Inspection on 19/12/06 for Porlock House

This inspection was carried out on 19th December 2006.

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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Porlock House Somerset Court Harp Road Brent Knoll Highbridge Somerset TA9 4HQ Lead Inspector David Kidner Key Unannounced Inspection 19th December 2006 09:30 Porlock House DS0000067301.V316290.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 Porlock House DS0000067301.V316290.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. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Porlock House Address 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) Somerset Court Harp Road Brent Knoll Highbridge Somerset TA9 4HQ 01278 760555 01278 760747 Vanessahalfacre@nas.org.uk National Autistic Society Mrs Sarah Ann Matthews Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: As part of Somerset Courts Modernisation Programme each previous accommodation area that comprised of Somerset Court, has now become a separate registered service. Porlock House comprises of a large purpose built detached bungalow and an attached two-storey cottage situated in the extensive grounds of Somerset Court. The home is registered as one service and currently has two distinct accommodation areas. Six service users are accommodated in one living area and four in the other. The Registered Manager is Mrs Sarah Matthews. The National Autistic Society remains as the Registered Providers. The home was registered with the CSCI on 16/06/06 and is registered to accommodate ten services users. One accommodation area has a lounge, a large dining room, domestic style kitchen, and six single bedrooms with full en-suite facilities that are all located on the ground floor. The other accommodation area has a lounge, kitchen/diner and two bedrooms on the ground floor one with full en-suite and two further bedrooms on the first floor with a family type bathroom. The home has some laundry facilities but the majority of the laundry is sent to the main on–site facility. The home has a ‘fenced off’ garden area with areas laid to patio with garden furniture. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection conducted by the Commission for Social Care Inspection. This inspection was a Key Unannounced Inspection and was conducted by one Inspector. The inspection lasted one day (8.0hrs). The Inspector met a number of the service users and care staff. The Inspector spoke to three service users in more detail than others. Some service users did not wish to engage in conversation with the Inspector. Service users who were able to express their opinion stated that they liked living at the home and that they were happy. The service users appeared very relaxed in their environment. Some time was spent observing care practices and how staff interacted with the service users. This was all very positive. As part of the inspection process the Inspector viewed records in relation to care and support plans, health and safety, medicines, risk management, the management of behaviours and physical intervention, staff recruitment and viewed most areas of the home except bedroom areas. The Inspector sent comment cards called ‘Have Your Say’ to nine service users. All nine were returned. The vast majority of service users needed support to complete the survey. There was clear evidence that recently admitted service users had the opportunity to visit the home prior to admission. The vast majority of service users knew who to speak to if they were unhappy and knew how to make a complaint. Service users commented that they help to keep the home clean and tidy and that the care staff listen to them. Some service users said that they would like to make more decisions about what they do each day. This was fed back to the Registered Manager. Comment cards were sent to relatives, care managers, GP and other health care professionals. The Inspector sent twelve comment cards to relatives/visitors. Seven were returned. All comments stated that they were made to feel welcome at the home, that they can visit their relative in private and they are kept informed of important matters that affect their relative. All comments received stated that they are satisfied with the overall care provided at Porlock House. Only one comment was received from care managers and health care professionals. However, the comments received from the health care professional were very positive about the home. The Inspector would like to thank the service users for making the Inspector welcome in their home and for their contribution in the inspection process. Staff were very helpful and professional. All staff receive training in Equality and Diversity. The Inspector was advised that senior care staff would be attending more in-depth training in equality and diversity. The Registered Manager stated that at present the home is not Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 6 accommodating service users from various cultural backgrounds. There are no matters relating to diversity issues. As a result of this inspection the home has four requirements and six recommendations. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that the Service User Guide contains the required documentation. All care and support plans must be regularly reviewed and amended to reflect service user’s current needs. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 7 The home must ensure that it improves on some issues relating to fire safety. The Registered Manager should ensure that all interested stakeholders are aware of the home’s Complaints procedure. The Registered Manager should ensure that two staff signatures are obtained for all service users financial transactions and sign all accidents as part of the audit process. 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. Porlock House DS0000067301.V316290.