Inspection on 04/12/08 for Ormsby Lodge

This inspection was carried out on 4th December 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

Ormsby Lodge 09/02/07

Ormsby Lodge 13/03/06

Ormsby Lodge 14/06/05

Ormsby Lodge 11/01/05

Ormsby Lodge 02/09/04

Ormsby Lodge 07/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ormsby Lodge 1 Ormsby Road Southsea Portsmouth Hampshire PO5 2AL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janet Ktomi     Date: 0 4 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Ormsby Lodge 1 Ormsby Road Southsea Portsmouth Hampshire PO5 2AL 02392738752 02392367956 declarke@ormsbylodge.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr David Ernest Clarke,Mrs Ninfa Clarke Name of registered manager (if applicable) Sally Peta Fenner Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 12 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home Ormsby Lodge is a residential service providing care and support to ten adults who have learning disabilities and complex behavioural needs. Ormsby Lodge is owned by Mr and Mrs Clarke who also own another residential service and a separate day service for service users with complex learning disabilities. Ormsby Lodge is a large period house set in a street of similar properties in a central location in Southsea. The house is set out over four storeys, the basement is used for storage and the service users Care Homes for Adults (18-65 years) Page 4 of 32 care home 12 Over 65 0 12 Brief description of the care home accommodation is on the other three floors. The top floor has a small semi selfcontained flat with two single bedrooms, this can accommodate people who need limited support. There are further bedrooms on the first floor, one of which is a twin room and there is one ground floor bedroom. The service does not accommodate people with physical disabilities or nursing needs. Service users are supported to use local amenities, which are a short walk away. The home is owned by Mr and Mrs Clarke and managed by registered manager Sally Fenner. Up to date information about fees is available from the manager. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report contains information gained prior to and during a visit to the home undertaken on the 4th December 2008. All core standards and some additional standards were assessed. The home was previously inspected on the 9th February 2007 and had an annual service review in January 2009. The visit to the home was undertaken by one inspector and lasted approximately six hours commencing at 12 noon and was completed at 6pm. The inspector was joined for part of the inspection visit by an expert by experience supplied by my life my choice. Care Homes for Adults (18-65 years) Page 6 of 32 The inspector was able to spend time with the registered manager and staff on duty and was provided with free access to all communal areas of the home, documentation requested and people who live at the home. Information from the Annual Quality Assurance Assessment (AQAA) completed by the registered manager and surveys received from people who live at the home, staff and external health professionals. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 32 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home would only admit new people whose needs could be met at the home and who were compatible with the people already living there. Evidence: The home has not admitted any new people since before the previous inspection when assessments for people admitted to the home were viewed and noted to be comprehensive. The home currently has several vacancies, however the provider has informed the commission that he is intending to reduce the number of registered beds at the home to ten so that there will only be one twin bedroom (the home currently being registered for twelve people encompassing three twin bedrooms). The home therefore had only one vacancy at the time of this key inspection in a large single bedroom. Prior to the inspection visit people who live at the home completed surveys and all confirmed that they had had information about and visited the home prior to moving in. The manager identified the procedure that she would undertake should she be in Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: the position of admitting a new person. This would include a thorough assessment including information from professionals and family members. The manager would arrange to meet the person and if it were felt that the home could meet the persons needs they would be invited to visit the home on a number of occasions. The opinions of the people already living at the home would be sought following the visits and a final decision would be based on their views and interactions with the potential new person. With no new people admitted to the home recently or by the current manager it is difficult to ascertain how effectively the home would manage an admission and meet the needs of a new person. However, based on the records available and observations of the current people who live at the home it is possible to say that people are happy living at Ormsby Lodge and their lives seem full and their needs are met. There have been no previous concerns about the statement of purpose, service users guide or contracts. Therefore these non core standards were not assessed. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are at the centre of the homes care planning system and are actively involved in their development. Staff are committed to supporting people to lead purposeful and fulfilling lives as independently as possible. People who live at the home make their own informed decisions and have the right to take risks in their daily lives. Evidence: Two care plans were viewed. Risk assessments and the ways in which risks should be managed were seen in care plans. The inspector spoke with staff and the people who live at the home about care plans. The inspector also discussed how decisions are made and observed how people who live at the home are encouraged and supported to be active and independent. The care plans viewed were person centred and followed a person centred format. Information is held in several folders with a separate medical file, daily records, risk Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: assessments and care plan. Also seen were individual folders with photos and information about social and leisure activities and peoples wants and wishes. These had clearly been compiled with and by the people who live at the home. Everyone has a drawer in the office in one of a number of filing cabinets with all information pertaining to that person being stored in the drawer which is lockable and the office locked when not in use. People were aware of their drawers and some helped themselves to their files to show the inspector things in their care plans. People confirmed they had been involved in reviews. Reviews are held every six months and evidence was seen in care plans. Following the previous inspection in February 2007 a requirement was made that care plans and risk assessments must be dated and records maintained to demonstrate that these are kept under regular review. Evidence seen on this inspection visit confirmed that this requirement has been met. Observations during the inspection visit and discussions with people living at the home confirmed that they are able to make decisions and that these are respected and acted upon by the home. Throughout the inspection visit people were observed making suggestions and their views being sought by the manager and staff. This was also noted by the expert by experience who stated Residents seemed very at home and didnt seem to have any worries about going where and doing what they wanted. People confirmed they are involved in decisions about meals. Resident meetings are held and the inspector saw minutes of these. People are able to choose what they spend their personal money on and bedrooms seen had been personalised reflecting the occupants interests. Records of what people had spent their money on confirmed that people are supported to make choices about their lives and what they do. The procedures in place to support people with their personal finances are robust and records well maintained. This enabled the manager to take appropriate action when she detected that money may have been spent by a staff member for which the person did not receive the items purchased. Care Homes for Adults (18-65 years) Page 14 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to live the lifestyle they choose. Evidence: The expert by experience spent time with people who live at the home exploring issues within this outcome group. The inspector viewed records in care plans of activities undertaken and saw photographs in peoples personal files of activities they had undertaken. The inspector spoke with staff and people who live at the home about how they spent their time. Information from comment cards is also included. The provider also runs a day service to which people living at the home attend weekdays with people who live at a sister home and also people who live in the local area. This provides people with opportunities to help develop and maintain life skills and provides opportunities for socialisation away form the home. Two people have Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: been supported to access local college courses, one person being at college on the day of the unannounced inspection and another telling the inspector about his computer course. People confirmed to the expert by experience that they had been to the day service which they said they enjoyed, the day centre is really nice, we go on outings and on Fridays its trampolining. Discussions with people who live at the home confirmed that they enjoyed activities organised at the day service and by the staff at the home. On a notice board in the dining room the inspector and the expert noted there were lots of photographs. People who live at the home stated to the expert that although they cant go out on their own they go out with staff to the pictures often. Another resident said that he was going to the pub that night. Information about social and leisure activities likes and dislikes were seen in care plans along with lots of pictures of things people have done. The manager stated that people have not been away on holiday this year but during August people had a two week break from the day centre and went on lots of outings. People confirmed this to the inspector. Within bedrooms seen were a range of home entertainment equipment including games consoles as well as televisions and music centres. People who completed comment cards stated that they are able to decide what they do during the day, evening and at the weekend adding that they go shopping, go to cafes or pubs, watch films and help to keep their room clean and tidy. Others commented that they go trampolining, play badminton, go for walks, sometimes play pool and go to music club. Another person listed that in the evening they cook, sometimes go to the pub, see their friends, go shopping to buy cakes and clothes. The home has access to the minibus belonging to a sister home and uses this for outings. People have been supported to continue to develop life skills with travel training and use of public transport. The home is situated within walking distance of local shops and amenities with the seafront and common close by. The home undertook a life experience questionnaire with all service users in April 2008 and identified action points from this were placed in the homes development plan. The home has also provided training for people who live at the home, with people attending staff meetings for fire and Makaton training. People confirmed this to the inspector and the inspector recognised peoples names in the list of those attending the training events along with staff. Certificates for training attended were seen in peoples files. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: People are encouraged to continue contact with family members with some explaining to the inspector their plans for visiting family over the Christmas holidays. Information about families and friends was seen in care plans. The expert by experience asked about meals at the home. Someone said I choose the food, I like burgers. The inspector and the expert were shown food diaries on the walls. The expert by experience noted that there werent any pictures of the meals which may have helped some people in knowing what was for their evening meal and in making choices. Care staff undertake the cooking of the main meal which is eaten in the evening. The home has a large separate dining room. Everyone spoken with said the food in the home was good and that they always have sufficient amounts. The manager explained and staff and people who live at the home confirmed, that menus are devised at the weekly house meetings and everyone is encouraged to contribute to the process. Individual dietary needs such as diabetes were catered for and people are encouraged to choose a health diet. The pantry showed that where possible fresh ingredients are used. Individual preferences are respected with one person having a different main meal on the day of the unannounced inspection because, as he explained to the inspector, he did not like chili. Three people are more involved in the preparation of their evening meal having a dedicated support worker in the flat area at the top of the home and their menu was seen to be different to the main house reflecting individual choices they had made. People stated they could help with cooking but seemed to prefer making cakes etc to main meals. Care Homes for Adults (18-65 years) Page 17 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care and support in the way they prefer and their health needs are met. Medication is appropriately managed in the home. Evidence: Information about personal and health care needs and that provided was viewed in care plans. Surveys and discussions with the people who live at the home and staff is also considered. The arrangements for the storage and administration of medication were viewed with related records. A comment card was received from an external health professional which was positive about the service provided in respect of peoples health and behavior needs.The health professional stated they are good at responding to crisis and then following advice and guidance and completing any forms etc required by the health team, adding that they are very proactive at seeking advice when needed. The external health professional stated that they felt that the service always met peoples health care needs, always respected peoples privacy and dignity and that care staff usually had the right skills and experience to support individuals social and health care needs. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: The home operates a key worker system and people told the inspector who their key worker is. Male and female staff are employed so choice would be available if support were required. Information was seen in care plans providing detailed guidance as to how peoples personal support and care should be provided with detailed morning and evening routines. Each person has a health file with individual slots for various health related activities such as dentists, opticians and hospital specialists. Some of the people living at the home have additional communication needs. Staff have undertaken training with this being seen on training records and as part of staff meetings. People living at the home have also been involved in communications training (Makaton) with care staff enabling them to communicate effectively with other people who live in the home. People had certificates of training attended in their personal files. The expert by experience comment on this saying that staff interaction was appropriate (using Makaton) and respectful. A resident used Makaton to talk to a non-verbal resident and helped us to be understood. People living at the home have also completed training in how to be safe in the sun. The home provides a service for some people with potentially complex behaviour needs. Information supplied by the manager and discussions with the staff confirmed that they have undertaken training to meet peoples needs and support them and other people living at the home should incidents occur. Training information also stated that staff have attended training on first aid, Autism, Schizo Affective Disorder, positive approach to Managing Mental Health, Mental Capacity Act, Rational Emotive Behaviour Therapy, Active listening, risk assessment and Schedules of Reinforcement. At the time of the unannounced inspection all medication was found to be stored correctly. The medication administration records were viewed and had been fully completed. Medication coming into the home and that returned unused had also been recorded. None of the people living in the home self medicates, therefore all medication is administered by care staff who have received training and been deemed competent. The procedure for medication involves two staff. The home uses blister packs dispensed by a local pharmacist for most medications. With separate blisters for lunchtime medications at the day centre. This eliminates the need for medication to be transported on a daily basis. Some medication is prescribed for use on an only when required basis. Guidelines and information about when this should be given was seen. This is individualised for each person and each medication. There were no expiry dates on the as required blister packs; these stated the date dispensed by the pharmacist but it is not clear for how long the home can use these before needing to request new stocks as out of date. A requirement/recommendation is not made as the manager stated she would ask the pharmacist to add an expiry date to the blister packs. Care Homes for Adults (18-65 years) Page 19 of 32 Care Homes for Adults (18-65 years) Page 20 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are able to complain and should be protected from abuse. Evidence: The manager stated in the AQAA and to the inspector that there had been no complaints in the past twelve months. The home has a policy and procedure in place for complaints and would record any received. There was information on the dining room wall also seen by the expert by experience about advocacy. Two people said to the expert that they knew what to do if they had a complaint. The expert also commented that he didnt see any information displayed about complaints although they acknowledged that there may have been something which they didnt see. People who live at the home also confirmed to the inspector that if they had any concerns they would say to the staff or manager. They seemed to be confident that the manager would sort things out for them. Interactions between people living at the home and care staff and manager were warm and friendly and people seemed able to say what they thought. Comment cards from people who live at the home and from staff confirmed they knew how to complain and what to do if someone raised any concerns. Staff stated they would try to sort out any issues and if they were not able to do so would report these to the manager. The providers are frequently at the home so people would also be able to see them and raise any concerns/complaints directly to the providers. Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: There are regular service user meetings once a week where people could identify things they were not happy about, records showed that people do raise issues in the service users meetings and that these are responded too. People who live at the home have a monthly meeting with their keyworker and records are kept of these. Information provided by the manager in the AQAA and during the inspection stated that staff have undertaken safeguarding training November 2008. Staff spoken with were aware of safeguarding and need to report concerns. Staff have also undertaken other relevant training such as the Mental Capacity Act, behaviour and interactions and SCIP with an in house SCIP trainer. Care plans viewed contained risk assessments and guidelines about managing peoples behaviour in a positive way to limit any need for intervention. People showed the inspector records and plans to help them meet their identified goals in respect of appropriate behaviour. Staff confirmed training they had undertaken. Some people have additional funding for a higher level of support and duty rotas showed that they were receiving this and who was identified to provide it. People stated they felt safe at the home. The expert commented that people seemed relaxed and didnt seem to have any worries, going where they wanted and doing what they wanted. The home has acted appropriately when it identified a safeguarding concern about a staff member. The homes recruitment and personal finances procedures and records should also protect people. Care Homes for Adults (18-65 years) Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, homely house which overall meets their individual and collective needs. Evidence: The home is located in a pleasant residential area of Southsea within walking distance of Southsea High Street and the common and seafront are not far away. The home is a large older property. The inspector viewed records relating to services (gas, electric and fire equipment). People living at the home showed the expert by experience round their home including all communal rooms and some private accommodation (bedrooms). The home has one shared room with all other bedrooms being for single occupancy. The expert spoke with one of the people who shares a bedroom and commented that the resident didnt mind sharing and the rooms are big enough for two, however it doesnt offer much privacy. Other bedrooms are all for single occupancy and equipped with a wash basin. Bedrooms seen had been individually personalised by their occupants. Bedroom doors had locks and people confirmed they could have keys if they wanted them. The expert also commented that the house was a bit dull and dreary in places. Since Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: the previous inspection parts of the home have been redecorated and the home has retained many original features. New garden furniture has been provided at service users request as well as new sofas and bedroom furniture and soft furnishings in some bedrooms. The hall and kitchen in the flat on the top floor has been redecorated and new furniture provided in the flat. The amount of living space within the home is adequate for the number of people living there, especially as three people spent time in a separate area (the flat) on the top floor. The home has a large lounge and dining room on the ground floor capable of comfortably seating everyone who lives at the home and staff on duty at the same time. All parts of the home are accessible to people who live there. Fixtures and fittings are suitable for the home and people who live there. Records demonstrated that gas and electric supplies and equipment have been serviced and checked by appropriate external professionals. As had fire equipment with a weekly check of the fire detection systems. People who live at the home have joined staff for fire awareness training and told the inspector what they would do if the alarms sounded. The home employs cleaners separate to support/care staff. This ensures that the home is kept very clean throughout. Infection control procedures are in place and the laundry area is appropriate for the size of the home. Care Homes for Adults (18-65 years) Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a consistent staff team, provided in sufficient numbers and with the necessary skills to meet their individual and collective needs. Evidence: Interactions observed during the visit indicated that people and staff have a warm friendly relationship with people feeling able to express themselves in all respects. Surveys received from the people who live at the home stated that staff treat them well and act on what they say. The expert by experience stated the staff were really helpful and kind to the residents, staff interaction was appropriate (using Makaton) and respectful. The expert also stated the staff seemed to have a really good relationship with the residents and were natural and caring with them. One resident said to the expert that the staff are loverly, very nice people. The inspector asked to see the homes duty rotas, one of the providers (who is responsible for the rotas) showed the inspector the rotas and explained how the home is staffed. The home does not usually have staff during the day Monday to Friday as people are out at the day