Inspection on 28/10/08 for Parkside Health Care Ltd

This inspection was carried out on 28th October 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

Parkside Health Care Ltd 10/06/10

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Parkside Health Care Ltd Parkside 1a Tibbington Terrace Tipton West Midlands DY4 9HJ     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: Sally Seel     Date: 3 0 1 0 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. the things that people have said are important to them: They reflect 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 31 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 31 Information about the care home Name of care home: Address: Parkside Health Care Ltd 1a Tibbington Terrace Parkside Tipton West Midlands DY4 9HJ 01709565822 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jane Deborah Blunt Type of registration: Number of places registered: Exemplar Homes Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 20. The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder (MD) 20 Date of last inspection Brief description of the care home Parkside is a new two storey building that is located in a residential road close to the Tibbington estate in the Tipton area of Sandwell. It is close to all amenities and transport links for Sandwell, Dudley and Birmingham. and is close to bus links, train stations and motorway networks. The accommodation consists of twenty single occupancy bedrooms all with en-suite facilities, which include a walk in shower. Ten bedrooms are on the on the first floor, and ten ground floor bedrooms. All bedrooms Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 20 Brief description of the care home exceed current National Minimum Standards about personal space. All rooms have access for wheelchair users. A training room located on the 1st floor that will also be used as function room. Furnishings are in accordance with relevant sections of the National Minimum Standards for younger adults and are of a high standard. A laundry room is provided on the first floor with relevant equipment being provided. There is a bathroom with toilet on each floor and separate toilets. Each bathroom includes sensory facilities. Of the six lounges and it is intended that two will be used as quiet rooms, the ground floor lounges have access to the large garden via double doors. A large commercially equipped kitchen with catering equipment is available that is conducive to the size of the home and number of people to be accommodated. This includes an adequate dinning area for up to 12 people on each floor. The home has private parking for twelve cars is located at the side of the property. There is a pleasant garden to the rear of the premises mostly laid to lawn but has patio areas aswell. The garden has suitable perimeter fencing to provide privacy and is gated guaranteeing access and security. In the garden area there is a gazebo which can be used for people who smoke as people cannot smoke within the home. Specific information regarding fees charged for living at the home is not included in the homes Statement of Purpose. Interested parties should contact the home. Care Homes for Adults (18-65 years) Page 5 of 31 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: The focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements and minimum standards of practice and focuses on aspects of service provisions that need further development. One inspector undertook this fieldwork visit to the home over a fourteen hour period. The registered manager and clinical manager and staff members assisted us throughout. The home did not know that we were visiting on that day. There were three people living at the home on the day of the visit with the fourth person visiting their family. The inspector gathered information from speaking to staff members and some observation of people who lived at the home. Three people were case tracked Care Homes for Adults (18-65 years) Page 6 of 31 with a fourth care record partially sampled. This involved discovering peoples experiences of living at the home. This was achieved by meeting people or observing them and speaking with staff members looking at medication and care records and reviewing areas of the home relevant to these people, in order to focus upon outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records and health and safety records were also reviewed. Prior to the inspection the registered manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This gave us good detailed information about the home staff and people who live there improvements and plans for further improvements, was taken into consideration. Also surveys were sent out to people who use the service and two surveys were completed and returned to the Commission for Social Care Inspection, (CSCI). Information from all of these sources was used when forming judgements on the quality of service provided at the home. The people we case tracked consisted of both male and female with differing communication and care needs. We asked the registered manager how people who lived in the home would like to be referred to within this report and it was confirmed that ther term residents would be most appropriate. The atmosphere within the home is inviting and warm and we would like to thank everyone for their assistance and co-operation. What the care home does well: What has improved since the last inspection? What they could do better: Care planning needs to be further developed to ensure that individuals, families and/or friends are appropriately part of this process so the choices and preferences in relation to meeting peoples specific needs are upheld. The home must ensure that individuals last wishes are recorded so that people can be reassured that their rights and choices will be upheld when the time comes. The home must monitor difficult to manage behaviours and ensure that daily recordings provide sufficient and consistent information for staff to follow so that appropriate actions are taken to safeguard people living in the home. The home must support individuals to develop their life skills and to participate in activities within the home and community that meet peoples needs. Care Homes for Adults (18-65 years) Page 8 of 31 Improvements to some medication practices must happen to ensure greater protection to residents. The home must ensure that all people are able to access the homes complaints/issues/compliments systems so that people can be reassured that their concerns and recommendations are listened to and acted upon. Sufficient numbers of staff, at least 50 , must complete their National Vocational Qualification Level 2, (NVQ), to ensure that residents can feel confident that their needs are met by a knowledgeable and skilled workforce. A list of recommendations is located at the back of this report if people wish to view. 