Inspection on 18/06/08 for Primrose House

This inspection was carried out on 18th June 2008.

CSCI found this care home to be providing an Good service.

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

Other inspections for this house

Primrose House 03/07/07

Primrose House 27/06/06

Primrose House 09/02/06

Primrose House 28/06/05

Primrose House 25/11/04

Primrose House 20/04/04

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 28/09/2008.

CARE HOME ADULTS 18-65 Primrose House 2 Moor View Western Road Ivybridge Devon PL21 9AW Lead Inspector Wendy Baines Unannounced Inspection 18 /19th June 2008 10:00 th Primrose House DS0000003780.V363987.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 Primrose House DS0000003780.V363987.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. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Primrose House Address 2 Moor View Western Road Ivybridge Devon PL21 9AW 01752 894222 NONE 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) Mrs Cheryl A Nurse Mrs Cheryl A Nurse Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd July 2007 Brief Description of the Service: Primrose House is a small care home registered for five younger adults with a learning disability. The home provides a service primarily for people with autism and Aspergers syndrome. The emphasis is on a homely atmosphere where service users can be as independent as possible while being supported within a safe and caring environment. Service users are included in the daily domestic routine of the home and are encouraged and supported to voice and express their views and concerns. Primrose House is a large terraced house in the centre of Ivybridge village, which is located ten miles to the east of central Plymouth. Service users accommodation is spread over two floors. The home does not have appropriate facilities for potential service users with significant physical disabilities. The house has a large garden to the rear. The location of the home allows service users to walk to local shops and amenities and enjoy a lifestyle that minimises restrictions but provides support and guidance as necessary. The registered provider, Mrs Cheryl Nurse, has owned and managed the home for the past nine years. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star: This means the people who use this service experience good quality outcomes. This report is a summary of a cycle of Inspection activity at Primrose House since the last inspection visit. To help CSCI make decisions about the home the Provider gave us information in writing about how the home is run; any documents submitted since the last inspection were examined along with the records of what was found at the last visit; A site visit totaling 8.5 hours was carried out with no prior notice being given to the home as to the date and timing; discussions were held with the Registered manager and staff on duty; various records were sampled, such as care plans and risk assessments; surveys were sent to a sample of staff ; and a tour was made of the home and garden; time was spent with the people who use the service and the inspector was able to talk with, and observe the staff on duty. The inspector visited the home on a second day specifically to spend time talking with some of the people who use the service. A sample group of residents were selected and their experience of care was tracked through records and discussions with staff and management from the early days of their admission to the current date, looking at how well the home understands their needs and the opportunities and lifestyles they experience. Where possible time was then spent with these people, and feedback was sought from their care managers, health professionals and family. This inspection approach hopes to gather as much information about what the experience of living at the home is really like, and to make sure that service users views of the home forms the basis of this report. What the service does well: Primrose House is a small care home situated within the close-knit community of Ivybridge in the South Hams district of Devon. The location of the home Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 6 allows the people who use the service to develop their skills and independence by accessing facilities in the community with minimal support from staff. Residents are of a similar age and are encouraged and supported to lead an active and fulfilled lifestyle. One resident had recently started a regular work placement and said that the home had helped them achieve this goal. Friendships are encouraged and promoted within and outside the home and residents are supported to maintain regular contact with family and other important people in their lives. There is a small and consistent staff team who have a good understanding of the day- to- day care needs of the people using the service. The staff recognise peoples rights and work hard to support and encourage people to make choices and have control over their lifestyle. Due to the small size of the home and consistent staffing arrangements staff are able to monitor any changes in health and make relevant and prompt referrals to specialist and healthcare services. As part of an independent lifestyle people are encouraged and supported to have control and make choices where possible regarding their medication, finances and daily routines. What has improved since the last inspection? Information sent to the Commission prior to the inspection stated that since the last inspection there have been improvements including; • • The lounge and dining room have been redecorated. Two residents have been supported to access alternative day opportunities. For one of the residents this has been the first regular daytime activity they have been involved in since moving to the home. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 7 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. Primrose House DS0000003780.V363987.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 Primrose House DS0000003780.V363987.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): Quality in this outcome area is good. 1,2,3,5. This judgement has been made using available evidence including a visit to this service. The homes admissions procedure ensures that the assessed needs of people who may use the service can be met. Individuals and their representatives are provided with the information they need to make an informed choice about where they live and the services and support they receive. EVIDENCE: There had been no new admissions to the home since the last inspection. Therefore these areas of the standards were not looked at in detail on this occasion. The homes admissions procedure was discussed with the manager, which confirmed that all new residents would have a full assessment prior to the placement being agreed and would be given the opportunity to visit the home, view their room and meet the other people who use the service and the staff. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 10 The manager said that at the point of admission information gathered about the individuals needs is used to develop a care plan for the home. The home must ensure that when someone moves into the home they are informed of and agree any arrangements, which may restrict their freedom and /or choice. Any potential restrictions on choice, freedom, services or facilities should be included in the homes Statement of Purpose or individuals care plan. All residents had a written contract and information about the home and services provided. One resident was able to recall the time when they moved into the home and said that ‘ Primrose House has understood and met my needs, which has meant that I have settled and am able to live an independent lifestyle’. Primrose House DS0000003780.V363987.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes care planning system provides staff with the information they need to meet resident’s needs on a day- to- day basis. People who use the service supported to make choices and take risks as part of an independent lifestyle. EVIDENCE: The care plans and records relating to three people living in the home were looked at in detail during the inspection. Care plans included information about individuals current care needs and how they are supported. Discussion took place with the manager and senior staff about the need to further develop the homes care plan procedures to ensure that the individual is involved in this process and that information about the Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 12 individuals goals, wishes and preferences about how they receive their care and support is recognised and recorded. Each area of the care plan included a risk assessment, which outlined any possible risks and how these can be managed to ensure the safety of the individual whilst promoting independence whenever possible. Care plans included information about how each resident communicates and it was evident through discussion and observation that staff were able use this knowledge and understanding to encourage people to make choices and be as independent as possible. During the visit staff were observed responding promptly and sensitively to changes in mood and behaviour and as a result of this awareness were able to prevent difficult situations occurring. The home has in the past supported people to access advocacy services when requested or if they feel that independent advice is necessary. Information regarding advocacy services was available on the homes notice board. The information provided by the home stated that ‘ Service users have a lot of say in the day to day running of the home, they partake in chores and attend to many of their own daily tasks. Most do their own washing and ironing’ Throughout the inspection all the residents were being supported and encouraged by staff to make choices and to be fully involved in matters concerning the home and their individual care arrangements. Although staff were involved and offered support when required it very much felt that people were able to make their own decisions about there home and lifestyle. One resident was refusing to go to their day placement. Staff were observed being patient and respectful of the individuals decision whilst sensitively and gently encouraging them to partake in the activity they know the resident would normally enjoy. Feedback within surveys sent to people living in the home confirmed that most residents feel that they are able to make decisions about what they do during the day, evenings and weekends. Feedback regarding the time people go to bed indicated that some people using the service may feel that the current arrangements in the home restrict their freedom and their ability to make choices appropriate to their age and lifestyle. All records inspected were found to be well maintained and up to date. The home now has a small office, which is used for the safe storage of records and also allows staff privacy when making private calls and completing records relating to people who use the service. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 13 Primrose House DS0000003780.V363987.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to make choices about their lifestyle, and are supported to develop their life skills. People are involved in meaningful daytime activities of their own choice and according to their individual interests and capability. Where appropriate education and occupation opportunities are encouraged, supported and promoted. People who use the service have the opportunity to develop and maintain important personal and family relationships. EVIDENCE: Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 15 Primrose House is located within easy access to the shops and facilities in the small community of Ivybridge. Most of the people currently living in the home are able to access opportunities outside the home with minimal support. The home has the use of a large people carrier, which is used for some of the homes activities, however residents are encouraged and supported to use public transport and are within easy reach of the main bus route and train service into Plymouth City Centre and Cornwall. The atmosphere in the home on the day of the inspection was warm and welcoming. Residents were either getting ready to go out for the day or having a relaxing breakfast and chat in the dining room. All of the residents have a full week of activities inside and outside the home. Some of these include regular planned day placements and voluntary work as well as a range of leisure activities planned and organised by the individual with the help of staff when necessary. One resident was keen to talk about their voluntary work that they had started during the last 6 months. The resident said that the care and support provided by the home had enabled them to fulfil their wish of leading a more fulfilled and independent lifestyle. The manager said that some residents require a very structured routine to their day and need support to deal with any sudden changes that may occur. One resident had a written planner for each week. Where necessary the staff support