Inspection on 24/05/07 for Park End Road

This inspection was carried out on 24th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 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

Park End Road 18/05/09

Park End Road 02/11/05

Park End Road 19/07/05

Park End Road 23/02/05

Park End Road 23/11/04

Park End Road 24/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Park End Road 20-22 Park End Road Romford Essex RM1 4AU Lead Inspector Mr Roger Farrell Unannounced Inspection 24 May 2007 11:00 Park End Road DS0000027869.V337442.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 Park End Road DS0000027869.V337442.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. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park End Road Address 20-22 Park End Road Romford Essex RM1 4AU 01708 736439 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) utel@outlookcare.org.uk Outlook Care Vacant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2005 Brief Description of the Service: Park End Road is a care home that can provide accommodation and support to seven people who have a learning disability. The premises are two joined together semi-detached houses that are a short walk away from the shops and transport links of Romford town centre. Each resident has their own wellfurnished bedroom, and share the homely communal rooms. It is run by Outlook Care, a not-for-profit organisation who provide a range of services for vulnerable service users in N E London and Essex. The building is owned and maintained by Havering Council. The seven original residents moved in when the home opened in May 2000, six having lived in a council run old-style home called Hamlin House. For the last seven years this home has been twinned with another home three miles away in Harold Hill, sharing the same manager. The registered manager, Gill Leonard, retired in early 2007, and it has been decided that both homes will now have their own manager. The current fees are £831.50 per week. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place between 11am and 5pm on 24 May 2007, with the inspector returning the following week to complete his checks. On the first day three residents arrived back from a holiday in the Algarve. The two other residents had been away the previous week at Centre Parks in Suffolk. Indeed, the inspector had called the previous month, but all residents were out with staff taking part in a bowling tournament. Gill Leonard had been the registered manager of both the twinned homes for the past four year, having worked at the Widecombe Close home since it opened seven years earlier. She had worked with the original residents at Hamlin House. Sadly, she was away from work from February 2006 due to ill health. Just ahead of this inspection she had decided to retire early. Whilst she was away the deputy had stepped forward as the acting manager. The organisation have made the decision that Widecombe Close and Park End Road will now have their own managers. Soon after this inspection, the deputy/acting manager – Ute Liniker – was confirmed as the new manager and has applied for registration. She returned to the home on the first day of the inspection, and did an excellent job of dealing with the inspector’s enquiries. This included being able to provide clear and up-to-date records. She was also able to give detailed accounts of individual’s current health and care needs without having to refer to notes or other staff. She clearly has been a big success in stepping forward to run this service whilst the registered manager was away with health problems. Appreciation was evident in the comments from residents and staff. The home currently has five residents. Sadly one resident passed away, the manager having kept all parties informed regarding this person’s medical condition. In January this year a resident moved to the twinned home in Widecome Close. He was already good friends with the people in that house, and his good day-to-day living skills were better matched to those in his new household group. He has settled well, and told the inspector a couple of weeks earlier how happy he was with the change, saying - “This is a nice house. I like it, and I like the people.” The inspector would like to say thank you to all the residents who spoke to him, especially hearing about the success of the holidays and being around whilst people were settling back into their home. The inspector sent questionnaires to the relatives of all service users who have family contact. He is grateful to those who returned ratings and comments. In particular, he has noted that ticks and comments regarding the service and staff support are all positive. He is also very grateful to the resident that acted as the ‘link service user’, making sure the inspector got a high return of forms giving residents’ views. These comments, and those of relatives have been important in helping the inspector arrive at the conclusions reached in this report. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 6 The inspector took time to explain to the manager the changes in the way care services are monitored. Using a flow chart, he described each change, including – the frequency and types of inspection; the increased importance of self-assessments; ‘star-ratings’, and how these will be made public next year; and ways of hearing the views of people who use services and their representatives. He also outlined how the Commission is moving towards having regional contact offices, and how to make sure information reaches the right inspector. What the service does well: What has improved since the last inspection? In addition to meeting all the standards checked by inspectors, this service can still show excellent innovations. Examples of the this include the approach to health care monitoring and how this is recorded in the new files – which also shows the ways they