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. 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 31 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 31 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. Sufficient information is provided to people considering moving into this home so that individuals can decide if the home fulfils their needs and aspirations. Peoples needs are always assessed prior to moving into the home so that people can feel confident that their needs will be met appropriately. Evidence: This is the homes first inspection since being registered with us. We were informed that there are currently four residents living in the home with one of these individuals on home leave at the time of our visit. The home is registered for twenty people. The home have undertaken further assessments of peoples care needs who are considering moving there. The home also offers respite care which means that people can live in the home for short periods of time and some people may be following a rehabilitation programme so that they can return to their own home in the community to live as independantly as possible. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: The home has a statement of purpose and service user guide which set out the aims and objectives of the home. For example, they include details in relation to the registered managers experience and qualifications, the environment, daily life and activities, staff roles and qualifications, rules on smoking and how to complain. Both the statement of purpose and service user guide are avaliable in larger print, Braille, alternative languages and audiotape on request. We partially sampled a care record of a person who was going to move into the home in about a weeks time. This person was visited by the care manager and a nurse from the home who spent an hour and a half with the person to gain sufficient knowledge of their life, mental health and medical needs, physical needs and interests. This would ensure that staff have sufficient knowledge of the individual so that they can meet their needs. it will also help the prospective resident to decide if the home is suitable for them. Although the care record sampled stated that this person was included in their assessment it was not clear that this had happened from reading the care records ( further discussion in individual needs and choices). We did not find any contracts of residency within any of the three residents care records that we case tracked. Therefore we could not assess if residents legal rights are being protected with regard to terms and conditions of residency during this visit. Two questionnaires have been completed by residents who live in the home. These state that both people were asked if they wanted to move into the home and enough information was provided so that they could make a decision about whether the home was the right place for them. Care Homes for Adults (18-65 years) Page 12 of 31 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. Care planning and risk management are good and ensures individuals needs are identified, met and reviewed. There needs to be further work around ensuring people are involved in writing their care plans where possible with evidence that this is the case. Daily records should be written with respect to the person ensuring that this is promoted in practice. Evidence: We examined two care records and partially looked at a third one, we talked to staff and indirectly observed practices and found that the care planning processes do generally meet all residents needs. They are very detailed in relation to highlighting individuals specific needs and risks with goals for staff to meet these and who will be responsible for monitoring these processes. For example, in one persons care record it is identified that the individual will be supported to have a shower regularly with unfragranced toiletries to prevent any skin irritations and the home to purchase unbiological washing powder. In another residents care records within their care plans Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: it has detailed information about their behaviour which is linked to their mental health needs. It states the goal is to prevent this individuals mental health from deteriorating. It provides staff with instructions to follow and ensures medication is given but also informs staff that they should allow this resident to express their own feelings and thoughts. Daily records are completed for each person living in the home. These give an insight into the persons routine each day, their state of wellbeing and any appointments they have attended. Additional care should be taken to ensure that the recordings are respectful to the person. For example, in one care record that was sampled staff used the word trick in describing how they would manage a persons problematic behaviour and referred to this person as being just a management problem. We expressed our concerns to the registered manager with regard to how peoples daily recordings are written by staff members. The registered manager acknowledged this and would ensure that this practice is looked at. We were told that residents are involved and consulted in relation to drawing up their care plans. This is also confirmed within the homes statement of purpose, Residents are encouraged to be involved with their personal plans. In one care record that we sampled there was evidence that the individual had been included in this process and they had signed their name on each plan. On another residents care plan it was stated that the individual would be too distressed if staff tried to inform them of their care plan. However, there was no evidence to suppport whether the staff had involved a family member, appropriate friend or an advocate for this person. We discussed this with the registered manager who will ensure that staff do involve family members and/or professionals if individuals lack insight into their needs due to their mental health. This will help promote peoples needs, rights and compliance with the Mental Capacity Act. The residents in the home have a range of needs including communication, behaviour and sensory. The home operates a key working system which means that residents are supported by an identified person to relate to if things are not right for them. Some staff were seen communicating with people with respect and dignity but it is now recommended that the home ensures that residents meetings do take place in the future as the home has more people coming to live there. This will ensure peoples choices are listended to and they are involved in decision making. We were unable to have discussions with residents within the home and therefore spoke with four members of staff who were on duty at the time of our inspection. We asked, how they support residents, their responsibilities and their understanding of the values and principles behind person centred approaches to care. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: In the main staff gave good responses. For example, with regard to supporting and promoting residents indpendence, You should never assume a person cannot do something as X can use the swingball activity and play football. Told X they can make a drink as this is their home. Care Homes for Adults (18-65 years) Page 15 of 31 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. The home are in the process of recruiting an activities co-ordinator to ensure people have opportunity to develop their life skills and to participate in activities to meet their needs so that individuals lead active and fulfilling lives. Meals are well presented with healthy options and inidviduals cultural needs are promoted. Evidence: We talked to staff and examined records and found efforts are being made to support some people to lead stimulating and interesting lifestyles but this is very limited at this time. However, there is some evidence on care records that residents go to the cinema, visit local shops, go for walks, activities such as painting and swingball are undertaken within the home. Improvements to the choice of activities in the home and particularly in the community should now be undertaken so that people are able to lead fulfiling lives. For example, there is one person who used to attend a day care Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: centre but they are no longer able to go there. There is evidence that supports staff are awaiting this persons social worker to identify a new day centre which this individual could attend. The registered manager told us that they are in the process of recruiting a person dedicated to complete activities with people of their choosing. The home has not done this before now due to only having a few residents. The registered manager also has ideas to improve the homes environment to develop a relaxation room for people. The environment has been planned to promote individuals independance and safety. For example, people have a choice of room prior to moving into the home and there is a kitchen where people can be supported to make drinks together with snacks. Also there are sensory bathrooms where lighting and pictures are projected onto walls to stimulate peoples senses. The registered manager showed us that the home had bought very large bath towels to be used when people have taken long baths for added luxury. Meals that residents have are varied and well balanced. We sampled a meal on the day of our visit which was well presented. The catering manager has promoted residents choices and takes people to the local supermarket to choose their food. Also the catering manager has asked residents families for recipes of meals that could be prepared for peoples enjoyment. This means that cultural choices are well promoted within the home. People are assisted and supported with their meals appropriately. For example, the catering manager noticed that one individual was struggling to eat their meals and special cutlery was bought to help this person. Their independance was promoted by staff only supporting and assisting this person when they are struggling. Mealtimes are flexible to meet the needs of residents. Dining tables are well presented with place mats and condiments for people to use. The home has an open policy in relation to visiting and there is evidence of families and friends visiting the home. One resident had gone home for a few days when we visited. A visitors suite is available with en-suite facilities for families that wish to stay overnight which shows that the home further promotes and helps residents to maintain the relationships that are important to them. Care Homes for Adults (18-65 years) Page 17 of 31 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. In the main health and personal care that people receive is based on their individual needs. Further work is needed with regard to administration and recording of medication to ensure that individuals are safeguarded by a robust medication system. Evidence: We observed that staff paid attention to each persons personal care; people were wearing clothes in good condition suitable to their age and gender. Staff were seen promoting residents privacy and dignity by ensuring that inidviduals receive any assistance with their personal care in their preferred way and in private. There were good plans in place to meet individuals health needs with problem areas identified with goals and intervention so that residents can be reassured that their health is managed safely. For example, in one persons care plan it was noted that the person had diabetes which is managed by insulin. This individual had no insight into their diabetes and would therefore be at risk of neglecting the management of this without staff administering their insulin. The goal was to ensure that the residents blood sugar levels are maintained closely to the recommended level of 6 or 7. The Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: intervention by staff was documented, to monitor blood sugar levels and measure these regularly. To administer insulin as prescribed. Also there was advice from the diabetic nurse on management of this individuals diabetes for staff to follow so that any insulin given would be effective. In another individuals care plan it was noted that staff needed to be aware of residents known neglect of their insulin. The goal was for staff to, monitor and maintain individuals blood sugar levels and encourage the person to take responsibility of their own insulin administration but blood sugar levels needed to be checked. Insulin must always be available and ordered on time. It was also recorded that if nails need cutting to arrange this with chiropodist. The care records we sampled had evidence of residents being supported to attend various appointments for eye care together with doctors appointments for monitoring purposes as well as when residents feel unwell. This shows that the home are not just using reactive measures when people are feeling unwell. Medication systems require some improvements to ensure greater protection to residents. For example, the home must have a robust system in place when administering medication to ensure that staff are able to account for what medication they are giving to residents. Also the codes that are used on individuals medication administration records, (MARS), to inform other staff when some medication has not been given must be the correct one. This will enable other staff on duty to see at a glance the reason for an individual not having received their medication. It is recommended that all creams and lotions have the date when they were opened together with a