Inspection on 19/09/07 for Phoenix House

This inspection was carried out on 19th September 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Phoenix House 25/09/08

Phoenix House 18/12/06

Phoenix House 15/03/06

Phoenix House 25/10/05

Phoenix House 14/02/05

Phoenix House 13/07/04

Phoenix House 01/02/04

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 Phoenix House 122 Bromyard Road St Johns Worcester Worcestershire WR2 5DJ Lead Inspector Christina Lavelle Unannounced Inspection 19 & 28 September 2007 1.30-6.30 &11th th Phoenix House DS0000018670.V344107.R02.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 Phoenix House DS0000018670.V344107.R02.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. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Phoenix House Address 122 Bromyard Road St Johns Worcester Worcestershire WR2 5DJ 01905 426190 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) Phoenixhouse122abtconnect.com Mr Nigel Hooper Mrs Susan Mary Jones Mr Nigel Hooper Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 18th & 19th December 2006 Brief Description of the Service: Phoenix House was set up as a care home in 1986. Mr Nigel Hooper is the sole registered provider and joint manager of the home. Mr Hooper also operates another care home situated next door and supported living accommodation for two people on the same site. Mrs Susan Jones is the joint registered manager. The home provides accommodation with personal care for eleven adults (men and women). Service users must require care due to learning disabilities. The aims of the home are stated as being to offer care to people with moderate learning disabilities. Also to provide a permanent and homely environment and to encourage the people who live there to be involved in household tasks. The property is a large, late Georgian, detached house located on a main road on the west side of Worcester. There are shops, pubs, a Church and various other facilities locally and the home is on a main bus route into Worcester city. The house has five single bedrooms and three shared bedrooms (none with ensuite facilities), two are on the ground floor. The home has a sitting room, a dining room, three bathrooms, two showers and three toilets for everyone to use. There are garden areas at the front, side and rear of the house. Information about the home is provided in a statement of purpose and service users’ guide. This document is also in a format that is easier for people with learning disabilities to understand and is available from the home. The weekly fee for the service was from £319.18 up to £460.35. People who live there are also expected to pay for personal items & clothing, newspapers, phone calls, transport, hairdressing, chiropody, social activities, holidays and college fees. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a key inspection of the service provided by Phoenix House. This means all the Standards that can be most important to people who live in care homes were checked. The inspection visit was made without telling anyone at the home beforehand. The inspector spoke with one of the care staff. Also with the managers about the way the home is being run and any changes since the last inspection. An Expert by Experience (called the Expert in this report) also helped with this inspection. This is someone with personal experience of using learning disabilities services who is trained to go with inspectors on a visit to a service. Experts observe what happens in homes and talk to people who live there to obtain their views of the service. They then make a report of their findings and parts of this Expert’s findings are included in this report. Surveys were left at the home for some staff and people who live there asking what they think of the service. Other surveys were sent to their families and to seven health or social care professionals involved with their care. Eleven surveys were returned and their comments are mentioned in this report. An annual self-assessment form was also completed before the visit. This asks managers to say what they feel their home does well, what it could do better, what has improved and about their plans to improve the service. It includes information about the people living there, staff and other aspects of the home. Various records kept by the home were checked and the house looked around. All information received by the Commission about Phoenix House since the last inspection is also considered, such as events affecting people who live there. What the service does well: Most people have lived at the home for years and say they are happy. The home is friendly and the Expert comments “Overall the home did have a nice feeling and we had some very positive comments from people who live there”. Relatives of people who live in the home say they think the home gives good care. Also that staff are open and tell them when important things happen. Staff support people who live at the home with their personal care. They also make sure they have regular health checks and manage their medicines safely. People living at Phoenix House have a safe and comfortable home. It is near to shops and pubs etc. and they go out to visit these regularly, mostly as a group. This has helped them to mix and become part of the local community. There is a small and stable staff team who work closely together. People who live there know staff well and say they like them and can talk to the managers if they are worried about anything. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 6 Staff receive training so they know how to keep the home and people who live and work there safe. New staff are checked to make sure they are suitable to work in care. These both help to protect the people who live at the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 7 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 Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to the service. Assessment and admission procedures are in place to help to make sure that the home could suitably meet the needs and wishes of potential service users. EVIDENCE: Required information documents are provided including a statement of purpose and service users’ guide, which are available in a user-friendly format. There is also a Contract of Residence that should specify the fee and additional charges. No one has moved into Phoenix House for some time. However the manager confirmed the assessment and introductory procedures the home would follow should a referral be made. They would first receive a copy of a community care assessment made by a social worker from prospective service users’ funding authority. The manager would visit them at their current residence to assess their needs. Introductory visits to the home would then be arranged and if successful they could move in for a trial stay. Their family and other relevant people would be involved in the introductory process, with a review held after their trial stay when a decision is made about the suitability of the placement. The issue of compatibility with people living at the home was not discussed but it is presumed that their views would be taken into consideration. Also that all the information would be shared with the staff team and their opinions sought. