingham Neurodisability... 13/07/04

Nottingham Neurodisability... 10/06/04

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

CARE HOME ADULTS 18-65 Nottingham Neurodisability Services Aspley Robins Wood Road Aspley Nottingham NG8 3LD Lead Inspector Karmon Hawley Unannounced Inspection 19th December 2007 10:00 Nottingham Neurodisability Services Aspley DS0000059536.V351895.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 Services Aspley DS0000059536.V351895.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 Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nottingham Neurodisability Services Aspley Address Robins Wood Road Aspley Nottingham NG8 3LD 0115 942 5153 0115 942 5154 aspley@fshc.co.uk/ colette.manning@ffhc.co.uk 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 Post Vacant Care Home 32 Category(ies) of Physical disability (32) registration, with number of places Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Aspley Neuro-disability Unit is a purpose built unit situated in the inner city area of Nottingham. The home is within access to local shops, library, health centre, churches and a pub. A variety of communal areas are available which includes two lounges and a dining area. Resident’s bedrooms are situated on the ground floor and the first floor and a passenger lift facilitates access to the first floor. All bedrooms are of single occupancy and fitted with an en-suite facility. The fees currently charged at the home start at £650 per week depending upon individual needs. Additional costs for hairdressing, newspapers, toiletries, holidays and podiatry intervention are charged at current retails prices. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken by an inspector reviewing all the previous inspection records available, looking at information provided by the manager about the service and by undertaking a visit to the service with the inspector using a method called “case tracking.” “Case tracking” involves identifying individual service users who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. The inspector also checked that information provided by the manager matched individual experiences of the service user living at the home by talking with them and observing the care received. Documents were read as part of this visit and medication was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken, all communal areas were seen and a sample of bedrooms to make sure that the environment is safe and homely. Three members of staff and three residents were spoken with as part of this inspection. In addition the views of three other residents who were not part of the “case tracking” were sought to form an opinion about the quality of the service. The registration document was reviewed as part of this inspection to ensure it was correct. No amendments were necessary at this inspection. What the service does well: On entering the home staff were welcoming and respectful. Staff were observed to interact well with residents and good relationships were observed. Residents offered the following comments: “I am settled here, the staff are very good, you can have a laugh and a joke with them,” I am comfortable, I get help when I need it,” “I was able to bring in my own things which has made me feel better as it is more like home,” and “the staff are nice and friendly, there are no restrictions imposed upon you.” Staff spoken with were knowledgeable in regards to service users individual needs and were able to discuss the level of care that they offered. A wide variety of activites are on offer should residents choose to join in and regular trips into the local community take place. Residents are supported to attend day centres or jobs if needed. Residents individuality and their personal needs are respected and staff offer care according to this. Residents may spend their time as they choose and lead an independent lifestyle as they wish. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 6 Staff training remains at a good standard and both compulsory and specialist training has been achieved, ensuring that a knowledgeable staff team are available to meet service users needs. What has improved since the last inspection? What they could do better: Provide more information about the terms and conditions of the service and the cost of each persons care so that they are fully aware of how much it will cost them to live in the home before they decide to move in. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 7 To further develop risk management plans to ensure that all highlighted risks are reduced are far as practicable and thus residents are protected. To further explore the practice of using disrespectful language and whether deemed appropriate or not must be explored further for each individual service user, this must also be documented to ensure that all service users are protected from abuse. The recruitment polices and procedures needs further attention to ensure that residents are fully protected from unsuitable people being employed. 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. Nottingham Neurodisability Services Aspley DS0000059536.V351895.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 Services Aspley DS0000059536.V351895.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): 1,2,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the service users guide has been updated, further information about individual costs and the terms and conditions of admission is required to ensure that residents have all the required information needed to make an informed decision before moving into the home. Prospective residents are assured that their individual needs will be assessed and that these can be met before they decide to move into the home. EVIDENCE: The service users guide has now been updated and reflects the minimum fee charged for the service, ensuring that residents have the basic information required. The manager stated to ensure that each individual is aware of the specific cost of their care a contract and terms and conditions of admission is currently being devised, a copy of this however was not available. Prior to admission the manager visits prospective residents in the community if able to carry out a preadmission assessment to ensure that staff are able to meet their needs. There was evidence of the preadmission assessment taking place within the residents files observed, there was also evidence that essential equipment had been obtained before a resident was admitted. On speaking with one resident they discussed how they had visited the home before they decided to move in and they had received all the information they felt they had needed to enable them to make a choice. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 10 Nottingham Neurodisability Services Aspley DS0000059536.V351895.