description of the part of the body they should be applied. The storage space for medication was clean and tidy with no overstocking. A member of staff has now been nominated to ensure that safe medication practices are upheld at the home and staff are completing the medication administration records appropriately. The care records that we sampled did not have any details of inidviduals end of life care so that peoples wishes are taken into account at this time. This was discussed with the registered manager and care manager and we were shown documents that have been devised and it is recommended that these are now implemented. This will mean that people will have the opportunity to plan their end of life care and the home will make arrangements to meet their needs when the time comes. Care Homes for Adults (18-65 years) Page 19 of 31 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. Efforts need to be made to ensure that people living in the home know how to make a complaint. The management of behaviours need to be safe particularly when administering medication. Recruitment practices are robust and safeguard the people living in the home. Evidence: The homes complaints procedure is included in their statement of purpose and service user guide so that people know how to make a complaint if they need to. However, the home may need to promote their complaints procedure as one questionnaire that we received stated that the individual knew who to speak with if they were unhappy but did not know how to make a complaint. In another questionniare the resident confirmed that they do not know who to speak to if they were unhappy and did not know how to make a complaint. The registered manager confirmed that the home have not received any complaints and neither have Commission for Social Care and Inpsection, (CSCI). The home have a complaints book for people to use which is stored in a cupboard in the homes main reception area. Following discussions with the registered manager we recommend that this book is on show in the main reception area so that all people are able to access this book without asking. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: The home has an adult protection policy which staff are able to refer to. All staff have received training in adult protection procedures so that residents can feel confident that the home is able to keep them safe from harm and the staff will act appropriately when allegations are made. Also all of the staff we spoke to demonstrated a good knowledge and understanding of their responsibilities with regard to protecting residents from harm. For example, Would report it to senior and manager. Would raise it with the person abusing even if it is a colleague. Go straight to the manager. We found evidence in one individuals daily recordings where staff had been advised by this persons previous accomodation to hold the individuals arms down so that insulin can be given if they decline their insulin. It was not clear in the residents daily records whether staff actually took this advice and practised it. Therefore we strongly recommend that within all residents care plans and risk assessments, the home must include triggers for certain behaviours if known, forms of behaviour amd diversion tactics. In addition to this the home should take further advice from residents own doctors in relation to individuals declining their medication. Guidelines should also be agreed within a multidisciplinary forum when required. This will offer greater protection to residents and ensures that peoples human rights are not compromised. Care Homes for Adults (18-65 years) Page 21 of 31 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. Individuals live in a safe, well-maintained and comfortable environment that encourages independence. Evidence: We toured the premises and found it to be decorated and furnished to a very high standard. The home was built new and the service was registered with us in April 2008. It was assessed as meeting the requirements set out in the Care Homes Regulations and stated in the National Minimum Standards. Parkside is located along a residential road close to the Tibbington estate in the Tipton area of Sandwell. It is close to all amenities and transport links for Sandwell, Dudley and Birmingham. There is sufficient off road parking located at the rear of the home. The home has a ground floor and a first floor each floor comprising of ten bedrooms. The first floor is accessible via a lift. All bedrooms are for single occupancy all with ensuite facilities which include a walk in shower. All bedrooms are generously sized with high quality furnishings and fittings. There are also two kitchens attached to two dining rooms on each floor for the use of the residents. These promote individuals independence as drinks and snacks can be Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: prepared with the assistance and support of staff where required. There are two sensory bathrooms within the home where residents have the opportunity of taking long baths with sensory stimulation of lights and pictures that can be projected on to walls. Also the individuals choice of music can be played adding to residents pleasure and relaxation. The home has a large fully equipped kitchen which has been inspected recently by the environmental health officer and the home has been awarded gold. There are also separate staff changing facilities and toilets. Also the home have various lounges on both floors which can be used for residents who want some quiet space and others that have televisions. The home does have a training room which can also be used as a meeting room. There are separate laundry areas and these have the necessary equipment in place to ensure infection control practices are maintained such as additional wash hand basins and dispensers for liquid soap and dispoable towels. There are also dispensers for liquid soap and disposable towels in shared WC facilities. There is a pleasant garden to the rear of the premises mostly laid to lawn but there are patio areas and a large gazebo where residents are able to smoke. The garden has suitable perimeter fencing to provide privacy and is gated quaranteeing access and security. Care Homes for Adults (18-65 years) Page 23 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are supported by staff who are able to meet their needs and supplied in sufficient numbers. Evidence: Staff are employed in sufficient numbers to meet the needs of the people living in this home. The home has both registered nurses and care assistants so that people can be assured that their needs will be met by a skillful workforce and in a timely manner. Staff were observed to interact well with the people living in the home and the atmosphere was friendly and relaxed. Four staff files were reviewed and were found to contain all of the