Inspection on 20/06/06 for Pen y Bryn

This inspection was carried out on 20th June 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pen y Bryn 26/10/09

Pen y Bryn 16/08/07

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 48 Hafod Road Hafod Road Hereford HR1 1SQ Lead Inspector Christina Lavelle Unannounced Inspection (& additional visit 27 June) 20th June 2006 02.00p th 48 Hafod Road DS0000065468.V300852.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 48 Hafod Road DS0000065468.V300852.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. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 48 Hafod Road Address Hafod Road Hereford HR1 1SQ 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) 01543 437030 Milbury Miss Angela Tracy Townsend Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may also have a physical disability and/or mental disorder that are associated with their learning disability. The manager must achieve an NVQ 4 Qualification in Care and Management by March 31st 2007. N/A Date of last inspection Brief Description of the Service: The service provider is Milbury, which is part of a much larger company called Paragon Health Care Group. Milbury is also registered in respect of many care homes and supported living schemes across the country. This care home at 48 Hafod Road was registered in November 2005 to provide accommodation with personal care for eight adults, (men and women) aged less than sixty-five. Service users must require care due to learning disabilities and may also have a physical disability or mental health disorder that are associated with their learning disabilities. Service users are very likely to have an autistic spectrum disorder and may also use challenging behaviours. They will therefore have complex needs and require a high level of support from staff. One of the main aims of the service is stated as being “to encourage the people living at the home to achieve their maximum potential in social skills and everyday life skills, so they may live as independent a life as possible” Hafod Road is in one of Hereford’s older residential areas about a mile from the city centre. Service users could walk to town if they are physically able and the home is on a main bus route. The house is a large, detached Victorian property that was converted for use as a care home. There are parking spaces at the front of the house and a large, private and secure garden to the rear. The home has six bedrooms with en-suite shower or bath facilities and two selfcontained flats with their own sitting room, kitchens and bathroom. There is also a sitting room, dining room and fully equipped sensory room for everyone to use. Also a kitchen, laundry room, suitable storage areas and an office. The current fee charged for the service is from between £1680 and £1740 per week. Other charges made in addition to the fee are as follows: • Personal toiletries and clothing. • Holidays – the first £200 being paid by the provider. • Newspapers & magazines. • Hairdressing. • Home’s vehicle - £5.00 a week for service users receiving lower rate DLA & £15-00 a week for service users on the higher rate DLA. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. These two inspection visits are part of a key inspection of this service and is the home’s first inspection since it was registered. The main purpose of this inspection is to assess the service provided against key National Minimum Standards. The first visit was carried out unannounced in about four hours on a Thursday afternoon. Time was spent in the company of the service users, observing their activities and interactions with each other and staff, and one service user discussed their life at Hafod Road. The second visit was arranged at the first visit so the manager (who was on leave at the time) could be available to discuss how the service is developing and other relevant issues. This took place a week later during two and a half hours. Two staff were also interviewed individually and other staff asked about their experience working at the home, training received and knowledge of service users’ and their needs Evidence obtained during these visits and from any other information received since the home opened is also considered. This includes contacts between the Commission, home manager and provider, and written notifications of events in the home that had affected service users. Also the monthly reports made by a representative of the provider following their required monthly visits to check how the home is being run, during which they talk with service users and staff to obtain their views of the home. The manager had also completed a questionnaire that was sent to the home before these inspection visits and provided further helpful information about the service. Various records kept by the home were checked and a tour was made of parts of the premises. Survey forms had been sent to the home before the inspection to be given to service users and their relatives asking for their views of the home. There were only four service users living at the home at this time and so only one survey was returned (completed by the service user’s family). Another relative also contacted the Commission directly to discuss the home. Their comments and other feedback obtained from service users during the inspection visits are referred to in this report. What the service does well: The home carefully assesses the needs and wishes of possible new service users to ensure they could meet them properly before they move in. They also arrange visits and trial stays and give them information about the home in a guide they are able to understand to help them decide if they would like to live at Hafod Road. Relatives and one service user said they had settled well in the home and that the staff were helpful and encourage them to make choices in their daily lives and routines. Both service users’ relatives confirmed they had been fully involved in their move to the home, that staff are approachable and keep in close contact with families and that the house is nice and kept clean. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 6 Good care planning means staff know all service users’ needs and how to meet them. Each service user has a worker allocated to them from the staff team as a “keyworker” who spends time getting to know them and gives them more individual support. They help them to make a plan of their needs, wishes and goals, which makes sure that staff know and are able to meet their personal, health and social needs better. It is good staff receive training so that they are able to understand and support service users with their special needs. The manager and staff are trying hard to find and arrange a variety of interesting activities for service users, which they enjoy and will help them to mix more in the wider community and develop their life and social skills. They include college courses, a farm project, swimming and using local shops, pubs and other facilities. The home has a sensory room and a spacious, private garden, which staff encourage service users to use as well as take part in other activities at home, including cooking and helping with jobs around the house. Hafod Road is in a convenient place for getting into Hereford city and has given service users the opportunity to become part of a local community. The house is very well and suitably furnished, decorated and equipped. It offers service users a very comfortable home where they are able to choose whether to mix with others or to use their bedrooms as private space and make them personal There is an open and positive approach in the home and the manager and staff team are working well together to develop good quality care for service users. All staff undertake a lot of training to help them meet service users’ needs properly and to keep them and the home safe. Staff feel well supported by management and the home also receives good support from the provider. It is ensured only suitable people are employed to work with service users by using thorough recruitment procedures and taking up necessary checks on all staff. What has improved since the last inspection? What they could do better: Staff should receive instruction from the Herefordshire co-ordinator for the Protection of Vulnerable Adults. This would ensure they are clear about their responsibility to protect service users and how to identify indicators of abuse or neglect, but would also know how and to whom to refer any incidence or suspicion of abuse or neglect of service users. NVQ training for care staff should continue so at least half the staff team achieve this qualification soon. This will ensure staff have the knowledge and skills to do their job better and so provide good quality care for service users. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 7 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. 48 Hafod Road DS0000065468.V300852.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 48 Hafod Road DS0000065468.V300852.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Detailed information is provided for prospective service users to help them (with their families and/or representatives) decide if they may like to live at Hafod road and whether the home would suitably meet their needs. Thorough assessment and admission procedures should make sure the home would be able to meet the needs of prospective users appropriately. EVIDENCE: It was confirmed when the service was registered that the required information documents are provided for the home, including a statement of purpose, service users’ guide and a terms & conditions of residence. The guide is also availble in a format with symbols and pictures, which people with learning disabilities are more likely to be able to understand. Service users’ funding authorities also issue a service agreement (contract) specifying the service to be provided and fee, including any additional costs such as individual staffing. There were now six service users, two of them having been admitted to the home within the last month. One person was staying there on a temporary basis due to an emergency, and although this person’s needs are not really suitable for a long-term placement the manager and staff are ensuring their needs are being met and that their effect on other service users is minimised. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 10 Social Services were actively seeking a more suitable placement and the manager should continue to follow this up, as the stay has already been two weeks longer than was initially agreed. The care records of one service user who recently moved in were checked and appropriately include a copy of a community care assessment carried out by their funding authority, with information about their background. Their care and management plans from their previous care home were available and staff had already drawn up detailed risk assessments and would be completing a new admission summary sheet and plan with their goals and wishes. The manager and staff confirmed they always visit prospective service users to assess their needs and whenever feasible (due to distance and as suits the individuals) had arranged introductory visits and stays at the home prior to their admission for a trial stay. Service users and their families are given copies of the information documents about the home and their relatives confirmed they were fully involved in the assessment and admission process. 48 Hafod Road DS0000065468.V300852.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. There is a thorough care planning system in place, which is person centred and ensures staff know service users’ assessed needs and goals and how to meet them. Risks are assessed so any risks that could affect service users’ safety are minimised, whilst staff also aim to encourage service users’ independence and enable them to make decisions and choices in their daily lives and routines EVIDENCE: A sample of service users’ care records was looked at. They include a pen picture, their photograph, their likes and dislikes and details of family contacts, medication and finances. Information was being collected to complete a record called “getting to know me better” which it is was planned their keyworker would complete in due course and would say more about them as a person. Each service user has a plan of their care, which is called “ My Plan of Support” and is appropriately “person centred”. Plans therefore reflect their wishes and strengths, as assessed with their keyworker and home managers. They cover 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 12 all relevant areas of need i.e. personal and health care, communication, leisure interests, mobility, preferred daily routines and social & daily living skills. Each service user is allocated particular support workers from the staff team as a keyworker. They are involved in assessing their needs and in reviews of their care and aim to get to know them better. This helps to make the support service users receive be more personal and their wishes and preferences are known better. Staff spoken with are aware of service users’ individual needs and how they should manage their care and behaviour by following the plans. Daily reports are completed by staff, so providing an ongoing record of each service users’ activities, mood, health and events, which is helpful information about their progress and lives at the home. Any incidents and incidents are also noted, with body maps completed when marks or injuries are observed. Any risks and vulnerabilities have been identified and assessed for each service user, describing the action staff need to take to promote service’s user safety e.g. managing their finances, road safety and for when they use behaviours that could be challenging and/or socially inappropriate. It is evident staff aim to encourage and promote service users’ independence, and one service user confirmed this. Service users are currently involved in monthly house meetings with staff. The manager is considering developing meetings run by two service users however, where they can raise any issues, plan menus and group activities and go through the service users’ guide etc.. 48 Hafod Road DS0000065468.V300852.