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Inspection on 12/03/08 for Paks Trust 66 Oaston Road

Also see our care home review for Paks Trust 66 Oaston Road for more information

This inspection was carried out on 12th March 2008.

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

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home continues to provide a warm, friendly place for people to live with a homely, friendly and easygoing atmosphere. People spoken with said that they liked living in the home and were happy with the staff supporting them. Each person has a care plan which provides information about their everyday living, activities, personal care and support needs, and health needs. Individual risk assessments are also in place for each person. People were obviously being actively supported to make decisions about their lives both on a daily and more long term basis by staff. People are supported by the staff as appropriate to attend daytime activities of their choosing. These include attendance at local day centres and the PAKS Trust day service as well as participating in their interests, hobbies, chosen college courses, leisure pursuits and holidays. These are varied and reflective of individual likes and dislikes. The inclusion of families and friends in their lives is important to people, and is encouraged and supported by the home. The homes kitchen is domestic, clean and well stocked with a plentiful variety of fresh, frozen, processed and tinned foods available for people to choose their meals from. Staff ensure that people are encouraged to eat a healthy balanced diet. The people who live in this home are relatively independent with regards to their personal care needs. Staff however work with them sensitively and discreetly in this area if requested if requested. People are supported with both their routine and more specialist their healthcare needs as appropriate. Medication is managed safely on peoples behalf. The home has both a complaints policy and an adult protection policy in place. Any complaints and abuse allegations received by the home have been managed well within the organisations policies and procedures. Ten of the eleven surveys were very positive and indicated that the service meets peoples needs effectively. One survey contained negative comments. Comments made in some of the surveys received include: "the training is very good that we do" "The home does more for my relative than I expect" "the home helps the people in their care to live as full a life as possible" "...there should be more group activities...all they seem to do is watch tv..." "needs more male staff to relate to male service users...they have no first aid training..."

What has improved since the last inspection?

Since the last inspection work has commenced on reviewing one persons care plan. Some individual and generic risk assessments are in place. A formal record of induction has been introduced by the organisation which new staff are now working through. This includes medication competency. A training day on Challenging Behaviour has been held in October 2007.

What the care home could do better:

The service has not addressed all of the previously identified areas for improvement in a within their own timescales as identified in the completed improvement plan. People have not yet been issued with contacts that detail their terms and conditions of residency in the home. This is a requirement that is outstanding from May 2006, and demonstrates that peoples rights and responsibilities are not taken seriously or upheld.Three care plans have not yet been reviewed. This is a requirement that again dates back to May 2006. The lack of reviews of peoples care plans means that they cannot be sure that they staff are supporting them in the most appropriate manner. Risk assessments are not available within peoples care plans. Some were located in a separate file. They have not been reviewed in line with the care plans, thus people cannot be sure that they are living safe lives and are vulnerable to risk. Environmental and generic risk assessments have not been reviewed, thus leaving vulnerable to risk. In addition, up to date training records were not available within the home to confirm that staff have current training in the mandatory subjects.