relevant information including two written references, evidence of POVA first checks, (Protection of Vulnerable Adults), and CRB checks, (Criminal Records Bureau). Files were well organised and information was easy to retrieve. Staff had been provided with job descriptions and there was evidence that people are aware of their roles and responsibilities. We were told that four staff members have completed National Vocation Qualification Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: (NVQ) Level 2 with two further staff undertaking this qualification. The home must work towards achieving the recommended 50 of staff to ensure that a skilled workforce is provided who have the knowledge and competence to meet the assessed needs of the residents, both individually and collectively. Training records indicated that staff received training in areas, such as, NAPPI, (Non Abusive Physical and Psychological Intervention), fire safety, moving and handling, food hygeine, COSHH, (Control of Substances Hazardous to Health), adult abuse and infection control. Some staff had also received training in, mental health awareness, customer care and oral hygiene. This should ensure that staff have up to date knowledge in order to care for people living in the home. We examined staff supervision records and the contents show that both the employee and the manager have time to reflect on their practice and are able to discuss work related issues which is important to the home in its new beginings. Staff and manager are able to identify training needs to ensure that all employees continue to possess the skills required when looking after residents. The registered manager told us that the home are going to receive some student nurses who will do their placements at the home. This can only benefit the staff and residents alike. Care Homes for Adults (18-65 years) Page 25 of 31 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. The management provides very good leadership and direction, ensuring continuity and consistency, with communication and monitoring systems that are effective to ensure that staff are clear about their roles and responsibilities. Evidence: The home is run by a manager fit to be in charge who has many years of management experience in the caring profession, has completed her registered managers award and is a registered nurse. The manager is clear about further changes she would like to implement in order to ensure that the home is run in the best interests of the people who live there. Staff spoken to generally feel that the manager is supportive and caring. The manager is supported by a clinical manager who is an experienced registered nurse. Staff meetings are held so that people have the opportunity to voice their concerns and suggestions for improvement. Resident meetings have not as yet started but now the home is having more admissions the manager confirmed that these will be Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: implemented. Director of the organisation visits the home and completes Regulation 26 visit reports which look at the quality of the service being offered at the home. On the day of our visit a Regulation 26 visit was completed. The organisation has a number of audits in place to monitor the service provided and sends out questionnaires both to residents and staff. The information from these are collated but due to the home only being in operation since April of this year there are no reports to look at. Prior to the inspection the registered manager had completed an Annual Quality Assurance Assessment, (AQAA), and returned it to us. This gave us detailed information about the home, staff and people who live there and this was taken into consideration. If required residents monies are held by the home in a secure location. Individuals can be assured that the money the home holds for them is safe and secure at all times. Residents can have access to their money when they wish. There are satisfactory policies in place to further safeguard residents. All of the monies checked during inspection were correct with two signatures in place. Health and safety maintenance checks had been undertaken in the home to ensure that the equipment was in safe and full working order. Maintenance checks are completed on the fire system and equipment so that people should be safe in the event of a fire occurring. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 of 31 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 1 6 To consider strategies for improving record keeping by staff to ensure that descriptions of how challenging behaviour is diffused correlates with behavioural management guidelines or explanations are given as to why this is deviated from. This is particularly important when administering invasive medications, such as, insulin. To introduce a person centred planning process to assist residents with developing their care plans and to involve appropriate others where required so that peoples rights are upheld together with their choices and preferences. Staff should receive gudiance with regard to the completion of daily records so that they promote residents rights to respect. A best interest protocol should be introduced to ensure decisions are made in line with the Mental Capacity Act so that residents best interests and rights are upheld. Residents should be supported to develop interests and being integrated into community life so that people are supported to lead full and active lives. The homes medication administration records must reflect the medication that has been given to residents so that Page 29 of 31 2 6 3 6 4 7 5 13 6 20 Care Homes for Adults (18-65 years) individuals are fully protected by the homes medication practices. 7 20 All prescribed creams and lotions should have the date of opening noted on them together with clear instructions for staff to follow in respect of where these type of medications need to be aplpied. Advice regarding shelf lives of prescribed creams should be obtained to ensure they are used within manufactures guidelines as this practice will offer protection to residents. Specific wishes of residents with regards to their wishes around dying, death and funeral arrangements must be obtained and recorded so that inidviduals know that these will be in place when the times comes. A structure for capturing informal complaints/issues/compliments should be implemented that would promote a culture of openness within the home and aproactive approach to identifying and addressing concerns. It is recommended that the responsible person must aim to have at least 50 of care staff who are trained to Level 2 NVQ so that residents can feel confident that their needs will be met by a skilled and competant workforce. 8 21 9 22 10 32 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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