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Staff are seeking opportunities for service users to participate in a wide range of activities to develop their social and life skills. Also to enable them to mix in the local community and encourage them to lead interesting and active lives. Service users are supported to maintain close links with their families and staff also ensure service users eat meals they like which are wholesome and varied. EVIDENCE: Each service user has a schedule of activities and a checklist to evaluate what they have actually taken part in and if they enjoyed/benefited from them. The home is trying to involve them in as many community based activities as they are able and wish and some people were to be joining a farm project, to start a life skills course at college and on a waiting list for horse riding for the disabled During the first inspection visit service users had just started sessions at the Martha Trust swimming pool/Jacuzzi, and others had been out shopping. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 14 To some extent service users’ participation in activities is limited by their behaviours and also currently by a lack of drivers amongst the staff team. The manager is fully aware of what activities are available locally however and when two more new service users are admitted (and more staff are employed) it was felt staff could be deployed more flexibly to facilitate activities. Another vehicle was to be provided in September, by which time it was hoped that more drivers would also be available. Within the home there is a sensory room and foot spa for service users’ use and the garden is private and secure and large enough to allow service users space to walk around and play games in if they want to. They also have their own TVs and music centres and are encouraged to bake and be involved in household tasks, and cleaning their own bedrooms, doing laundry if they can. Social and leisure activities participated in outside the home include swimming, an art class, going to the cinema, pubs, bowling and shopping. Attention is paid to encouraging service users’ communication so that their choices can be obtained and promoted. Pictures and symbols are being used for two service users and there is a board in the dining room to stick pictures on that service users carry around (obtained from the home’s computer). It is good that staff had received training about this system and also the Speech therapist had taken a session on effective communication Staff, the manager and service users confirmed that their contacts with their families are supported. Families are made welcome in the home and kept informed and involved in their care planning and reviews. Keyworkers help to arrange and facilitate visits and stays at their family home. Regarding food provision a four-week menu is drawn up, taking service users’ preferences into account. Healthy food options are included such as cereals, fruit, yoghurts, vegetables and salads. Cooked breakfasts are only provided at weekends and the main meals are varied and staff cook them freshly as often as possible. One service user said they like the food and a daily food diary is kept for service users, when there are any food related issues. Staff encourage service users to help with cooking and food preparation, even just to observe, as part of developing their life skills. 48 Hafod Road DS0000065468.V300852.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Service users are supported by staff to meet all their personal care needs and promote their good health, with their involvement to the extent they are able. Medicines kept in the home for service users are managed safely and securely. EVIDENCE: Service users’ care records provide detailed information about their physical and mental health and any support they need from staff to keep good hygiene and health. Records are also kept of relevant physical checks, such as weight and a food diary and of health care appointments arranged, with outcomes. There is a choice of GP surgeries in the area and the manager is fully aware GP referrals can be requested to access other specialist health care support if needed. Some service users are patients of the local Consultant Psychiatrist and for out of county funded people the provider pays for the services of an external Consultant for twice yearly assessment visits and whenever individuals required any input. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 16 The home is in the process of setting up an Health Action Plan for each service user. These should be completed as soon as possible and will provide a comprehensive checklist of how service users health care needs are being addressed and the preventative measures being taken to identify health care issues as they arise. Regarding medicines kept in the home, all staff designated to deal with and administer them appropriately undertake safe handling of medicines training. This includes training in the administration of rectal diazepam. There are protocols in place when any medicines are prescribed “as when required” and only seniors can authorise their use and are expected to record the reason in care records and have another staff member countersign this record. The home provides policies & procedures on medication, including guidance on such as controlled drugs and relating to specific medications some service users are prescribed. Patient Information Leaflets are also kept and there is an up to date medication reference book available. Records of medicines kept and administered are being maintained properly and include a sample of their signatures and photographs of the service users. Medicines are a stored in a suitable place and cabinet and staff hold the keys securely. There is a fridge available, with temperatures checked regularly. 