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 Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 124 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a detailed Statement of Purpose but the service user guide does not contain the required documentation. The home conducts detailed pre-admission assessments and ensures service users visit the service before moving to the home. EVIDENCE: The Inspector was advised that both the Statement of Purpose and the Service User Guide have been revised. It was noted that the Service User Guide did not contain the required documentation as listed in Standard 1.2 of the National Minimum Standards. This was bought to the attention of the Registered manager who confirmed that this would be addressed. The Statement of Purpose is very detailed and contains the required information as listed in Schedule 1 of the Care Homes Regulations 2001. There have been some recent admissions to the home. The Inspector viewed the documentation in relation to pre-admission assessments. The Registered Manager had conducted detailed pre-admission assessments to ensure that the home could meet the needs of the prospective service users. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 10 The Registered Manager had also documented that transitions that had take place before the service users were admitted to the home. There was ample evidence of the service users visiting the service and meeting other service users and staff prior to moving to the home. The Inspector spoke to one service user who confirmed that they visited the home before moving there. The Fees vary from £1,670 to £3,020 per week but depends on the individual’s assessed need. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home has detailed care and support plans but not all the care and support plans had been formally reviewed and amended to reflect the service users needs. Service users are offered as much choice as possible and are encouraged to make decisions. The service undertakes detailed risk assessments. Service users confidential information is kept secure. EVIDENCE: The Inspector viewed four care and support plans. The care plans viewed contained detailed information in relation to the care and support needed. They were nicely presented and easily accessible. Key Workers complete monthly Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 12 summaries and daily records are kept of the care provided in the form of a monthly document. Records are kept of the activities that service users undertake when on a home day. However, it was noted that the care and support plan for one service user did not reflect the current needs of the service user and had not been formally reviewed although reviews had taken place to address some areas of concern. Another care and support plan had not been formally reviewed since February 2006. Two other care and support plans that were viewed were for service users who had recently been admitted to the home. One care and support plan had been reviewed since admission and the other care plan is currently being developed but the service is currently using the care and support plan from the previous placement. Some service users use Somerset Total Communication (STC) to assist in expressing their views and needs. Staff were observed to be using STC to communicate with some service users. Communication needs are very individual and care plans identified the manner in which staff should interact with service users. The home has a notice board with photographs of staff that are on duty and some service users use TEACH boards. Staff offer service users with as much choice as possible. At the time of the inspection it was noted that the care team were offering service users with choices in food, meals and activities. The care team keep day-to-day records of all activities and experiences. At the time of the inspection none of the service users were able to manage their own finances. Each service user has a risk assessment in relation to the management of behaviours and other potential risks. Following this and where needed a Behaviour Support Plan is developed. It was noted that risk assessments and behaviour support plans had recently been reviewed and were due further reviews. The Registered Manager was aware of this. The Inspector did not view any risk assessments in relation to the risks identified and protocols developed in order to support service users participating in independent living skills. It is recommended that this be addressed. It is also recommended that the home reviews the format in which the risk assessments are stored within the care and support plans. Service users records appear accurate and are kept secure and confidential. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 13 Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 16 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home supports service users to access a variety of social and leisure activities. Contact with family members is good. The home provides menus that are varied and well balanced. EVIDENCE: All service users who live at Porlock House attend the on-site day service facility. The day service facility offers a variety of activities including arts and craft, life skills, sensory room, gym, gardening and an IT Suite. Some service users are accessing the local college. Currently there are no service users accessing work placement, volunteer jobs or work-related training schemes. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 15 Porlock House is located approximately three miles from Burnham town centre and due to its location there are very limited local community facilities that can be easily accessed. However, service users are supported to access a variety of leisure and recreation facilities in the local and wider community. These include visits to the pub, cinema, theatre, swimming, ten pin bowling, walking, Gateway Club, restaurants and cafés. Records are kept of all activities that individuals access. The Inspector was advised that staffing levels have been good and service users have been readily accessing activities both at evenings and weekends. Some service users receive extra funding for 1:1 or 2:1 support. Records are kept of the support that is given to access community based facilities or day to day activities. At the time of the inspection care staff were observed to be offering service users and