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Inspection on 26/02/07 for Portland Crescent Residential Home

Also see our care home review for Portland Crescent Residential Home for more information

This inspection was carried out on 26th February 2007.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This inspection found the overall quality of the support and care offered to residents was to good standards. The care provided was within a robust risk assessment framework, and was recorded within each person`s support plan. Residents` needs and wishes were very clearly recorded demonstrating that residents` were consulted about decisions and choices that affected their lives. Current medication procedures and records were detailed, and an audit of the medication held for residents, was correct. Life style and leisure opportunities were widely available for residents so the social needs of individuals were being properly met. This was confirmed by feedback received from residents, relatives and staff. Residents and relatives commented that the manager and the staff team continued to provide an excellent service. The home was found to be mostly clean and maintained. Staff employment and recruitment records were checked and found appropriately in place, and staff training and supervision continued. The management of the home continued to be responsive and inclusive to the needs of residents.

What has improved since the last inspection?

Since the last inspection, a small number of requirements including the cleanliness of the home, the testing of electrical appliances and improvements to risk assessments had been resolved. Very positively the lounge area had been redecorated to ensure that this area was more home like and comfortable for residents.

What the care home could do better:

While it was noted that the home continued to provide a good service for residents, a small number of issues required attention. This included the immediate provision of a risk assessment around the kitchen hot water tap temperatures, to assess their safety, and ensuring that the laundry safety valve is always shut off, when staff are not in attendance. One staff member required a protection of vulnerable adult check (POVA).

CARE HOME ADULTS 18-65 Portland Crescent Residential Home 43 Portland Crescent Woodbridge Suffolk IP12 4DZ Lead Inspector Kevin Dally Unannounced Inspection 26th February 2007 08:30 Portland Crescent Residential Home DS0000024474.V331157.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 Portland Crescent Residential Home DS0000024474.V331157.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. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Portland Crescent Residential Home Address 43 Portland Crescent Woodbridge Suffolk IP12 4DZ 01394 388011 F/P 01394 388011 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) www.mencap.org.uk Royal Mencap Society Mr Andrew Harvey Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: Portland Crescent was first registered in 1992 and provides care and accommodation to four adult service users with a learning disability. The home is owned and administered by Mencap and is situated on the outskirts of the town of Woodbridge, close to local shopping facilities and within walking distance of the town centre. The town of Ipswich can be accessed by train or bus and the coastal town of Felixstowe is some eight miles away. The home itself is a large, modern, purpose built, dorma style bungalow which provides very spacious accommodation for the four service users who live there and there is one very spacious bedroom on the first floor, accessible by a stair lift if required. Communal accommodation includes a large conservatory, which leads out onto the rear garden, a spacious lounge, a dining room and a domestic style kitchen. The home has a large secure garden to the rear of the property. Fees: From £926.68 to £974.71 per week. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Portland House provides care and support for up to 4 residents with learning disabilities. This unannounced inspection was undertaken on the 26th February 2007, between 8.30am and 5.30pm. Mr Andrew Harvey, the home’s manager was present for the duration of the inspection and fully contributed to the inspection process. This was a key inspection that assessed the core standards relating to younger adults. The report has been written using all the information gathered prior to and during the inspection. This inspection focused on the quality of the lifestyle outcomes for residents, including living at the home and individual opportunities within the community. A number of key areas were assessed including the personal care and support offered by the home, choices and independence, personal safety, medication practices and privacy and dignity. Residents’ care plans, risk assessments; accident and incident reports were checked for evidence of good record keeping and management monitoring. The meals provided were checked and the environment was assessed. The complaints book and quality assurance systems were checked. Two residents’ relatives came into the home at very short notice, and shared their views about the service. Residents’ surveys were received from all 4 residents, and staff members were spoken with during the day. Two staff members’ records were checked, including staff training and the supervision practises of the home. This inspection showed that of the 39 National Minimum Standards inspected, 4 were assessed as excellent, 33 were assessed as good, and 2 as adequate. Twenty-two of these standards are considered by the CSCI as key standards, of which the home met 20. What the service does well: This inspection found the overall quality of the support and care offered to residents was to good standards. The care provided was within a robust risk assessment framework, and was recorded within each person’s support plan. Residents’ needs and wishes were very clearly recorded demonstrating that residents’ were consulted about decisions and choices that affected their lives. Current medication procedures and records were detailed, and an audit of the medication held for residents, was correct. Life style and leisure opportunities were widely available for residents so the social needs of individuals were being properly met. This was confirmed by feedback received from residents, relatives and staff. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 6 Residents and relatives commented that the manager and the staff team continued to provide an excellent service. The home was found to be mostly clean and maintained. Staff employment and recruitment records were checked and found appropriately in place, and staff training and supervision continued. The management of the home continued to be responsive and inclusive to the needs of residents. 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. Portland Crescent Residential Home DS0000024474.V331157.R01.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 Portland Crescent Residential Home DS0000024474.V331157.R01.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): 1,2,3,5 Quality in this outcome area is good. Residents can expect to have their needs and aspirations properly assessed prior to admission, and know whether or not the home is able to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comment cards received from residents showed they had received sufficient information about the home, before moving in. The Statement of Purpose and Service User Guide checked was very detailed and included relevant information for residents about the services provided, including the aims of the service, who they can best a provide service for, and how to make a complaint. The home has not had any new residents for some time and so no new admissions have taken place for the last three years. All assessments for existing residents were in place which contained appropriate and very detailed information on their assessed care needs. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 9 Portland Crescent is a specialised service for younger people with severe learning disabilities who aim to provide a home-like environment for its residents. The staff group comprises of around 6 well trained support workers, and a number of relief support workers. The home has access to relevant specialist professionals and services, when this is required. For example the nurse who provides training around managing epilepsy. Further, as some of the residents are unable to speak, specialist communication systems are used to ensure appropriate communication. For example, “maketon” and “widgit” communication systems are in use at the home. Staff spoken with and records checked showed that staff were provided with comprehensive training by Mencap that was appropriate to the needs of people with learning disabilities. The premises were spacious, mostly on the ground floor, wheelchair friendly, and accessible by residents. The first floor bedroom was accessible by stairs or a chair lift, if required. The home offered a range of programmes and activities for residents, including wide access to day programmes and evening social activities. On the day of the inspection, all residents were on their way to the local day centre. From the information gathered it was clear that the home was able to meet the specialised needs of the service user group and provide a person centred lifestyle. Due to the high quality of the services provided, this standard was assessed as “excellent”. Residents at the homes are provided with a licence agreement with outlines the terms and conditions of their tenancy. Two service users’ records checked contained these agreements. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 10 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 good. Residents can expect to have their support needs thoroughly planned and regularly updated, so reflecting their care needs and wishes. Residents can expect to be enabled to make positive decisions about their life and be consulted on matters within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Portland house provides very comprehensive and integrated support plans, which includes information around residents’ personal care, their daily living support needs, work needs, social and leisure needs, and specialised communication needs. Two support plans checked showed that these plans assessed around 26 areas of assessed support needs, and were very thorough. Support plans had been constantly updated based on the changing needs of each resident. Further, support plans had been reviewed, and were dated and signed by the resident to confirm their agreement with the plan. Care records also provided specialised assessments around communication needs, epilepsy Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 11 safety, domestic skills, medication issues, and managing aggression. A personal social history called, “My story so far”, provided a very personal account of each resident’s significant milestones and achievements since childhood. This included pictures, and provided staff with significant background information about each resident. One resident who suffered from epilepsy, their care plan was tracked. Records provided very good guidance around the issues staff would need to be aware of and were clearly linked with other documentation. For example the need for staff training in epilepsy, and risk assessments, which linked with the potential risks around the resident’s swimming sessions and bath times. The home also maintained a record of when their epilepsy medication required a review by the Doctor. Due to the high quality and detail of the information provided within these support plans, this standard was assessed as “excellent”. Feedback received from residents and the relatives confirmed that life at the home and the quality of the support provided was very good. The interaction between staff and residents was seen as very positive, with residents being encouraged to be as independent as possible. Staff members enabled residents to select their preferences and make choices. For example one staff member supported a resident to make a cup of tea, but allowed the resident to achieve this in his or her own way. One resident’s relative stated, “My relative is treated as though any other person. This is how it should be”. Discussion with residents, relatives, and staff members confirmed they were supported by the home to access a wide variety of lifestyle activities and opportunities, within a risk assessment framework. Risk assessments were very thorough and enabled risks to be measured and considered. For example one resident’s risk assessment identified they had epilepsy, and the impact that this may have on daily activities. The control measures were to ensure correct and ongoing medication, training for staff in epilepsy, and ensure good house keeping to prevent trips and falls. Further, the resident enjoyed swimming, and staff were to accompany them when swimming, and to inform the lifeguard of their medical condition. Positively, the home had considered the risks of the activity, and the measures to reduce these, without preventing the resident participate in an activity they really enjoyed. Personal information was maintained securely within lockable cabinets and the computer was password protected. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 12 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 good. Residents can expect to have positive opportunities for personal development, participate in activities within the local community, and be consulted about their daily life and routines. Relatives and friends can expect to be made welcome when visiting the home. Residents would receive meals that are nutritious and appropriate to the needs of younger adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents had access to a wide variety of lifestyle activities and opportunities, including work based activities, social and leisure options. On the day of the inspection, residents were preparing for the journey to the local day centre. Relatives and staff spoken with stated that residents frequently had trips to the local cinema, the “Gateway club”, a social event for residents on Tuesday evenings, and the “Explorers travel club” at the pub. Two residents had a hobby of travelling on the local train as they had a fascination with this experience. Other residents enjoyed nature television programmes. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 13 Residents’ records checked included very personalised details of the key activities they enjoyed. These included walking, horse riding, swimming, music, television and travelling in cars, buses and trains. Records were provided with “widget pictures” for ease of understanding and described the “things I like doing”, including regular contact with their families. Personal resident statements explained their preferences and choices in their own words. For example, one resident’s records stated, “I can swim (at least a length of the pool with no help or floats) but I also like to sit in shallow water or sit on the edge of the pool with my feet in the water”. Relatives spoken with confirmed residents were able to maintain positive links and regular contact with their relatives. One relative stated that the service was very much like a ‘home from home’, and that they sometimes were invited to have a meal with their relative. Comments received from relatives and staff members, and records checked evidenced that the daily routines and home activities promoted the resident’s independence and encouraged personal choice. Where individual freedoms had been restricted due to safety considerations, this was undertaken within a risk assessment framework, and a record maintained on their support plan. Residents’ relatives were also kept informed, for example one resident’s diet had been discussed with their relative. A record of each individual’s preferences and choices are also kept of their files. For example one residents meal preferences included strawberries, prawns, seafood, ice cream, sweets, cheese, pickles and crisps. One relative stated, “The home support my relative making choices. They know what they enjoy. Living at the home enables my relative to possibly make even more choices, than if they were at living at home with me”. The menu choice checked was appropriate to the needs of younger adults, which provided a good balance between their nutritional needs, and more modern food. An example of the menu for the previous 2 weeks included, beef sausage casserole, spicy chicken casserole and mash, takeouts at Mac Donald’s, Sausage or cod and chips, pork chops potatoes and vegetables, shepherd’s pie, roast chicken and vegetables. One of the residents was identified as having slight over-weight issues, and careful monitoring, and a diet plan were positively addressing this issue. Records of the aims of a weight plan had been maintained on their records, and relatives were informed of their progress. One relative had expressed concern to the home about their relative’s weight, and the home had provided a photographic record of the food being provided. This evidenced a very healthy well balanced diet. Desserts varied, with fresh fruit and yoghurts as always available. Comments received from 2 residents around the meals they received at the home confirmed that they were always happy with the meal provision. All food records were complete but did not always all contain the date these had been received, and is recommended. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 14 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. Residents can expect to receive good quality personal and healthcare support. Residents can expect to receive appropriate assistance with their medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents’ records checked showed that the home were aware of residents personal care needs and preferences, and their needs were reflected in the support plans. Healthcare needs had also been assessed and records showed that health problems were addressed and regularly monitored. The local Doctor could be consulted, and if required, residents would be taken to the local surgery. Feedback received from one resident’s relative confirmed that there was access to professional staff including their Doctor, or the Dentist. However, they raised a concern around the need to have improved access to the Chiropodist. The home should therefore consider how access to this service could be improved. One resident stated, “My relative’s medical needs are very well looked after and I am well informed of all Doctor and hospital visits”. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 15 Relatives spoken with stated residents’ well being was promoted by the home. One relative stated, “Staff are supportive of my relative, and treat them with respect and allow them their privacy”. Further, relatives observed staff respecting residents, by knocking on doors before entering. Incident records indicated that there had been around 40 incident reports of one resident verbally abusing others. This situation had been monitored, and various meetings called to find a solution to this matter. Warnings had been issued to the tenant about this behaviour, and because this continued, the tenant had been asked too leave. More appropriate accommodation had now been organised. The home’s medication policies were provided by the Mencap organisation, and these were in place and available for staff guidance. Blister packs and medication administration record (MAR) sheets were in operation. One staff member was responsible for the reordering of medication and this was undertaken each 28 days. The medication records were checked for one resident and these provided detailed guidance for staff. A front sheet provided a picture of the resident, details of their Doctor, and full details of the medication that is required. Records also included a medication risk assessment that identified the hazards, and the control measures to reduce the risks. One resident’s medication held in the home’s locked cabinet was audited against the MAR sheet records, and these were found to be correct. Records checked for the period of the 19th to the 26th February 2007 were found to be completed and accurate. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 16 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. Residents can expect to have their complaints taken seriously and acted upon. Resident’s personal safety, including by staff recruitment checks and training can be expected and would ensure that residents are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints policy and procedures in place, including a Mencap complaint recording form. Any complaints are also monitored by the Mencap organisation. The home and the CSCI had not received any formal complaints since the last inspection. Four of 4 residents’ feedback forms indicated that they or their advocate were aware of how to make a complaint if they needed to. The home had access to adult protection procedures, and the manager was aware of their need to report any allegations of abuse to Social Services. Feedback received from one resident’s relative stated, “Our relative moved in a number of years ago. We would not have let them move in if we had any doubts”. Staff training records checked showed that staff had received adult protection training. Two staff employees’ records checked included Criminal Bureau Record checks (CRB), 2 reference checks, and an identity check. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is good. The building and living spaces create a homely environment for residents. The home is generally well maintained, comfortable and usually safe. Residents can expect the home to be usually clean, hygienic and odour free. They can also expect to have the aids and equipment to meet their individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Portland Crescent is itself is a large, modern, purpose built, dorma style bungalow which provides very spacious accommodation for the four service users who live there and there is one very spacious bedroom on the first floor, accessible by a stair lift if required. Communal accommodation includes a large conservatory, which leads out onto the rear garden, a spacious lounge, a dining room and a domestic style kitchen. The home has a large secure garden to the rear of the property. Since the last inspection the lounge area has been improved with a fireplace, modern pictures, leather couches, coffee Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 18 tables and a television. This was very much the focus of the home during the later afternoon period. I was invited by a resident to view their bedroom and this was personally decorated, with individual preferences, painted walls, appropriate fixtures and fittings and ideally adapted for their particular use. Personal items and pictures were in evidence. The bathroom and toilet areas were modern, well adapted for people with any physical/learning disabilities, with ample space, and the bath had a fitted hoist. The toilet areas were spacious with grab rails. The home was found to be mainly clean, hygienic and odour free. The bathrooms, toilets and bedrooms seen, were provided with hand wash cleaner and paper hand towels. Residents’ and staff confirmed the home was maintained in a clean and hygienic state. The kitchen area was seen to be adequate but part of the bench top was marked and may need replacing, and the kitchen floor areas should be better maintained. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Quality in this outcome area is good. Residents can expect to have their needs met by an appropriate number of trained and qualified staff. Staff are supervised and supported to ensure complete residents safety. Recruitment procedures would usually ensure residents safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with staff and rota checks confirmed the home continued to maintain an adequate number of support workers to meet residents’ needs. A minimum of two support workers is always maintained during the evenings and the morning period, before residents leave for their day centres. When residents require one to one support, this is arranged, and so staff numbers may include up to 4 during outings etc. Some days, no staff are required during the day, due to residents attending their day centres. On the morning of the inspection 2 support workers were on duty, with a third agency staff member undertaking an induction to the home. The manager arrived shortly after. Feedback from residents confirmed that 4 of 4 residents and/or their advocates considered that staff were available when they needed them. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 20 Two staff members’ recruitment records were checked and suitable recruitment and employment procedures were found to be in place. Both employees’ records included Criminal Records Bureau (CRB) checks, identity checks, 2 written references for each employee, a declaration of health status, and a contract of employment. One staff members’ CRB did not include a Protection of Vulnerable Adults (POVA) check and which is required. This was because the employee had been at the home for a number of years, and the CRB pre-dated the implementation of the POVA list. Staff training records checked confirmed that staff receive comprehensive training to meet the specialised support needs of the residents. One staff member spoken with confirmed they had received appropriate key training including autism, epilepsy, moving and handling training, medication training, and adult protection. One new employee’s records confirmed they had received detailed induction training, and this met the requirements of the Skills for care programme. The manager confirmed that 5 of the 6 support workers, had obtained an NVQ in care. From the records checked and staff spoken with confirmed they received regular supervision, personal support and attended staff meetings. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40, 42 Quality in this outcome area is good. Residents can expect the home to be inclusive and open, and have their views considered by the management. The home would usually have adequate safety checks in place to ensure residents safety. This judgement has been made using the available evidence including a visit to this service. EVIDENCE: Mr Andrew Harvey, the manager, has obtained his NVQ 4, Registered Managers Award (RMA). The home was assessed as being well run with a supportive staff team. Feedback received for residents and relatives included, “We get full support from the present management now and it is much better since Mr Harvey was appointed”, and, “The manager and staff provided me with an excellent service”. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 22 The quality assurance systems were checked which showed the home had undertaken an annual stakeholders survey in 2006. This was a detailed survey with feedback from 11-stake holders including the residents, the families, healthcare professionals, and any friends of the residents. The quality assurance form was detailed and in picture form. It included questions around access to information, healthcare, support, respect, choice, where I live, activities, safety, abuse and complaints. Very positively, the abuse questions included the question for residents, “Overall my level of feeling safe at the home is… Good- poor etc”. A selection of service users’ responses to the home’s questionnaire included the following comments. “On the whole I am generally happy with the service but one thing I am concerned about is access to dental and chiropody appointments”. “My relative is the most relaxed and the calmest I have known them in many years. They appear to be very content with things and the quality of life”. “I have always found staff supportive and helpful when calling. Communication is good and have found the home have a flexible approach that allows for changes, even at short notice”. “The manager and staff at Portland Crescent continue to provide an excellent service to my relative”. Based on the information gathered including feedback from residents and relatives, quality assurance was assessed as “excellent”. During the inspection a selection of records were checked including policy around adult protection, challenging behaviour, complaints policy, medication policy, the Statement of Purpose and the Service User Guide. Records checked included medication administration sheets (MAR), two staff member’s records two residents’ records, the complaints book, and fire safety records. All records were found appropriately maintained. Records confirmed that staff had received appropriate health and safety training including moving and handling training, food hygiene, fire safety, medication training and first aid training. There are always two support workers on duty, when residents are at the home. Hot water tap temperatures tested found the kitchen hot water tap temperature excessive at around 52 degrees Celsius. The manager was aware that a risk assessment had been undertaken but was unable to locate this on the day of the inspection. The laundry hot water tap temperature was found to be excessive at 54 degrees Celsius. A safety stop valve had not been turned off that day. All other hot water taps checked evidenced that hot water was delivered around 43 degrees Celsius. Routine fire testing, and hot water tap tests were routinely undertaken and evidenced within records checked. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 23 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 4 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 4 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 3 4 3 3 2 x Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 24 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 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 YA34 Regulation Mis. 2004 19,4,e Sc 2,10 Requirement Timescale for action 08/04/07 2. YA42 The registered person/s must be able to evidence that staff who work with vulnerable adults have had a POVA check completed and a record kept on file. 13(4)(a)(c), The registered person/s must 13(6). ensure that a risk assessment of the kitchen hot water tap temperature is undertaken to determine if this poses a risk to vulnerable residents. If so, this risk must be reduced or eliminated for residents’ safety. This is an immediate requirement. 13(4)(a)(c), The registered person/s must 13(6). ensure that the laundry hot water tap shut off valve is activated, for residents’ safety, when staff are not in attendance. This is an immediate requirement. 19/03/07 3. YA24 19/03/07 Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 25 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. Refer to Standard YA17 YA24 Good Practice Recommendations Food records should contain the date when meals were provided. All areas of the home should be maintained to a satisfactory standard of cleanliness and hygiene. Portland Crescent Residential Home DS0000024474.V331157.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Portland Crescent Residential Home DS0000024474.V331157.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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