practically help residents make choices and decisions about their lives, including using innovative ways to communicate using pictures and photos. The move on of one resident who had lived at the home since it opened has been a real success. Staff at this home recognised that this person would benefit from being part of a more able household group, which indeed has been the case. It is positive that the organisation have now arranged for Park End Road to have its own manager, and the person appointed has demonstrated over the past year that she has the necessary skills and knowledge to keep this service on an even foundation. She in turn was quick to praise the significant contribution of the acting deputy and the team as a whole. She has quickly shown that she can maintain the managerial, practice, and administrative systems in line with the expectations of Outlook Care and the Commission. The expense of replacing the fire alarm Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 7 system has delayed other improvements. Nevertheless, it now looks that building an extension is a real possibility. Compliments this year have included how the facilities have been improved, including making the garden more attractive. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Park End Road DS0000027869.V337442.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 Park End Road DS0000027869.V337442.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, 3, 4 and 5. Quality in this outcome area is ‘good’. This judgement has been made using available evidence including a visit to this service and hearing about the arrangements for the two service users thinking about moving to this home. The inspector also looked at the arrangements for helping the residents who moved to Widecombe Close. All these standards are scored as satisfactory. The use of pictures and symbols helps make key information understandable. This includes the information that can be used help the new residents make a choice about moving to this home. EVIDENCE: The inspector looked in detail at the paperwork covering the two service users who were likely to join this household. A staff member gave an overview of the contact so far, and later the manager gave a fuller description of the assessment and move-in plans. One person was likely to move-in in a few days, the plans having taken into account his current circumstances in a supported living scheme. There was a log of the new person’s initial visits, and a weekend stay. The manager said – “He was considered to be at risk where he is staying, so we have had to move quite quickly. All the service users seem quite happy, and we have not heard or noted anything negative. His parents have been very involved, there has been positive and close contact.” The manager and a more senior service manager had completed the assessment forms and had followed the guidelines set out in the organisation’s ‘Referrals Procedure – Residential Care’. The file contained a good referral report from the local CTLD, and a copy of the person’s current care plan. There Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 10 was also a detailed ot report, and copies of other important information such as earlier assessments and college reports. Both prospective residents have the same social worker, the manager saying how helpful she has been, adding – “She has been very good at providing all the information we required. She understands our circumstances, and accepts that it will be better to settle (the first person) in, and then plan for the other service user. We would like to have involved an advocate but this has not been possible, but we will arrange it as soon as possible.” The same attention to good information gathering was also the case with the second prospective resident. The manager said – “She is moving from home, so everyone realises what that this is a big change…but the service user and her family are saying they are looking forward to it. She visited last Sunday for the first time, and we are looking at how she is with the noise around her as she does not like too much noise.” The inspector has previously seen examples of the original assessments that were used to match places at Park End Road. These showed good cooperation between all those involved, including residents and their families. The up-todate files have carried forward some important early information, such as the good profiles and medical details. Equally, there was very good joint working around the transfer of the resident who moved to Widecombe Close last year. The inspector can confidently conclude that this service is taking a detailed and well thought through approach to assessments and move-ins, all in line with Outlook’s policies and procedures. The ‘statement of purpose’ and ‘service-users’ guide’ have been put together in a way that make them understandable to the residents using pictures and photos. Each person has a pictorial contract of residency, and a signed copy of the licencee agreement on their personal file. Park End Road DS0000027869.V337442.