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): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and assisted appropriately to ensure that their individual needs are met. Residents are enabled to make their own decisions and take risks as part of an independent lifestyle. EVIDENCE: Residents undergo various assessments such as the activities of daily living; manual handling and nutritional needs to ascertain resident’s needs. Plans of care are then based upon these findings. Plans of care seen were personalised and reflected resident’s individual needs and preferences and informed staff on how the needs of residents can be met. Relevant plans of care were in place for individuals in regards to supporting and assisting them with their religious needs, sexual orientation and specialist needs such as speech and language therapy and aids used. There was evidence of residents being involved in the plan of care and negotiating this with the staff. Reviews were seen to take place on a regular basis and the plan of care updated to reflect any changes with the exception of one plan, which was no longer relevant; this was Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 12 discussed with the manager. Risk assessments were also in place for all highlighted risks to ensure that residents are protected with the exception of lap belts, which could potentially leave residents at risk of entrapment. A plan of care in relation to a food allergy was in depth and the risk assessment covered the emergency action required should an allergic reaction occur. Residents spoken with offered the following comments: “the staff are very helpful, I am comfortable and my physio needs are met,” “ I feel settled, the staff are nice and friendly, I can have a laugh and a joke with them, the nurses do my dressing for me,” and “the staff are good, my needs are met, I just ask them if I need anything.” Staff spoken with were able to discuss residents individual needs and outline the support offered to them to meet these. Residents spoken with all stated that they were able to make independent decisions in regard to their daily lives. One resident said that although this happens they sometimes feel that staff do not always listen to their requests, however they had discussed this with the manager and felt confident that this would be dealt with. One resident said that they can make their own choices about how they spend their day, they felt that their own room was like their home and they could do as they pleased and have visitors when they want. All residents stated that they felt that staff promoted their independence as much as they were able, offering them additional support if needed. Both staff and service users stated that the routines of the home were flexible at all times, throughout the visit residents were seen to occupy themselves, join in activites and generally spend their times as they wish. The practice of discussing resident’s confidential information in open has been addressed during staff meetings to ensure that residents respect and dignity are upheld. Staff spoken with were able to confirm that this had taken place. Staff were not observed to break residents confidence. Residents spoken with felt that staff were respectful and that they had no concerns. A resident chairs the residents meetings and there were minutes of these meeting available to demonstrate that these are taking place. Issues such as activities, recreation and the menu are discussed. One service user spoken with confirmed that these meetings take place and they have the opportunity to have their say about the developments taking place in the home if they want to. Nottingham Neurodisability Services Aspley DS0000059536.V351895.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): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are many different activites available for residents to join in if they wish, these are individualised and aimed towards each residents individual needs and aspirations. Residents are enabled to remain part of the local community and invite visitors into the home as they wish. EVIDENCE: Social activity co-ordinators are employed at the home to provide a varied and stimulating social activities programme and residents said they are satisfied with the recreation provided. A fully equipped activities room is available for residents on the first floor of the building. Records showed and residents confirmed that activities performed within the home include board games, arts and crafts, cookery sessions, quizzes, crosswords and newspaper readings, to ensure residents are kept up to date on current events in the media. There were many examples of the artwork taking place on display around the home. One resident spoken with discussed the pictures that they had painted and Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 14 how staff had assisted them in their art work due to the restrictions imposed because of their disabilities. One resident was looking forward to the Christmas celebrations and said that staff had ordered them some beer for the party. Staff spoken with discussed the varied activites and one to one time that residents may access; they felt that there were sufficient things to do to occupy residents. A large wide screen television is available in the residents lounge together with a DVD player so residents can enjoy films and television programmes. Several residents were seen to watch the television during the visit. One resident spoken with said that there were not many activites that they wanted to join in, so they enjoyed watching the television. A wheelchair accessible minibus is available and residents confirmed that they are able to access trips into the local community. Several residents spoken with discussed how they are looking forward to going out to do their Christmas shopping with the staff. Several service users also attend day centres and one service user attends a voluntary work placement, which they stated that they really enjoyed. Several residents attend the local church and regularly hold in house church meetings that people may join in if they wish. Within plans of care there was reference to residents religious beliefs and how they are supported in ensuring that these are met, such as dietary needs, personal care needs and celebrating religious festivals. Staff spoken with discussed how they ensured that service users were treated as individuals and how they are supported in maintaining their religious needs. To ensure that service users are enable to maintain contact with people that are important with them there are no restrictions imposed upon visiting. Visitors were seen to enter and leave the home freely. Two service users spoken with said that their visitors are always made very welcome and they could entertain them in private should they wish. There was reference to maintaining important relations and the support one made need in doing this within plans of care seen. A varied menu is on offer to residents and there was evidence of choices being available at each mealtime. All service users spoken with stated that the food was at a good standard, which they enjoyed. Two confirmed that choices were available at each meal. The main meal on the day of the visit looked appealing and residents were seen to have different meal. Staff during this time assisted residents in an appropriate manner to ensure that their dignity was maintained. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 15 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assisted with their personal care needs in a manner, which supports their preferences and meets their needs. Residents are protected by the medication policies and procedures employed by the staff. EVIDENCE: Records showed that residents health care needs are met, they have access to health care services both within the home and in the local community such as a General Practitioners, Dentists, Social Workers and Opticians. Residents spoken with also confirmed that staff respond appropriately to their requests to see their GP if they feel unwell. There was evidence within residents plans of care to show that contraceptive advice had been offered as needed and health check ups had taken place. A range of mobility aids are available throughout the home to promote the health, wellbeing and independence of the residents with restricted mobility. Specialist mattresses and cushions were also observed during the tour of the home, which ensure that service users pressure area care is maintained and Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 16 the risk of developing pressure sores is reduced. One resident spoken with stated that their specialised chair was very comfortable. Work has taken place on the specialist equipment in the bathroom, new baths have been installed and there was evidence to show that the work will be completed very shortly which will ensure that residents choices in regard to bathing facilities are no longer compromised. All residents spoken with stated that staff were respectful at all times and assisted and supported them as they needed. The issue in regard to staff sleeping during the night was discussed with the manager, it was felt that this did not occur and residents may feel that staff are asleep as a number of staff do in fact have a sleep during their allocated break. Sufficient staff remain on the floor to assist service users as required during this time. Medication procedures and practices were observed. Medication was signed for after administration. All medication record charts matched the prescription. The fridge and room temperatures continue to be recorded on a daily basis and if there are any concerns the fridge is defrosted and the temperature reset to ensure that they remain within the acceptable range of 2-8 degrees centigrade. Resident’s needs and preferences for their medication administration was recorded within their plan of care. One service user spoken with confirmed that the staff give them their tablets, which they felt, was for the best as they would not be able to manage them. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 17 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 and 23 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents feel that they can approach staff and express any concerns that they may have and feel confident that these will be resolved. Although policies and procedures are in place and staff have been trained in adult protection there is still a risk that service users may be exposed to abuse due to the current practices in regard to swearing. EVIDENCE: The service has not received any complaints since the previous inspection, however work had taken place since to ensure that all complaints when received are now recorded appropriately, evidence to confirm this was available within the complaints file. A complaints procedure is displayed in the foyer of the home and a complaints procedure is provided within the Service User Guide. Residents spoken with all stated that staff were kind and caring and that they felt they could approach them should they have any concerns. One resident said that they had in fact discussed a concern with the manager and felt that this would be addressed, another stated that they felt sure that staff would act upon any concerns that they had and they would tell them straight away. Staff spoken with were able to discuss how they would deal with a complaint should it be received. Staff training records demonstrated that staff have received training in Safeguarding Adults. Staff spoken with were able to confirm that this training had taken place and that certain policies and procedures were available. They were able to discuss what they thought constituted abuse and how they would deal with abuse should they suspect that it was occurring. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 18 Four service users personal allowance accounts were checked, all of these were correct. Receipts were available as required and staff and residents where able had signed for transactions. One service user was observed to request and access their money during the visits. Plans of care were in place for support and assistance service users may require in managing their finances. To address the concerns raised at the previous inspection in regard to staff using inappropriate language, which residents found offensive, a staff meeting had been held to discuss these issues, minutes of which were available. Staff spoken with were able to confirm that this meeting took place. Residents spoken with raised no further complaints. On discussing this with the deputy manager and the manager it was felt that some residents respond better if staff swear with them during conversation, the appropriateness of this needs to be further assessed and documented to ensure that residents are fully protected from abuse. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable and homely environment, which is well maintained. They are enabled to bring in their personal possessions to make it feel more homely. EVIDENCE: The homes internal environment, including the dining rooms and the lounge areas are well maintained and homely throughout offering residents a comfortable and homely environment. One resident spoken with stated that they had been able to bring in their own things when they entered the home, which has made them feel more settled. Residents rooms observed during the brief tour of the home were personalised. All areas within the home are accessible to residents in wheelchairs and equipment to promote the residents independence is available throughout the home, such as adjustable height beds and hoists. As mentioned earlier in the report the specialist bath will soon be ready to use again offering residents further choice in bathing facilities. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 20 All areas of the home accessed were clean and tidy, sufficient staff are employed to maintain the cleanliness of the home and they were observed to be cleaning throughout the visit. One resident spoken with said that the staff were always busy cleaning to make the home look nice. There is a smoking room available for residents to use, an extractor fan is available and there are windows that open for ventilation. Several residents were observed to use this facility and one resident stated that they though it was good that they could smoke. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 21 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): 32,34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A well-trained and supportive staff team support and assist residents as needed. The current recruitment practices still leaves the potential for residents to be exposed to unsuitable staff being employed. EVIDENCE: The staff duty rota showed that sufficient staff were employed to meet service users needs. Staff spoken with confirmed that a good number of staff were available on each shift enabling a good standard of care to be delivered. All resident spoken with also felt that there were enough staff available to meet their needs. Staff were observed to tend to residents needs as required. To ensure that all new staff are aware of their responsibilities and job roles on commencing employment staff said and records confirmed that an induction process is performed. Records showed that four members of staff are working towards completing the national vocational qualification level 2 (a nationally recognised work and theory based qualification) which ensures staff achieve knowledge and skills in caring for the client group and four have achieved this Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 22 qualification, one member of staff has achieved level 3 and another is working towards level four. A requirement was set at the previous inspection visit in respect of ensuring that satisfactory police checks and two written references are gained before new staff commence employment. Staff personnel files observed demonstrated that all files with the exception of one contained the required documentation by law; such as references and proof of identity to demonstrate that service users are protected by the services recruitment policies and procedures. The file, which did not contain all the necessary evidence, was missing both references needed. This was discussed with the manager who stated that these had actually been received, however these were not produced during the inspection. The manager stated that she would send a copy to the Commission as soon as possible. To date these have not been received. Therefore this requirement is not fully met. To ensure that all staff have the necessary knowledge and skills to carry out their job role and ongoing training programme takes place. Records demonstrated that staff continue to work towards completing compulsory training such as first aid, nutrition, health and safety, moving and handling, infection control, and that further training had been arranged. Staff spoken with stated that training offered was at a good standard and they felt supported in their development by the management. They were able to discuss relevant issues in regard to maintaining health and safety and residents nutritional needs. Two residents spoken with said that they felt that staff were well trained as they knew how to look after them properly. One resident discussed how they have assisted in staff training and giving an account of their own personal experiences to enable staff to understand what it is like from a residents perspective. Staff supervision sessions have now recommenced to ensure they are effectively supported and developed to perform their roles within the home. Documentary evidence of these taking place was observed. Supervisions take the form of formal discussions and working along side staff to observe their practices. Staff spoken with confirmed that these are taking place and that they found them useful. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 23 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is well managed and run in their best interest. They are enabled to express their views and opinions with the assurance that these will be listened to and valued. EVIDENCE: The acting manager has been working at the home for several years in this position. She has now applied to the Commission for Social Care Inspection to become the registered manager in order to confirm that she is fit to carry out the job role. She has achieved a degree in relation to working with the client group and ensures that she remains up to date with necessary training. Staff spoken with said that they felt supported and valued and that the manager promotes a good team spirit. Residents spoken with said that the manager was always approachable and they could tell her any concerns that they may have. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 24 Residents confirmed that they are provided with the opportunity to contribute to any developments within the home as “residents meetings” are performed on a monthly basis. Minutes of the previous meeting were seen, there was evidence that residents are currently making decisions about the colours to be used when the bathrooms are redecorated. Residents said that the meetings are of value and they feel included in any developments within the home. Questionnaires are sent out on an annual basis to residents, these are sent directly to the head office and once analysed an action plan to address any shortcomings is devised. The annual questionnaire is not yet due, however a short survey on the meals provided had been completed with positive results. The manager has completed quality auditing in several areas of the service, such as the environment, care planning and medication to ensure that a quality service is delivered to service users. Information supplied by the registered provider within the AQAA evidenced that resident’s health and wellbeing is promoted by effective routine maintenance. Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 25 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 2 2 3 3 X 4 X 5 1 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 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 26 Yes 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 YA5 Regulation 5,1,b,c Requirement To ensure that residents are fully aware of the cost of their individual care and the terms and conditions of admission they must have written documentation in place to reflect this. To ensure residents are fully protected risk management plans for all highlighted risks must be in place. The practice of using disrespectful language whether deemed appropriate or not must be fully explored and documented accordingly to ensure that service users are protected from abuse. To ensure that residents are protected from unsuitable staff new staff must only be employed following completion of two satisfactory written references. Timescale for action 20/02/08 2 YA6 13(4,c) 20/02/08 3 YA23 12 31/01/08 4 YA34 19 31/01/08 Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Nottingham Neurodisability Services Aspley DS0000059536.V351895.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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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