48 Hafod Road DS0000065468.V300852.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Systems are in place to manage complaints and protect service users. EVIDENCE: The home provides an appropriate written complaints procedure, which service users are given a copy of during admission. Service users’ relatives are aware of this procedure and one service user said they could express their views. The home had received one complaint and there is a system in place to record, investigate, take action and report on outcomes of any complaints. It was good the manager had dealt positively with this issue that had been brought to the provider’s attention by a neighbour of the home. Having apologised to this neighbour, a risk assessment was carried out and supervision of the service user involved had been increased so the problem should not happen again. Staff spoken with were aware of their responsibility to whistle blow if they observe or suspect abuse or neglect of service users. Staff are required by the provider to attend their training session on abuse, adult protection and whistle blowing, although one new staff member had yet to do so. The home has a copy of the Herefordshire multi-agency procedures for Protection of Vulnerable Adults (POVA), however it is strongly advised that staff should also attend a training session taken by the local POVA co-ordinator so they are clear about how and where to make a referral if they ever needed to. 48 Hafod Road DS0000065468.V300852.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. The home provides accommodation that suitably meets service users’ needs and offers them a safe, secure and very comfortable home. Attention is paid to keeping the house clean so that good hygiene and infection control are maintained, for service users’ health and welfare. EVIDENCE: Hafod Road is conveniently located for the shops, services and amenities of Hereford city, which are within reasonable walking distance. The home also provides a vehicle for transport further afield. A site visit was made to the home before it was registered and it was noted the premises and facilities fully meet with the National Minimum Standards. The home has been decorated, furnished, fitted and equipped to a very high standard and provide a homely and comfortable environment for service users. It was also confirmed the home met the requirements of other regulators, such as Building Control, Planning and Environmental Health Services. Although the Fire Authority confirmed the home was satisfactory at the time of registration 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 19 in respect of the fire safety system, equipment and fire risk assessment, a follow up visit had been made and some deficiencies identified. The provider is already taking appropriate measures to deal with these. The accommodation includes six spacious and suitably furnished bedrooms, with en-suite facilities, including a bath or shower. There are also two selfcontained flats with separate entrances, their own living room, kitchen and bathroom, which could give their occupants an opportunity to lead a more independent lifestyle if they wished. Service users are encouraged to make their bedrooms personal and to use them as private space when they want to. The home has a separate sitting room and dining room and a fully equipped sensory room available to service users as communal space. The furniture is suitably robust and mirrors etc are stainless steel for protection against the possibility of destructive behaviours. The décor is low stimulus and there are arrangements to ensure the security of the building, such as fencing around the garden and front door and other keypad locks. It was confirmed this would not restrict access to any service users capable of going out or into the kitchen alone and they could have the code (if able0 or staff would facilitate access. In addition there is suitably equipped laundry room, storage areas and office. There are policies and procedures in place relating to infection control and protective gloves and clothing are provided. The home was seen to be clean and tidy and a cleaning schedule is operated to make sure necessary jobs are done. The home has a clinical waste contract and liquid soap and paper towels are used for good hygiene. 48 Hafod Road DS0000065468.V300852.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. Staff are clear about their role and responsibilities and are well supported and work together to provide service users with consistent and good quality care. Suitable staffing levels are being maintained and staff have received relevant training so they should be able to meet service users’ needs and keep them and the home safe. The staff team’s knowledge and skills should improve when a programme for more staff to achieve an NVQ qualification is set up. Thorough recruitment procedures are operated to help to ensure that only suitable staff are employed to work with service users, for their protection. EVIDENCE: Information was obtained about staff from sampling staff related records, and from talking with the manager, deputy manager, and support staff, including individual interviews with two staff. It was evident from this and staff rotas, that suitable staffing levels are being deployed to meet service users’ needs and to do the cooking and household tasks, with service users assistance when possible. Additional staff were still being recruited and staff levels will increase as new service users move in. Another five staff had recently been interviewed and were awaiting necessary checks before they could start their induction. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 21 Staff are all expected to undertake the provider’s comprehensive induction programme, which includes training sessions on attitudes & values, positive communication, risk assessments, abuse & protection, and person centred planning. In addition to topics relating to service users’ special needs such as epilepsy, autism and all the mandatory health & safety courses. A training programme was seen for the next few months and staff confirmed they had either completed all the necessary training, or would be doing so soon. The home is introducing the LDAF induction programme, which is accredited especially for staff who work in care with people who have learning disabilities (and is the induction training specified in the Standards). In addition although only four staff currently had an NVQ qualification in social care, one other was currently doing the course and it was planned that more people would enrol to do so, following their LDAF induction. As it is expected that at least half the staff team are qualified this trained should be arranged as soon as possible Staff described their recruitment, which appropriately included completing an application form, interviews and meeting with the service users. Also that a CRB/POVA check and two written references had been taken up, including one from their most recent employer. After satisfactory checks had been obtained they had worked supervised “shadow” shifts and started their induction; also going through all the home’s policies & procedures and service users’ plans, All staff receive individual supervision and undertake a six month probationary period before their appointments is confirmed. Supervision and appraisals of support staff is appropriately also delegated to the deputy manager and seniors. Staff meetings are held monthly and staff report there is good and open communication within the staff team. 48 Hafod Road DS0000065468.V300852.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to the service. The manager is suitably experienced and has undertaken relevant training for the role. Whilst already knowledgeable about service users’ special needs and the management task, her knowledge and skills should be enhanced however when she achieves the required qualification in care & management. Service users benefit from an open and positive management approach and from a well-motivated staff team who understand their responsibilities and role. The home is well supported by the provider and there are processes in place to ensure the service develops as service users and relevant people wish. The home’s has all necessary policies and procedures in place to guide working practices and so ensure the home, service users and staff are kept safe. EVIDENCE: The registered manager (Angela Townsend) first trained as a nursery nurse, although only worked as a nanny for a year. Following this she worked for 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 23 years as a health care support worker at a home for young adults with severe learning disabilities. Since 2002 Miss Townsend was a senior at this home, and during this time took over the home’s management whilst the manager was on extended sick leave. She therefore has substantial experience working with people who have learning disabilities and complex needs, and is familiar with the management responsibilities and duties required of a care home. The manager has achieved a management certificate covering aspects such as management & supervision skills, recruitment & selection, staffing review & development and effective time management. She is an NVQ assessor and is currently making progress to achieve an NVQ level 4 in care & management, which is the qualification specified in the National Minimum Standards for care service managers. Hence obtaining this qualification was made a condition of the home’s registration. She has also undertaken other training relevant to care and service users’ special needs, such as the management of challenging behaviour; autism awareness, epilepsy and person centred planning. It is apparent the manager is very knowledgeable about the health, social and other implications arising from learning disabilities, in particular autism. She clearly has a real commitment to understanding associated conditions and to promote service users’ independence and offer them a good quality of life. Staff consider the home’s managers are open and approachable and promote good team work. They feel their views are listened to and they are given sufficient information to be able to do their job and to know what is going on. The home provides all the necessary policies & procedures to guide working practices. It was also confirmed the provider is supportive to the home. External managers are always availble to offer advice and support and being a large organisation the home benefits from the input of Training, Human Resource, health & safety and finance officers. The company also employs the services of a Behavioural and Crisis Prevention Intervention officer who will provide input to the service whenever needed. The Operations manager visits at least monthly for the required provider visits. They include interviewing some service users and staff and the completion of a checklist to audit relevant areas e.g. record keeping, environment, finance and complaints. This is one part of the quality assurance and monitoring of the service and there will also be an annual review, with a focus on outcome for service users and staff development. The original business plan for the home will appropriately evolve into an annual development plan, which will involve consultation with service users and other stakeholders to reflect their wishes. It was confirmed in the pre-inspection questionnaire that staff had recently taken part in a fire drill and there are regular service/maintenance contracts. Monthly checks are undertaken of the fire safety system, vehicle, water etc and COSHH and other risk assessments carried out. Staff receive training in all health & safety topics and there were no safety hazards noted during visits. 48 Hafod Road DS0000065468.V300852.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 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 4 28 4 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 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 3 3 3 X 2 3 3 3 3 3 3 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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 Regulation YA37 9 Requirement In line with a condition of the home’s registration the manager must achieve an NVQ 4 Qualification in Care & Management Timescale for action 31/03/07 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 2 3 Refer to Good Practice Recommendations Standard YA32 NVQ training in social care for staff should be prioritised to ensure that at least half the staff team achieve this qualification as soon as possible. YA35 The learning Disability Award Framework (LDAF)-accredited induction training should be fully implemented for all new staff. YA23 Staff should receive instruction relating to the protection of service users taken by the Herefordshire co-ordinator for the Protection of Vulnerable Adults. 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Office The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 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 48 Hafod Road DS0000065468.V300852.R01.S.doc Version 5.2 Page 27 - 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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