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, 8, 9, and 10. Quality in this outcome area is ‘excellent’. This judgement has been made using available evidence including a visit to this service. This included seeing how residents’ files are kept up-to-date, and the very successful ways that are used to include residents in decision making. Individual choices are evident throughout the personal files, and this was the case in residents’ comments to the inspector EVIDENCE: Outlook Care use the ‘Person Centred Planning’ (‘pcp) approach. This provides the framework for the layout and content of service-users’ plans. This includes a comprehensive set of needs assessments under a wide range of user-friendly headings, which lead on to the action plans and risk assessments. The main sections of the ‘pcp’ files are designed to fully involve the resident in their support planning and how they spend their time. Understanding and inclusiveness is helped by the extensive use of pictures and photos. At this visit the inspector looked at a sample of service user files, including for one person who has little verbal communication. The main positive development is how there is now a more systematic approach to health monitoring. This can be seen in the ‘health folders’. The inspector talks about Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 12 this innovation a bit later. However, the main support plans are of a very high standard. This includes the extensive use of photos and pictures to help understanding. The care plans covering practical support are excellent, with point-by-point guidance, again using pictures wher appropriate. This thorough approach includes making sure all sections are reviewed regularly. For instance, the support plan sheets and wide range of individual risk assessments had all been reviewed the previous month, and there were helpful summary sheets. Other excellent highpoints were the detailed ‘pcp’ reviews, and more recent ‘in-house reviews’; monitoring sheets such as for weight and foot-care; and the sensitive detail in the first section following the ‘my plan’ sequence. This is very good news as a couple of years ago the inspectors said practice files were not being kept up-to-date. The top ‘commendable’ rating is now deserved for the excellent standard of support plans, including how they are made understandable to the service users and show how they have a large voice in how they live their lives. In addition to day-today notes there are also individual diaries covering items such as appointments and helping with household tasks. All practice files are being maintained and kept up-to-date in line with Outlooks Care’s policies. , Files also have a good range of individual risk assessments, and a record of where there may have been an infringement of rights. Equally, there are lots of ways residents are able to express their views on wider matters. This includes - monthly house meetings, and the inspector saw the agenda sheets and the file of minutes; a monthly in-house advocacy group with a facilitator from ‘People First’ who does pictorial minutes; Outlook Care’s own service user forums, with forward planning sheets such as deciding on the theme of future party evenings; an agreed set of ‘house rules’; and a range of Makaton guides. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is ‘good’. This judgement has been made using available evidence including a visit to this service. All the standards are achieved, meaning that residents continue to get the right support to develop their living skills; be involved in planned weekday activities; and have lots of fun on holidays and social events. They are helped to stay in touch with their families. Residents say they are happy with the meals. Asked what they thought the home did well, one person wrote – “My wife and I feel that the loving care and affection shown to clients by the staff is extremely good.” EVIDENCE: Files have weekly programmes showing that residents continue to attend a range of centres and colleges, typically for at least three days each week. This includes Nason Waters, Boxhill College and the Western Road Lifeskills Centre. All residents need to be accompanied when going out. The home does not have it’s own vehicle, but residents make good use of the council’s transport scheme and ‘dial-a-ride’. There are ten extra hours a week used for supporting activities in the community. Popular activities include – pub lunches; evening meals out; swimming; bowling; cinema; themed parties with other Outlook homes; a couple of evening clubs; and the monthly Spillsbury disco. At this Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 14 visit the inspector went through the ‘activities resource book’. The ‘pcp’ files have monthly resume sheets of activities, and set out each person’s family links and friendships. Additionally, the inspector saw the ‘photo-story’ yearbook showing last year’s highlights such as the holidays to the Isle of Wight, a farm break in Norfolk; the musical Oliver; residents casting their votes; a Caribbean Fun Day; and the organisations ‘inclusion conference.’ He also saw the music workshop folder, and the teaching skills pack. As mentioned earlier, three residents had just been on holiday to the Algarve, with the other two residents having been to Centre Parks. Further examples of educational and social events are recorded in the pictorial ‘End of Year Review.’ This lists matters such as a behaviour therapist giving tips on avoiding arguments and how residents got involved in improving the garden. Also included are other innovations based on using pictures and photos rather than words – such as the ‘photo-rota’; ‘today’s appointments’; and the picture menu. At previous visits the inspector has joined the residents for a meal, and has always found them relaxed and pleasant. At his recent residents told the inspector that they were still very happy with the meals, confirming that they have a main say in what is served. Park End Road DS0000027869.V337442.