centre. The manager stated that should a service user be unwell and not wish to go to the day centre then staff would be provided at the home to support them. One person has additional staffing provided on a 1-1 basis for a few Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: hours each evening and this is recorded on the duty rota. The homes own staff cover for sickness and holidays, and can also use staff from the day service as occurred on the day of the inspection. Only one member of staff does not have an NVQ. These figures dont include day centre staff who cover extra hours. The home has two bank staff who previously worked at the homes so are known to the people who live there and are flexible providing shifts when needed. The home has an identified coordinator on each shift. The manager explained the homes recruitment process. The process described and recruitment file for a new staff member seen confirmed that all the necessary preemployment procedures are undertaken. The inspector spoke with the new staff member who was on duty who confirmed that all the procedures as identified by the manager had occurred and checks had been completed. The new staff member also confirmed that she had had an induction and further training undertaken. The new staff member stated that she felt she had sufficient skills to meet peoples needs and the induction had provided her with the skills she needed. Staff are given an employment booklet, which was viewed by the inspector and seen to contain information about safeguarding as well as other important policies and procedures. Staff sign to confirm they have received the booklet. Staff are also given a copy of the General Social Care Council Code of Conduct. The induction booklet was seen and is based on the common induction standards. People who live at the home have undertaken training to enable them to assist with staff selection. Information about training was provided by manager and certificates were seen in the staff files. Staff training records were good and showed that staff are able to access a wide range of training opportunities. Training often occurs on the same day as staff meetings which are held twice a month with the minutes seen. As previously stated people who live at the home have joined staff training events such as for Makaton and fire awareness. Care staff confirmed that all training had occurred and felt they had the necessary skills to meet peoples needs. The external health professional stated that they felt that staff had the necessary skills and experience to meet peoples needs and expressed no concerns re the homes staff. Staff on duty at the time of the inspection visit were all friendly and stated they get on well with each other. Care staff completed comment cards and additional comments included the training and support I have been given are exceptional, I feel that I have been equipped with the right knowledge and skills to meet individuals needs. On occasions when I feel I need extra information, expertise or support, it is always available. Care Homes for Adults (18-65 years) Page 26 of 32 Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from a service that is well run in their best interests. Evidence: Since the previous inspection in February 2007 the manager has now been registered with the Commission and has also completed her Registered Managers Award in July 2007. The manager also has an NVQ level 4 in care. The manager provided the inspector with information about other training she has undertaken and this includes both mandatory and service specific training. The manager therefore has the necessary qualifications. The expert by experience stated that the manager was very friendly and seemed interested in the residents. Observations by the inspector throughout the visit to the home and during other discussions with the manager would confirm this. Throughout the inspection visit people living at the home were seen to discuss issues and make comments to the manager whose responses clearly showed that she had a good understanding of them individually. Staff also stated in comment cards and to the Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: inspector that they felt the manager was approachable and they could discuss any concerns with her. One stating I am always able to arrange a time, promptly, to gain any additional support or feedback from my manager (as well as having regular supervisions). The manager has undertaken a range of quality assurance activity. Within care plans were copies of service user surveys (My home Questionnaire) completed in January 2008. The manager has collated the responses and provided an action plan for any issues identified individually and collectively. The manager has also sought the views of other stake holders including care managers, unfortunately the response was not good and the manager stated she is intending on repeating this exercise in the future having identified that a number of care managers listed are no longer working for the relevant sponsoring authority. The inspector also viewed minutes of staff meetings (bimonthly) and service user meetings (weekly). The manager completed the Annual Quality Assurance Assessment (AQAA) to a high standard and returned it within the requested timescale. The home has a development plan which is reviewed and updated on a regular basis throughout the year. The inspector viewed a number of records throughout the inspection visit and these were all well maintained and stored appropriately with access only to those who should have access. There were no concerns in respect of health and safety identified during the unannounced inspection visit. Information about the environment and its maintenance is recorded in the relevant outcome group. All staff had received health and safety training and workplace risk assessments were in place and regularly reviewed. All accidents and incidents are recorded and records were clear with the manager stating that she reviewed these to ensure there were no patterns ans that any action to prevent a recurrence that could be taken is taken. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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