supporting service users in in-house activities. Staff were observed to be supporting some service users on a 1:1 basis. The Inspector was advised that some service users have been on holiday to Cornwall and Weymouth. Some service users go to stay with their parents/relatives on a regular basis. Due to some service users complex needs providing holidays may not be in the persons best interest, as they could not cope with the change within their personal routine. However, care staff commented that day trips out are arranged. The home encourages contact with family and friends. Records are kept of the contact made. The Inspector sent ten relative/carers comment cards and a total of seven were returned. All comment cards indicted that all the relatives/carers are satisfied with the overall care provided, that they can visit their relative in private and that staff make them feel welcome. There were no negative comments in relation to the home not having adequate staffing levels. Service users have keys to their bedroom doors. Staff that the Inspector spoke to demonstrated on how they promote privacy and dignity. At the time of the inspection the Inspector observed care staff communicating with service users in a polite and courteous manner. Staff were sensitive to the needs of service users who had challenging episodes. Each service user has a ‘home day’. This time is spent usually with their key worker and service users are encouraged to participate in the cleaning of their bedrooms, laundry, basic cooking skills and other household activities. A record is kept of the home day and forms part of the key worker monthly report. As previously stated all service users attend the on-site day service. When attending day services all service users access the main dining facilities at Somerset Court. This is a refectory style service. There is a varied and nutritious menu on offer with a number of choices. Porlock House has two separate kitchens and dining areas. Some service users are able to prepare their own breakfast and prepare a small snack. The home has a menu that service users have contributed to compiling. However, service users are able to Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 16 have alternatives if so wished. On the day of the inspection service users were accessing snacks and drinks as they so wished. At the time of the inspection the kitchen cupboards, freezer and fridges were well stocked with fresh fruit and vegetables. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care staff are aware of service user’s needs in relation to personal care and support. Service users have access to a variety of healthcare professionals with good records kept of all visits. Medicines are well managed at the home. EVIDENCE: Wherever possible intimate personal care is provided by a person of the same gender. The service users have very differing care and support needs. Some service users are able to fully meet their personal care needs and may only require guidance or gentle reminders. Other service users require full support. Staff that the Inspector spoke to were able to describe the type of care and support individual service users required and appeared very knowledgeable and fully aware of individual service users needs. Times for meals and getting up and going to bed are flexible. Service users who were at home when the Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 18 Inspector arrived were having a lie-in and breakfast was unhurried. On the day of the inspection service users appeared well attired. Service users have access to all other health care providers. These include, psychology and psychiatric services, speech and language therapy, chiropodist, The Inspector was able to view the records that are kept in relation to visits to a variety of health care professionals. Service users who had recently moved to the home had registered with the local GP and had visited as needed. The Inspector viewed the arrangements for the management of medicines. The home has a policy for the management of medicines and designated staff are nominated to dispense medicines and sample signatures are kept within the MAR sheet file. The home’s policy is that two staff dispenses the medicines. The home keeps two records of the medicines that are administered. The second person signs a separate MAR sheet to witness the actual administration. The MAR sheets were viewed. All records were satisfactory and were well maintained. The home keeps a record of all medicines that are returned to the pharmacy. The home currently does not have Controlled Drugs. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 19 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 a visit to this service. The home has a robust Complaints procedure but it appears that not all interested stakeholders are aware of the process. The home has policies and procedures in relation to the protection of vulnerable adults. EVIDENCE: The home has a Complaints Policy and Procedure. The service users have a copy of the complaints procedure. This is presented in STC. There was one recorded complaint from a service user. The Inspector viewed the documentation in relation to this. The complaint had been satisfactorily addressed. The feedback that the Inspector received from relatives/carers comment cards is not all relatives were aware of the complaints procedure. The Registered Manager should ensure that all interested stakeholders are aware of the process. The home has policies for the protection of vulnerable adults including policies for adult protection and the management of service user’s finances. Care staff that the Inspector spoke to were aware of the home’s Whistleblowing Policy and were able to demonstrate the action that they would take if needed. The service is in the process of training all staff in the use of the SPELL approach and the Studio 111 procedures for the management and defusing of Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 20 challenging situations. The Inspector was advised that a person has been appointed within the service of providing staff with Studio 111 training and supporting staff teams