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including these visits to the service. People who live at the home should all be more involved in making their own plans and their plans should identify their personal goals and action needed to meet them. Whilst they can make some choices in their daily lives and routines their plans and risk assessments should also show that their individuality and independence is encouraged and promoted within and outside the home. EVIDENCE: A sample of care records kept for people living at the home was checked and care planning discussed with the manager and staff. The records include their photograph, background information, a skills assessment and care plan. Plans cover some relevant areas of need, preferred routines and likes & dislikes. Whilst staff clearly know people and their needs and skills well, they should be more involved in planning their own care to the extent they are capable. Care services are now expected to adopt a more “person centred” (PC) approach so that the personal goals of service users are sought and form the basis of their Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 10 plans. This should result in action plans to support them to meet the identified goals with timescales that are regularly reviewed with the outcomes recorded. Since the last inspection the home has received some input from local person centred planning facilitators to train staff and help them set up PC plans. It is disappointing therefore that a PC approach had still not been implemented. Only two people at the home have had PC action meetings to review their care and to start drawing up a PC plan. Part of this process is to develop life books, which had also only just commenced. Responsibility for care planning could be delegated more to keyworkers who are allocated to each person from the staff team because they should spend more time with them and know their needs and wishes better. Whilst keyworkers aim to give service users some individual input, time for this is limited however due to the home’s staffing levels. Furthermore PC plans that had been set up do include goals (one person wants to develop their IT and life skills e.g. cooking and using public transport) but their plan doesn’t show how these goals could be achieved with staff support. Another person has limited verbal communication and so their plan is drawn up in symbols and some pictures are used to show their likes & dislikes. However they do not have a communication profile and/or plan, also signs, symbols, pictures and/or photos are not being used to help them to make more choices. The manager says this person previously had speech therapy input and staff understand their body language but using more effective communication techniques should also be considered. Care planning appropriately includes the home carrying out risk assessments. These relate mostly to reducing safety hazards e.g. bathing and going out. They should however also be used as a means of encouraging and promoting an independent lifestyle in areas included in the PC plan format e.g. managing medication, social skills & relationships and finances. Any limitations placed on an individual’s choice and freedom should also be assessed and recorded. Care services must always consider consent issues and understand the process to ensure that decisions are made in service users’ best interests when they may not be able to make informed decisions themselves, as per the Mental Capacity Act. People living at the home make some choices in their daily lives and routines; more at weekends as no day services. Resident meetings are held when they discuss and decide about group activities and holidays and could raise other issues. However these meetings are not regular and although the last one was this August the previous one minuted was April 2006. The Expert was told some attend external self-advocacy meetings, which as he says is “excellent practice”. The Expert also feels having their own banks accounts is very good and that they can draw it out and spend on what they wish, although two have money delivered by the manager and should access it themselves in the community. There is scope for them to be more involved in making decisions about their lives, which is discussed further in the next section of this report. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including these visits to the service. People living at the home take part in various activities out in the community. With more staff time available the opportunities for them to pursue individual activities they like and that would promote their independence could increase. The home also supports them to maintain links with their families. Staff aim to promote healthy eating, but should encourage people who live at the home to choose their menus and be more involved in cooking etc. Also to take more responsibility for other household tasks to develop their life skills. EVIDENCE: People living at the home have a list of activities they take part in every week, including day services, college courses, social clubs, shopping, going to pubs etc. Group outings, parties and an annual holiday are also arranged and the home has a minibus and people carrier for transport. The home and people who live there mix and appear to be well integrated in the local community. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 12 Whilst the more able people can go out as they wish it is clear those who need staff support have less opportunity for individual interests and activities, which is due mostly to limited staff time. Two people could possibly benefit from more sensory activities such as visiting a snozelen sensory centre, which also reflects that staff have not had training in autism awareness. Outings also often include people from the home next door and some of them come to Phoenix House for supervision during the day or if they do not want to go out, which is not really acceptable as it is not their home. This concerned the Expert, as does the group holidays especially as he was told some people do not always get on well with others. He comments “How do people’s individual choices be heard when so many are together?”. He was also told sometimes they are unable to go out to a chosen activity due to lack of staff and as two people like IT he feels a computer could help them develop their skills. Regarding family contact some people go home and most have regular visits. Keyworkers help them to keep in contact, remember birthdays, send cards etc. The three relatives who completed surveys say they are always kept in touch and up to date; one saying “Weekly family contact is encouraged”. Only one person has an outside friend who regularly visits the home, although some do meet their friends in the community. It was really nice that one person had a big birthday party planned at a local pub with their family and friends invited. Food provision was discussed with staff and people living at the home. Menus are drawn up by staff and include mostly traditional homemade meals. Fresh fruit and vegetables and healthy food options are used and always available. It is clear however that although staff know what people like they are not involved in menu planning. During this visit the meal had been prepared when most people arrived home and they didn’t know what it was. The Expert was told they had not been asked what they wanted to eat for a long time. They are also not very involved in cooking or other household tasks unless they wish to help with such as drying and washing up, although one stated aim of the service is to encourage this. The Expert was told that one person does cooking at college but is not allowed to do so in the home. He comments “The home should support people to be as independent as possible and not do things for them. People should have opportunity to write shopping lists, buy the food, choose the meals and cook them or they could be deskilled”. Although some people make decisions about their lives the ethos of the home is still that of a traditional care home, with emphasis placed on group life. This approach has been accepted (most having lived there for years) but is as the Expert terms “old fashioned”. The current emphasis for supporting people with learning disabilities is to promote their individuality and independent lifestyles. Greater commitment from management and staff input is therefore needed to introduce a more person centred approach and provide more individual support to promote their life skills. This inspection and two social care professionals support this view. One of them commenting that “More focus is needed on person centred planning and more staff training needed around values issues”. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including these visits to the service. People living in the home are well supported with their personal care and staff manage their medicines safely on their behalf. Their good health would be better ensured if they all have a Health Action Plan and staff receive more training in health related matters. EVIDENCE: Plans of people living at the home show the support and/or guidance they each need with their personal care. They were observed to be well presented and appropriately dressed and some people say they choose and shop for their own clothes with staff. One health care professional says “Service users are well cared for and their presentation is smart & clean. Health needs are addressed”. Records include some details of their medical history and of health issues as they arise. Routine and specialist health checks are being arranged with staff support and some physical checks are made and recorded e.g. weight. One person has had input from a Dietician to advise about their diet and exercise. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 14 Whilst this is so it there is limited information and guidance relating to some particular conditions. Greater staff knowledge could help to ensure that any problems would be identified, monitored and dealt with proactively and it is strongly recommended that opportunities for training on relevant topics such as mental health, autism awareness and epilepsy are sought and arranged. Furthermore it is disappointing that the home has still not set up Health Action Plans (HAPs) for everyone. HAPs focus on an assessment of health care needs and promoting good health through a healthy lifestyle and preventative as well as routine & specialist health care input. They are considered good practice by the Department of health for people with learning disabilities as they ensure that special health care needs are recognised and managed appropriately. The manager states in their self assessment they are planning to implement HAPS and risk assessments with more detailed care plans and a special needs profile. Regarding medication prescribed for people who live at the home there is a policy & procedures for its management. Most staff received training relating to safe handling of medicines last year. There is suitable storage provided and keys are kept securely. The home has a sample of staff signatures and records of medicines kept and administered are being maintained appropriately. Each person has a medication profile of those medicines prescribed for them and any possible side effects. There is a self-medication assessment form available, which should be completed for everyone and self-administration encouraged. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to the service. There are frameworks in place for managing complaints and to protect people living at the home. Whilst they feel able to express their concerns to staff their views should be sought more to influence the day-to-day running of the home. EVIDENCE: The home provides a written complaints procedure that is available in a userfriendly format. There is a copy on the notice board and some people have one in their bedroom. They told the Expert they can talk to staff when they are upset or have a problem and he says “Its great to hear people are confident in talking to the managers”. Their relatives also know about the complaints procedure and although they have not needed to use it comment that staff are open and responsive. Whilst there is clearly an open rapport between people living at the home and staff, as already mentioned house meetings have not been held regularly and should be a means of enabling them to express their views and make decisions about their lives and the running of the home. The home or Commission had received no complaints or any referrals made regarding Protection of Vulnerable Adults, since the last inspection. The home has an appropriate record to complete if any complaints are made, with details of the investigation, response and outcome. Some staff attended training on abuse and protection issues last year and the home has copies of relevant guidance and procedures. They plan to update staff through meetings and training programmes, which should include the new Safeguarding protocol. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including these visits to the service. Phoenix House offers a secure, safe, clean and comfortable home that is well situated for local services and facilities. People living there would have more privacy and space if they all have their own bedroom and another sitting room. EVIDENCE: The home is located in a busy area on the West side of Worcester. It is on a main bus route into the city, and there are local shops, pubs, Churches etc in walking distance. The house is large and detached with two storeys and was extended to provide accommodation for eleven people. The impression overall is homely but the decor and furniture etc would benefit from updating. The Expert noticed this and was also disappointed to see few pictures and only one photo on the wall of a person living there in shared areas and wondered if one man had chosen his flowery bed linen. He comments “The home is homely in an old fashioned way but not really person centred to the people living there”. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 17 There is one large lounge, a dining room, kitchen, laundry and bathrooms for everyone living there to use. A former second lounge is now the home’s office although consideration is still being given to converting it back to a lounge when the planned extension is completed. This would be good and give them the option perhaps of a quieter room without a television for their visitors and activities. Some people told the Expert that a lack of space in the home for activities could be an issue and he feels that “People shouldn’t be in a home where they are unable to find any quiet time for themselves”. Three bedrooms are shared, which the Standards specify is now only accepted for pre-existing care homes and when occupants have made a positive choice to share. The provider has planning permission to extend the home and make all bedrooms single and had said this would be completed within the next year, although it has yet to be started. This will offer people who live there more privacy and personal space for their possessions. The Expert was told by one person and their relative says “ X would love to be in a room on their own.” Maintenance and repairs are ongoing and some redecoration has been done and new kitchen units fitted since the last inspection. All areas seen were clean and tidy and in relation to infection control and hygiene the home has relevant policies and procedures in place. There are also arrangements for the disposal of soiled waste. Staff are provided with gloves and protective clothing and most of the team have attended training on infection control. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including these visits to the service. Whilst people living at the home benefit from stable staffing the team is small which affects their flexibility and time available to offer individualised support. More staff should be qualified and receive relevant training so they have the knowledge and skills to meet the individual and special needs of people living at the home better. Recruitment procedures are thorough overall which helps to ensure only suitable staff work at the home to protect people living there. EVIDENCE: The staff team comprises of the managers and six care workers. Two staff work between 7.00am and 10.00pm weekdays and from 9.00am on weekends, with one staff member sleeping in on call at night. The managers also work a substantial number of hours that include some weekday shifts over and above direct care hours. These levels appear adequate to meet personal care needs and for staff to undertake cooking, cleaning and laundry tasks. Although some staff from the care home next door provide cover when needed however it is clear there is not enough staff to provide individual support for activities and so that keyworkers can have one to one time with their allocated residents. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 19 Staff and people who live at the home know each other well and the Expert comments “I noticed the atmosphere was very friendly between people who live there and the staff”. Whilst a small stable staff team does have positives, such as for care consistency and good communication there is limited scope for flexible working. Therefore staff levels and deployment needs to be reviewed by the provider, if necessary in consultation with the finding authorities. It is confirmed that new staff are not allowed to work with people living at the home until a satisfactory police (CRB) check is obtained. There had only been one new staff lately and although they have started their induction without a CRB this was just with the manager and when they had a POVA first check. Staff records include copies of relevant documents, a CRB and full employment history. One written reference however was from a personal friend but the manager explained that a previous employer had refused to give a reference. Whilst this creates a problem if the person does not have another employer a more creditable referee should be sought when possible e.g. a tutor or teacher. This person was now working alongside other staff and completing a threemonth probationary period during which they would undertake core health & safety training topics. The Expert felt it is great practice that people who live at the home are being involved in interviewing their own staff. All staff had completed the LDAF induction programme, which is accredited especially for staff caring for people with learning disabilities. Only two have an NVQ in social care, which is the qualification that staff in care services are expected to achieve. NVQ and more specialist training should be sought by the home and it ensured that updates of such as food hygiene are maintained. There is an open atmosphere in the home and staff feel managers are always available and approachable and that all the team get on well and work closely together. There are plans for the provider/manager to take over individually supervising staff and to introduce annual appraisals. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including these visits to the service. The home is run by experienced managers but consideration still needs to be given to review and update the ethos and approach of the service so it reflects currently accepted practice for supporting people with learning disabilities. Appropriate steps are taken to promote the safety of people who live and work at the home. A system has been implemented to monitor and review service quality and should result in an action plan for the home to continue improving, also incorporating what people living there and other stakeholders want. EVIDENCE: The provider/manager (Mr Nigel Hooper) and joint manager (Mrs Susan Jones) (and the manager of the care home next door) share the management tasks Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 21 and responsibilities for both services. They have many years experience caring for people with learning disabilities, including at Phoenix House. This report highlights that there is a caring and friendly atmosphere in the home and most people living there seem to have accepted that the style of the home is that of a family/group living environment. It does not focus on and/or promote an independent lifestyle however as the government’s plan “Valuing People” describes and is currently accepted good practice. The registered persons still need therefore to review the service and plan to fully implement this approach with support from relevant professionals and funding authorities. In respect of quality assurance and monitoring (QA) the home is using a formal system obtained from an external consultant that relates to National Minimum Standards (albeit for older people). Self-assessments had been completed by managers in May and reviewed in October 2006. Some actions detailed such as person centred planning and HAPs, the building project and introducing staff appraisals. However these actions had yet to be implemented and there should be a plan with timescales for addressing them and the principles underlying the service, including issues of equality & diversity. The feedback from questionnaires, meetings and individuals living at the home and other stakeholders should also inform the plan and how the service develops. Regarding health & safety in the home, training is arranged for staff covering the mandatory health & safety topics i.e. fire, moving & handling, food hygiene and infection control. Most hold a first aid certificate and completed training on the safe management of medicines. The information received confirms the home’s fire safety system is checked regularly and tests and checks on the fire system and equipment are being carried out. Also that gas and central heating services are maintained and checks on portable appliances and COSHH risk assessments are available. There were no safety hazards observed during these inspection visits and overall it is apparent therefore that the home pays due attention to promoting the safety and welfare of service users and staff. Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X 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 2 25 2 26 2 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 2 12 3 13 3 14 2 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 X 2 X X 3 X Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered persons meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered provider must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the registered providers to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations Each person living in the home should have a care plan that is drawn up with them and reflects their personal goals and the support needed and/or how they can achieve them. The home should continue to work with the local person centred planning facilitators to set up person centred plans for everyone living at the home. Risk assessments should be carried out as part of the person centred planning process that also support people to take risks and promote a more independent lifestyle. People living at the home should have more opportunities for individual activities and their responsibility for their daily lives should be promoted to help develop their life skills. Health Action Plans should be set up for everyone living at the home. HAPs would help to ensure that their specialist health needs are identified and being monitored and their good health is promoted. Also that they are supported to manage their own health to the extent they are capable. DS0000018670.V344107.R02.S.doc Version 5.2 Page 24 2 YA6 3 YA9 4 YA11 YA16 5 YA19 Phoenix House 6 YA26 & YA28 The planned extension should be started as soon as possible so that everyone can have the privacy of a single bedroom. Also so that more communal space could be available. The home’s staffing establishment and levels deployed should be reviewed and consideration given to increasing staff to ensure there are sufficient staff to facilitate flexible and individual support to people living at the home. The programme of NVQ training should continue and other training opportunities be sought in relation to the specialist needs of people who live at the home. This would help staff to understand and be able to meet their needs better. The ethos and approach of the service should be reviewed to ensure it reflects currently accepted practices for supporting people with learning disabilities. This is based on them having choices and as independent a lifestyle as they can, including involvement in household tasks, as the home’s statement of purpose describes. The home’s Quality Assurance system should result in an action plan for the continual development of the service based on the views of service users and other stakeholders. 7 YA33 8 YA35 9 YA37 10 YA39 Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Local Office The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Phoenix House DS0000018670.V344107.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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