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 and 21. Quality in this outcome area is ‘excellent’. This judgement has been made using available evidence including a visit to this service. The descriptions of contacts with doctors and other health care workers - along with the high standard of records - means that there is a strong evidence of good personal and health care support. EVIDENCE: Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 16 Earlier the inspector mentioned the good standard of recording personal support plans, including the individual guidelines – and this now includes the new health care folder and a ‘my health care’ section. This includes a health care action plans; an annual health care planning grids; details of medication, drug reviews, and consent forms; related correspondence; medical reviews, including a pct health care check list done with the GP. This included involving an advocate – for instance a resident’s choice to carry on smoking. Some sections again use pictures to help understanding, such as the consent forms. There are individual tracking sheets for each type of practitioner – GP, dentist, optician and so on. Files also have details of involvement of psychologist, occupational therapists, and a speech and language therapist. The manager described the support they receive from their local GP practices which is satisfactory. All relevant sections of the health care records seen by the inspector had been reviewed within the last couple of months. No resident who is currently on medication is assessed as capable of taking control of their medicine. The inspector looked at the arrangements for the ordering, storage, administration, and disposal of drugs. Boots supplies medication monthly in their monitored dose blister packs, with printed recording sheets. Whilst the manager was away last summer supplies were relocated to a locked kitchen cupboard. However, this cupboard was above the washing machine and at time the temperature was over the recommended level. A sturdy lockable bureau is now used, kept in the dining area. This was neatly and safely arranged. Medication is provided by Boots in their monitored dose bubble cassettes, with printed recording sheets. Medication is locked away in a cabinet. The inspector looked at the medication records on the first day, ahead of the manager arriving. The medication recording sheets have photos attached. In addition to the general procedures, the inspector saw the helpful individual guidelines and information on the drugs being used, and the individual risk assessments. Boots have provided staff with training in the past, and visit to inspect the arrangements about every three months. The manager and other staff have done the more detailed ‘Safer Handling of Medication’ course. Outlook Care also carry out their own detailed medication audits. One of the supplying pharmacists earlier reports concluded – “The records of medication are the best I’ve seen in a home….the atmosphere is light and happy – a lovely home.” Park End Road DS0000027869.V337442.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 ‘good’. This judgement has been made using available evidence including a visit to this service that involved looking at the ‘complaints and compliments folder. The manager is aware of the action to take if there is a complaint or a suspicion of abuse. Residents and relatives are made aware of how they can raise concerns, and can be confident that these will be followed through. This includes having regular contact with a ‘formal advocate’ who the service users know well. The one relative to comment under this heading in the questionnaire said - “I have never had to use the complaints service.” EVIDENCE: Outlook Care have a clear and effective complaints procedure pack, and a copy is available at this home. Information on making complaints is included in the pictorial ‘service users’ guide’, and displayed on the notice board. This includes details of how to contact the advocacy service and the Commission, with a ‘one touch’ telephone connection to both these external services. Complaints are a standing item on the agenda of the residents’ meeting held each month, there being a file that has the minutes of these meetings. The policies covering adult protection include ‘Infringement of Service Users’ Rights Procedures’; ‘Whistleblowing’; and ‘Abuse Management’. In addition there were copies of ‘No Secrets’, and the local Adult Protection Guidelines. The leaflet ‘No More Abuse’ produced by ‘Voice UK’ and ‘Change’ is also available. Staff do a one-day course on adult protection, and sign to confirm they have read the local guidelines. Each staff member has been given a copy of the General Social Care Council’s ‘code of practice’, and give informed answers when asked about safeguards. When issues have been raised in the past the procedures were followed. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 18 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, 25, 26, 27, 28, 29 and 30. Quality in this outcome area is ‘good’. This judgement has been made using available evidence including a visit to this service. This is a well-maintained, homely and clean house, which residents say they like. One person keeps her bedroom quite bare, but the other residents have made their own rooms very comfortable, which show their tastes and interests. The manager and staff say that adding a conservatory would be very helpful. EVIDENCE: The home was created by joining two neighbouring houses, there being one main communal room used as a lounge and dining area. The communal space falls fractionally below the recommended space standard, but overall the home provides reasonably good quality accommodation, and residents tell the inspector how much they like their home. The inspector again found the premises clean, safe, comfortable, well ventilated, and with good attention to home making. It is situated five minutes away from the main shopping mall in Romford. The surrounding area has restricted parking, but the house has a front parking bay. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 19 At this visit two residents showed the inspector their bedrooms, and he saw three others. These are generally pleasantly decorated and well equipped, reflecting individual’s interests. One resident’s room is quite sparse, but this is out of choice, and she does not like sleeping in a bed. Staff are continuing to try various ways to adapt her room to meet her preferences. The main room is decorated in a bright contemporary style, and new carpet has been fitted. However, when asked staff say that the main improvement they would like to see is a conservatory extension. They say that all residents use this room a lot, and just having the one main room means there can be restrictions, one person summing this up – “Sometimes some [residents] want to watch tv, some want to play music, and others want it quiet to get on with their writing or art.” The manager indicated that progress on adding such an extension could take place this year. The environmental health inspector has also said that they would like to see the washing machine moved out of the kitchen. There is plenty of garden space to the rear for such developments. The priority over the past year was to renew the fire panel and alarm system, which now has zones; and new kitchen units are due to be fitted. Three residents need to use a wheelchair at times away from the building, but all are mobile in-doors. Bathrooms have a small range of adaptations. There is an assistance call system but this is not used at present. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is ‘good.’ This judgement has been made using available evidence including a visit to this service. A relatively stable and caring team supports residents who live at this home. They are well trained, including most having gained relevant qualifications. Over the past couple of years they have shown that they can cope with some difficult demands, and carry on in the absence of the regular manager. EVIDENCE: The staff team is made up of – manager (21 hours); deputy (30 hours); 3 f/t, and 4 p/t support worker posts – giving a total of 253 hours, excluding the manager and deputy’s ‘off shift’), and a further 10 hours for community support activities. There is also a p/t housekeeper. Normal cover is - two people on each of the early and late shifts – though there is often an additional ‘day’ shift on weekdays – and one person on sleep-in duty. At his last visit the inspector looked at a number of staff files to check on vetting. These contained completed application forms; two written references; a photo; copies of passports; medical forms; and statements of terms and conditions. The organisation are a registered body with the CRB and have received enhanced level checks on all staff at this home. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 21 The organisation has a very good record on training and induction. The inspector was given copies of each person’s training profile. This shows that all have done training in all the expected core areas, including safeguarding procedures; first aid; food hygiene; and manual handling; and infection control. Additional training has included ‘Working with Dementia’, ‘personal safety’/lone working’; autism awareness; and the company’s quality control systems. Five staff have NVQ qualifications at level 3, with one person currently on the scheme. Five staff have NVQ qualifications at level 3, with one person currently on the scheme. This means that they have met the target to have at least 50 of qualified staff. The inspector checked a sample range of staff files. This showed that the required checks are carried out, including - written references, CRB certificates, and documents that prove identity, as well as a recent photo. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 22 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, 38, 39, 40, 41, 42, and 43. Quality in this outcome area is ‘good.’ This judgement has been made using available evidence including a visit to this service. Outlook Care are very good and running their services in an open and accountable way. There are a number of in-house and external service audit systems; good ways for residents to make their views known; and clear policies and procedures. This works well in providing monitoring and safeguards for those who use their services. The new manager said she has found the team, and her line managers very supportive. EVIDENCE: Ute Liniker has an NVQ in care at Level 4, and intends to start the registered manager’s award. At this visit the inspector asked to see a range of documentation and certificates covering health and safety. This included fire safety arrangements; electrical, gas and water safety checks; periodic building safety checks; and insurance cover. The last inspection by and environmental health inspector was in August 2007, with satisfactory findings, and the three recommendations are Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 23 being followed up. An independent fire risk assessment carried out in September 2006 – and the recommendation on fitting a new, zoned alarm system has been completed. The manager presented all the records in an ordered and efficient way, reflecting the good office arrangements. There are a range of quality assurance systems. This includes regular ‘monthly visit reports’; specialist audits such as the medication arrangements; and external accreditation schemes like ‘ISO9002’, ‘Investors in People’, and ‘Positive About Disabled People’. The company operate a quality assurance scheme – called the ’Continuous Improvement Programme’ (CIP). This includes steps to ensure that staff are familiar with all current policies, guidelines, and practice forms. This has also included doing some policies and procedures in an ‘easy read’ format. Recently, managers have been doing a ‘self-assessment of their service. This positive approach to quality monitoring leaves them well placed to tackle the ‘AQAA’ assessments being introduced by the Commission this year. Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 3 3 3 3 3 3 3 3 Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Park End Road DS0000027869.V337442.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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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