in the management of behaviours and collating incidence records/information. The home keeps records in relation to incidents that occur at the home as a result of challenging situations. The Inspector viewed behaviour management guidelines, risk analysis and risk assessments in relation to the management of behaviours. The Inspector was provided with an audit of the incidents/accident at the home for each service user who may present challenging situations. The audit has a breakdown of the nature of the incident/accident and if any intervention was used. The audits are very detailed and comprehensive and are used to review the type of approach used. All staff have an Enhanced CRB disclosure. The Inspector discussed the arrangements for the management of service user’s finances. The National Autistic Society has corporate appointeeship for all but one of the service users. Service users have individual bank or building society accounts. The Inspector sampled the records kept on the behalf of two service users. Records are kept of the transactions undertaken via the building society and the home also maintains records of financial transactions of monies spent from personal spending. The Inspector was able to follow an audit trail for transactions sampled. One service user spends a considerable amount of personal spending money on eating out, as this is one of the most enjoyable activities for the service user. The Inspector suggested that this be documented in the service user’s care and support plan and agreed by all. Receipts are kept of all transactions and balances were correct. The Inspector recommends that wherever possible two staff signatures be obtained for all financial transactions. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 21 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 27 28 29 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Porlock House provides homely accommodation. Most services users benefit from full en-suite facilities that further promote privacy. The home is well maintained, clean and hygienic. EVIDENCE: Porlock House comprises of a large purpose built detached bungalow and an attached two-storey cottage. One accommodation area has a lounge, a large dining room, domestic style kitchen, and six single bedrooms with full en-suite facilities that are all located on the ground floor. The other accommodation area has a lounge, a domestic style kitchen/diner and two bedrooms on the ground floor one with full en-suite and two further bedrooms on the first floor with a family type bathroom. The home has a ‘fenced off’ garden area with Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 22 areas laid to patio with garden furniture. Both accommodation areas provide homely accommodation. On the day of the inspection the home was warm and inviting and was well maintained. As previously mentioned seven bedrooms have full en-suite facilities and in one accommodation area there is a family type bathroom. There are adequate communal toilet facilities. There is adequate communal space. All service users are fully ambulant and at present do not require any specialist aids and adaptations. On the day of the inspection the home was clean and hygienic. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 23 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 good This judgement has been made using available evidence including a visit to this service. Staff demonstrated their awareness in the support required to meet service user’s individual needs. The home needs to further promote the care team in accessing NVQ qualifications. However, the home is committed to providing a well-trained workforce. Adequate staffing levels are maintained. The home has a robust recruitment process. EVIDENCE: The Inspector spoke to a number of staff both long standing and newly appointed staff. It was evident that the care team were aware of the service users individual needs. Staff were observed to be interacting with service users in a professional and sensitive manner and used alternative methods of Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 24 communication when needed. Staff appeared enthusiastic, motivated and committed. Staff have received specialist training in areas such as diabetes, SKIPP, autism awareness, Studio 111 and Somerset Total Communication (STC). Individual staff records were seen to confirm this. The Pre-Inspection Questionnaire stated that 23.5 of the workforce has an NVQ qualification. The National Minimum Standards state that 50 of the workforce achieves a minimum of NVQ qualification. An action plan must be developed to address this and a copy sent to the CSCI. The Inspector spoke to a number of staff at the time of the inspection. All staff stated that they felt that they had adequate staff on duty to meet the needs of the service users. However there had been some recent difficulties due to staff sickness and leave. The home has a number of vacant care hours and interviews are planned. The Registered Manager stated that staffing levels are adjusted to meet the needs of the service users and that staff have been working extra hours and agency staff have been used to ensure adequate staffing levels have been maintained including the need to ensure that service users receive the agreed additional funding. The rota identifies the team that work in both accommodated areas and is viewed as ‘one team’, including the night care workers. Of a morning the home usually has four staff on duty. Service users then attend the on-site day services facility. On ‘home days’ staffing is provided on a 1:1 or 2:1 basis. Of an evening and weekends the rota is adjusted to meet the needs of planned activities. The home has cross over shifts to ensure that activities can take place; therefore there is usually five to six staff on duty these times. Some service users receive extra funding to meet their needs. The Inspector viewed the recruitment files of recently appointed staff. The service has a robust recruitment process and has systems in place to ensure that the home obtains all the required documentation as listed in Schedule 2 of the Care Homes Regulations 2001. All staff have an Enhanced CRB declaration. The service has a Training and Development Manager and each staff member has a training and development plan. Records are kept of each staff member training. The Inspector spoke to a number of staff including recently appointed staff who confirmed that they receive regular mandatory and specialist training. Individual training records were viewed. Staff have received training in food hygiene, POVA, SPELL, TEACHH, STC, epilepsy, medication and first aid. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 25 Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 26 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 42 Standard 39 was not assessed at this inspection Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home is well managed The home promotes health and safety, however some areas in relation to fire safety need to be addressed. EVIDENCE: The Registered Manager is Mrs Sarah Matthews. Mrs Matthews has approximately 20 years experience working with people with autism and learning disabilities and has completed the Registered Managers Award. She Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 27 has also obtained A1 Assessors qualification and a variety of courses including SPELL, Studio 111 and person Centred Planning. Staff spoken to stated that Mrs Matthews is approachable, supportive and offers direction and leadership. Staff commented that Mrs Matthews has an excellent knowledge of the needs of the service users. The Inspector viewed a number of documentation in relation to health and safety. Fire Safety: The fire alarm system and emergency lighting system in both areas was last serviced on the 21/09/06. Fire fighting equipment was serviced in June 2006. The emergency lighting, fire points and the homes torches are tested weekly with records kept. The home conducts monthly fire drills with service users. However, it was noted that there are no records relating to staff receiving regular fire drills. This must be addressed. All staff have received regular fire training. In one identified accommodation area it was noted that the fire doors to the laundry room and to five bedroom doors were not closing correctly. The ‘connecting door’ between the two accommodated areas was also wedged open. Fire doors must be able to close correctly and fire doors must not be wedged open. This was bought to the attention of the Registered Manager at the time of the inspection. This must be addressed. Hot Water/ Legionnella: The home conducts weekly checks of the hot water. Records confirmed that the temperature is within suggested guidelines by the Health and Safety Executive. The home has received a certificate complying with Legionnella. Electrical Hardwiring Certificate: This Inspector requests that a copy of this certificate is sent to the CSCI. PAT: Portable Appliance testing was last conducted on the 05/12/06. Gas Safety Certificate: This is dated 20/07/06 COSHH: The home has a policy in relation to this. All products are stored securely. Fridge/Freezer: The home keeps daily records of fridge and freezers. It was noted that some temperatures had not been recorded. This was bought to the attention of the Registered Manager at the time of the inspection. Food was stored appropriately in the fridge. Risk Assessments: The home has a detailed risk management policy. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 28 First Aid: All staff receive training in first aid. The homes policy is that the first aid boxes are checked monthly, however it was noted that these were last checked on the 07.09.06. This was bought to the attention of the Registered Manager at the time of the inspection. Accidents: The home keeps individual records of service user accidents. The Inspector noted that accidents relating to staff had been completed but there was no evidence to suggest that the Registered Manager was aware of such accidents and further action if needed. The Inspector recommends that the Registered Manager sing all accident records as part of the audit process. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 29 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 “ ” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 X 2 3 LIFESTYLES Standard No Score 11 X 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 3 X X X X 1 X Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 5 Requirement The Registered Manager must ensure that the service user guide contains the required documentation as listed in Standard 1.2 of the National Minimum Standards and a copy be forwarded to the CSCI The Registered Manager must ensure that the service user’s care and support plans are kept under review and ensure it reflects the current needs of the individual. The Registered Manager must ensure that all care staff receive fire drills and practices at suitable intervals. The Registered Manager must ensure that fire doors close correctly and are not wedged open. Timescale for action 31/01/07 2 YA6 15 (2) (b) (c) 22/01/07 3 YA42 23 (4) (e) 22/01/07 4 YA42 23 (4) (c) 22/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 31 No. 1 Refer to Standard YA9 Good Practice Recommendations The Registered Manager should conduct risk assessments in relation to the risks identified and protocols developed in order to support service users participating in independent living skills. The Registered Manager should review the format in which the risk assessments are stored within the care and support plans. The Registered Manager should ensure that all interested stakeholders are aware of the home’s Complaints procedure. The Registered Manager should ensure that two staff signatures are obtained for all service users financial transactions. The Registered Manager should submit an action plan to the CSCI to address the need for 50 of the care team to achieve an NVQ qualification. The Registered Manager should sign all accident records as part of the audit process. 2 3 4 5 6 YA9 YA22 YA23 YA32 YA42 Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Porlock House DS0000067301.V316290.R01.S.doc Version 5.2 Page 33 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!