CARE HOME ADULTS 18-65 Paks Trust 66 Oaston Road 66 Oaston Road Nuneaton Warwickshire CV11 6JZ Lead Inspector Justine Poulton Key Unannounced Inspection 12th March 2008 10:00 Paks Trust 66 Oaston Road DS0000004457.V355208.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 Paks Trust 66 Oaston Road DS0000004457.V355208.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. Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paks Trust 66 Oaston Road Address 66 Oaston Road Nuneaton Warwickshire CV11 6JZ 02476 742201 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) PAKS Trust Alan John Sheppard Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 July 2007 Brief Description of the Service: The home is a 5 bedroomed narrow, long and tall Victorian end of terrace house in Nuneaton. The accommodation comprises of a lounge, kitchen diner, lean to/conservatory room, one bedroom, shower room and separate toilet on the ground floor. On the first floor there are two residents’ bedrooms and a bathroom. The other two bedrooms and a separate toilet are on the top floor. The staircase in the house is narrow and steep, with very little natural light. Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was carried out to establish the outcomes for people living in the home, and to confirm whether they are protected from harm. It took place over one day. Identified key standards were looked at, along with a review of the organisations progress towards meeting any requirements made at the previous inspection of this service. The pre fieldwork inspection record was completed, as well as a site visit to the home, during which time staff, people living in the home and the manager were spoken with. A completed annual quality assurance assessment was received from the service prior to the inspection along with a completed improvement plan and 11 completed surveys from people who live in the home, staff and relatives. Two people were identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for service users. Records, policies and procedures were examined and the environment was looked at. All of the people living in the home were at home for part of the inspection. The inspector would like to thank the people who live in the home, the manager and staff for their hospitality and co-operation during the inspection. What the service does well: The home continues to provide a warm, friendly place for people to live with a homely, friendly and easygoing atmosphere. People spoken with said that they liked living in the home and were happy with the staff supporting them. Each person has a care plan which provides information about their everyday living, activities, personal care and support needs, and health needs. Individual risk assessments are also in place for each person. People were obviously being actively supported to make decisions about their lives both on a daily and more long term basis by staff. People are supported by the staff as appropriate to attend daytime activities of their choosing. These include attendance at local day centres and the PAKS Trust day service as well as participating in their interests, hobbies, chosen college courses, leisure pursuits and holidays. These are varied and reflective of individual likes and dislikes. The inclusion of families and friends in their lives is important to people, and is encouraged and supported by the home. Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 6 The homes kitchen is domestic, clean and well stocked with a plentiful variety of fresh, frozen, processed and tinned foods available for people to choose their meals from. Staff ensure that people are encouraged to eat a healthy balanced diet. The people who live in this home are relatively independent with regards to their personal care needs. Staff however work with them sensitively and discreetly in this area if requested if requested. People are supported with both their routine and more specialist their healthcare needs as appropriate. Medication is managed safely on peoples behalf. The home has both a complaints policy and an adult protection policy in place. Any complaints and abuse allegations received by the home have been managed well within the organisations policies and procedures. Ten of the eleven surveys were very positive and indicated that the service meets peoples needs effectively. One survey contained negative comments. Comments made in some of the surveys received include: “the training is very good that we do” “The home does more for my relative than I expect” “the home helps the people in their care to live as full a life as possible” “…there should be more group activities…all they seem to do is watch tv…” “needs more male staff to relate to male service users…they have no first aid training…” What has improved since the last inspection? What they could do better: The service has not addressed all of the previously identified areas for improvement in a within their own timescales as identified in the completed improvement plan. People have not yet been issued with contacts that detail their terms and conditions of residency in the home. This is a requirement that is outstanding from May 2006, and demonstrates that peoples rights and responsibilities are not taken seriously or upheld. Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 7 Three care plans have not yet been reviewed. This is a requirement that again dates back to May 2006. The lack of reviews of peoples care plans means that they cannot be sure that they staff are supporting them in the most appropriate manner. Risk assessments are not available within peoples care plans. Some were located in a separate file. They have not been reviewed in line with the care plans, thus people cannot be sure that they are living safe lives and are vulnerable to risk. Environmental and generic risk assessments have not been reviewed, thus leaving vulnerable to risk. In addition, up to date training records were not available within the home to confirm that staff have current training in the mandatory subjects. 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. Paks Trust 66 Oaston Road DS0000004457.V355208.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 Paks Trust 66 Oaston Road DS0000004457.V355208.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): 5 Quality in this outcome area remains adequate. People resident in this home still do not have agreed Contracts, which set out the Terms and Conditions of their residency. Without this they cannot be sure of their rights and responsibilities whilst living in the home or those of the service provider. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No new people have moved into the home since the last inspection therefore standard 2 was not inspected on this occasion. There remains one vacancy in the home. As recorded in the last inspection report for this service, people do not have contracts detailing their terms and conditions of residency in the home. These were again available at this inspection but as yet have not been signed and issued to service users. The action plan from the last inspection submitted by the manager of the service in October 2007 indicated that this would be completed by 20th October 2007. During the inspection the manager made a Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 10 further commitment to have the contracts completed and issued to the people resident in the home by 31st March 2008. Paks Trust 66 Oaston Road DS0000004457.V355208.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, 9 Quality in this outcome area remains adequate. People are still not having their care needs reviewed on a regular basis, and remain unsure that the care they are receiving reflects their changing needs, wishes and personal aspirations. People living in this home are involved in decisions being made about their daily activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person living in the home has a care plan, which provides information about their everyday living, activities, personal care and support needs, and health needs. A requirement made at the last inspection was for these plans to be reviewed at least six monthly with their keyworker and any other interested Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 12 parties at the individuals request. Two plans were looked at as part of the case tracking process, where it was determined that they both required reviewing and updating. Although information was available to confirm that work had commenced on reviewing one persons care plan, it is noted that the requirement for reviewing people’s personal documentation dates back to March 2006. The action plan from the last inspection submitted by the manager of the service in October 2007 indicated that all of the care plans would be reviewed at the start of 2008 and then on a 6 monthly basis. Another requirement made at the last inspection was for risk assessments to be carried out for all of the people living in the home and for these to be recorded along with any risk management strategies and guidelines within their individual care plans. No risk assessments were available within the two care plans looked at, however some pertaining to individual people were later located within the homes generic risk assessment file. As with the care plans, these require reviewing. They should also be placed within each persons care planning file to ensure that staff have easy access to key information about each person. Observations made during the inspection when people returned home demonstrated that they are supported to make decisions about their lives with as much or as little support as requested. For example people chose what they wanted for dinner. One person spoken with said how she had chosen the décor for her bedroom whilst another said that they enjoyed being able to chose activities to participate in and where to go on holiday. Paks Trust 66 Oaston Road DS0000004457.V355208.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, 17 Quality in this outcome area is good. The people living in this home continue to be supported to access lifestyle activities of their own choice in the areas of education, work opportunity and leisure. Their right to live ordinary and meaningful lives is promoted. A balanced, healthy diet is offered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All four people living in the home attend various day services provided both by PAKS and external agencies. One of the two people case tracked spoke about the college courses that she attends via her day service, which she said she enjoys. As well as attending Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 14 day services the second person case tracked also spends one morning each week at home and two afternoons at an animal sanctuary. Records within peoples care plans and daily diaries confirmed that people continue to be offered a variety of activities during the evenings and weekends. These include going to the cinema, visiting local pubs, going out for meals, going shopping, reading magazines, arts and crafts, knitting and going on holiday. Support to maintain links and contacts with families and friends is seen as being of high importance and people are supported to maintain these links in whatever way they wish. This could be via the telephone, weekend or evening visits to their families, letters or cards. Records looked at confirmed that one person visits their parents each weekend whilst another gets together with her family members one evening each week. The home has a domestic sized kitchen with modern domestic appliances. It was clean and tidy, though some of the cupboard door handles and the microwave were in need of a clean. Upon arriving home from their various daytime activities each person was asked what they wanted for their dinner. Staff spoken with said that three uncooked choices are offered to each person on a daily basis, and they choose what they would like. This is then recorded on their personal record sheet so that it is possible to monitor that they eat a balanced and healthy diet. People spoken with said that they enjoyed the food they eat and also enjoy getting involved in purchasing and preparing their meals Staff on duty said that they were due to go shopping on the day of this inspection. That said, there were plenty fresh, frozen, tinned and processed foods available, should the shopping get delayed. All of the records necessary to confirm that safe food hygiene practices are observed were available. Paks Trust 66 Oaston Road DS0000004457.V355208.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, 20 Quality in this outcome area is good. People continue to be offered personal support in such a way as to promote and protect their privacy, dignity and independence. Peoples healthcare needs are managed appropriately. Medication is managed safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people resident in this home are relatively independent with regards to their personal care needs. Although these are identified within their care plans, the accuracy of this information cannot be confirmed due to the lack of reviews that have taken place over the last two years as recorded earlier in this report. Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 16 Information regarding the management of peoples healthcare needs confirmed that routine appointments such as the dentist and chiropodist are offered to people at the recommended intervals. Records available did not confirm that people have their eyes tested at the recommended intervals, therefore the manager and staff need to ensure that these are offered as a routine a minimum of two yearly. Records looked at also confirmed that where any specialist healthcare intervention has been required this has been sought in a timely manner. The home stores any medication prescribed to the people who live there in a looked cupboard. It is supplied to the home by a local pharmacy in blister packs that are accompanied by medication administration record charts (MARS). Examination of the cupboard showed it to be clean and well organised making it easy for staff to identify everything located in there. The manager said that he is generally responsible for checking the medication into the home when it is delivered, however if it is delivered when he is unavailable staff have been trained in how to do this as part of their medication training. Examination of the medication record sheets found three gaps in recording. Further investigation into these by the manager confirmed that he was responsible for the gaps, and undertook to be more vigilant when administering medication in the future. No other concerns with medication were found during the inspection. Paks Trust 66 Oaston Road DS0000004457.V355208.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, 23 Quality in this outcome area is good. People who use the service continue to be able to express their concerns and have access to an effective complaints procedure, which is in a format that is easy for them to understand. Allegations of abuse are managed appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an organisational complaints procedure in place that has also been provided in an accessible format that uses pictures and symbols. This is intended to help people understand how to raise concerns or make a complaint. People spoken with during the inspection said that they were very happy living in the home, and didn’t have any complaints to make. The surveys received from the people living in the home indicated that they all know how to make a complaint. This was confirmed in conversation with them. Similarly, three surveys were received from relatives of people living in the home, which again all indicated that they know how to raise a concern or make a complaint. Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 18 The home has received two complaints since the last inspection. Information was available to confirm that these were dealt with in line with the organisations policy and procedures. Although a complaints log was in place however this has not yet been used. Discussion was held with the manager about the importance of recording all complaints along with the actions taken and the outcome in a suitable log. The manager made a commitment to do this in the future. The home also has a policy and procedure on safeguarding vulnerable adults from abuse. In addition the organisation works within Warwickshire’s multi agency protocol on protecting people from abuse. One allegation of abuse has been made to the home, and subsequently to us since the last inspection. Examination of the paperwork relating to this allegation confirmed that this allegation was managed appropriately, and that people remain protected from abuse. Training records provided by the home indicate that staff have not received any training in safeguarding vulnerable adults since November of 2005. It is therefore strongly recommended that training in this subject be provided for all staff urgently. Paks Trust 66 Oaston Road DS0000004457.V355208.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, 30 Quality in this outcome area is good. The home continues to provide a warm, homely environment ensuring people have a comfortable and safe place in which to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a 5 bedroomed narrow, long and tall Victorian end of terrace house in Nuneaton. The accommodation comprises of a lounge, kitchen diner, lean to/conservatory room, one bedroom, shower room and separate toilet on the ground floor. On the first floor there are two bedrooms and a bathroom. The other two bedrooms and a separate toilet are on the top floor. The staircase in the house is narrow and steep with very little natural light. Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 20 At the last inspection it was recorded that staff were using the conservatory type room to sleep in over night. The manager said that this was not now the case, and staff were using a sofa bed in the lounge when on sleep in duties. Although comfortable and homely, the lounge was dark, with limited natural light due to the conservatory type room and close proximity of the neighbouring property, however it was decorated in light colours, and the manager said that he was considering purchasing vertical blinds for the windows rather than the current bamboo blinds that were pulled part way down to prevent people from looking in. The manager also said that a new carpet, redecoration and new light coloured doors were planned for the lounge and entrance hallway. Two peoples bedrooms were looked at as part of the inspection. Both people said that they liked their bedrooms and had participated in choosing the décor. Both rooms were pleasant with plenty of personalisation. The bathroom requires attention as the ceiling remains ‘cracked’ and the skirting board was still coming away from the wall. In addition the bath panel was damaged and in need of replacement. The home was clean on the day of inspection with obvious signs of good infection control procedures in place. Paks Trust 66 Oaston Road DS0000004457.V355208.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, 35 Quality in this outcome area is good. People benefit from an enthusiastic staff team who work towards common goals. People are supported and protected by the homes recruitment policy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs four support staff as well as the manager. The vacancy that was left by the departure of the senior support worker has recently been filled with a support worker. The manager said that he hopes to appoint a new senior support worker from within the existing staff team. Given the abilities of the people living in the home the staff ratio of one/ two staff on duty per shift appeared acceptable. This will require reviewing however when the homes vacancy is filled. Observation made during the inspection demonstrated that the staff treat the people living in the home with respect. Naturally flowing conversations were taking place, with people appearing at ease within their surroundings and with the staff on duty. Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 22 The recruitment records of two staff, including the newest staff member were looked at during the inspection. These contained all of the necessary documents including an enhanced criminal records bureau check, two written references and identification, thus confirming that the home operates a robust recruitment procedure. The manager of another service within the organisation is responsible for coordinating staff training across the four homes. He has a comprehensive training matrix accompanied by staff training records that details exactly who has done what training, when and when refreshers and updates are due. This was not available in the home however. The training records that were available within the home indicate that there are gaps in the mandatory training of staff that require addressing. All four staff have either completed the former Learning Disability Awards Framework (LDAF) induction and foundation courses, or have registered an the new Learning Disability Qualification (LDQ) induction and foundation that has replaced the LDAF. Staff spoken with said that the training provided by the organisation is very good. This was reiterated within the surveys received from staff. Paks Trust 66 Oaston Road DS0000004457.V355208.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, 42 Quality in this outcome area is adequate. The people living in this home cannot be sure that the manager demonstrates management competence in working with relevant legislation. People living in this home can be confident that their views underpin service delivery and development. Health and safety is generally managed safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 24 The home continues to be managed by a suitably qualified and experienced manager. Although a completed improvement plan was received from the manager giving timescales for the completion of requirements made at the previous inspection, the continued failure to meet some of these bring the managers competence into question. Relationships seen between people living in the home, staff and the manager confirmed that they are positive, with staff speaking very highly of him. The home undertakes annual quality assessments via the use of questionnaires that are sent to the people that live there, their relatives and other key stakeholders. This is in addition to the lifestyle audits that the people living in the home complete on an annual basis. Copies of completed questionnaires for 2007 were seen. The responsible person said that once they had all been received they were collated and a report and action plan produced based on the information obtained. Letters are then sent out to relatives and other key stakeholders informing them of the outcome of the quality assessment and how any areas identified as needing improvement are to be addressed. For example, communication was perceived to be poor in the 2007 audit which has been addressed. In addition, the quality of the service provided is monitored via regular staff meetings, and visits by the provider under regulation 26 of the Care Homes Regulations 2001, as well as via informal discussions with the people who live in the home. Evidence was available to demonstrate that the health and safety of people living in the home, staff and visitors is maintained. A sample of health and safety checks was taken, which included fire drills, portable appliance testing, electrical installation testing, fire alarm points and the landlords gas safety certificate, all of which were up to date. Generic risk assessments of the environment were required at the last inspection of this home, which the manager advised would be completed by 31st October 2007 in the improvement plan submitted prior to this inspection. Although a file with generic risk assessments was in place within the home, these were in need of reviewing and updating. There was no evidence of any specific environmental risks having been assessed and management strategies having been implemented. Paks Trust 66 Oaston Road DS0000004457.V355208.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 x 2 x 3 x 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 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 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 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 2 x 3 x x 2 x Paks Trust 66 Oaston Road DS0000004457.V355208.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) Requirement Copies of the written terms and conditions in respect of the accommodation provided must be available to service users. Previous timescales not met. Up to date care plans must be available, dated, and regularly reviewed with service users at their request, or at least 6 monthly, and updated to reflect changing needs. Agreed changes must be recorded and dated. Previous timescales not met. Timescale for action 31/05/08 2. YA6 15,12(4)(a) 31/05/08 3. YA9 13.4(a)(b)(c) All identified and known risks to service users must be recorded on their care plan and strategies agreed, with written guidelines for staff to follow, and recorded on the care plan of how the risk is to be minimised. Previous timescales not met. 31/05/08 Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 27 4. YA42 13.4(a) The manager must ensure that a risk assessment of the environment is completed to ensure that all parts of the home to which service users and staff have access are so far is reasonably practicable free from hazards to their safety and that the outcome of the risk assessment are documented and kept under review. Previous timescale not met. Accurate training records must be available within the home. 31/05/08 5. YA35 18(1)(c) 31/07/08 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 YA39 Good Practice Recommendations It is recommended that service users have the support of an advocate when involved in any process where their views of the service provision are sought, this could be a member of their day services staff, friend or family member. The manager should approach Warwickshire Social Services learning Disability Team and request care management reviews take place where these have not happened in the last twelve months. It is strongly recommended that the manager reintroduce strategies, such as resident meetings, for seeking feedback about the service from the people who are using it. 3. YA6 5. YA7 Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Paks Trust 66 Oaston Road DS0000004457.V355208.R01.S.doc Version 5.2 Page 29 - 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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