the resident to write the plan and then they look at it each morning to see if any changes are likely to happen. All of the residents spoke about the various leisure activities they enjoy either on their own or with others in the home. One resident said that he enjoys going with a friend to the theatre to see musicals and concerts. All of the residents use the local shops, library and leisure facilities. People using the service are supported to maintain links with family and friends and those spoken to were keen to tell the inspector about visits home and friends they have made in the local community. Feedback from family was positive and included ‘ My relative is always happy to visit home, but is equally happy to return to Primrose, the staff are helpful and assist with transport arrangements and any concerns we may have’ Residents are fully involved in the planning and preparation of meals. As the home is small meal times can be flexible and organised around each persons daily arrangements. During the inspection residents who wished to were able to prepare their own breakfast, packed lunch and snacks. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 16 During the past 12 months the home has had a large extension, which has doubled the size of the kitchen area. This has had a big impact on the home and has meant that all residents can partake in the planning and preparation of meals as well as having the space to enjoy being with staff and other residents within this busy part of the house. Information regarding any specific dietary requirements were documented and staff had received support and guidance from the specialist learning disability and health services when required. Primrose House DS0000003780.V363987.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): Quality in this outcome area is good. 18,19,20. This judgement has been made using available evidence including a visit to this service. The health needs of people using the service are well met with evidence of good multi-agency work taking place on a regular basis. EVIDENCE: Records confirmed that most of the people who live in the home are able to attend to most daily personal care tasks with minimal support. The staff on duty said that some residents need support in the way of prompts, guidance, and reminders about issues relating to daily personal care and hygiene. One of the residents required more assistance with daily care needs and these arrangements had been documented within the homes care plan. Discussion with people who use the service and feedback within surveys confirmed that people are able to choose their own daily routine, shop for their own clothing and make decisions regarding their appearance. As previously mentioned within this report some residents spoken to felt that they were not always able to make a choice about times that they go to bed. The manager was informed about these comments and advised that any Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 18 restrictions must be documented within the homes statement of purpose and if they affect the freedom and choice of an individual must be agreed as part of the individuals care plan. During the inspection residents were seen busy planning for their day and attending to daily tasks and household chores. Staff were observed supporting residents in a sensitive and respectful manner. Daily records confirmed that residents are supported and encouraged to attend routine health checks and to use local health facilities where possible. Care plans provided staff with information about each individual’s health care needs and any specific guidelines to meet them. Previous reports and information received prior to the inspection highlighted the difficulty experienced by the home to access health services for service users who live out of the area that provides funding for their care. Cheryl Nurse the Registered Manager and owner of the home has continued to advocate on behalf of a service user to ensure that the correct healthcare support is provided. As a result of the homes determination to secure the correct support a care plan is now in place, which includes regular meetings and close monitoring by the home and appropriate healthcare agencies. The staff at the home have also received training and support to ensure that they understand and recognise their role in meeting the individuals needs. People using the service are encouraged and supported whenever possible to manage their own medication. Care plans and risk assessments provided details of these arrangements. Facilities were available for safe storage of medication for those who self medicate and those who receive support from staff. Primrose House DS0000003780.V363987.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): Quality in this outcome area is good. 22,23. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows people to express their views, and concerns in a safe and understanding environment. People using the service are protected by the homes safeguarding procedures. Staff working at the home know when incidents need external input and who to refer the incident to. EVIDENCE: No complaints have been received by the Commission or direct to the home since the last key Inspection. It was obvious through observation that people using the service are very involved in discussions regarding the home and their care and most are able to voice their concerns verbally. The staff have a good understanding of each individuals communication methods and were able to respond promptly and sensitively to non- verbal forms of communication. The residents spoken to said that they know who to speak to if they have a problem and most said that they would raise any concerns with Cheryl Nurse the Registered Manager. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 20 Since the last inspection the Registered Manager has attended ‘ Safeguarding’ training and has passed this information on to the staff team to ensure that everyone is familiar with the procedures to follow if the suspect an incident of abuse has occurred within the home. Care plans included guidelines for staff about how to manage and support people who may present difficult and challenging behaviour. Staff are aware of when they need to seek external advice and support and a recent referral had been made to the specialist Learning disability service to ask for support for one resident who had been displaying a change in mood and behaviour. Staff were observed supporting people to attend to daily tasks and routines independently, whilst offering advice and guidance on keeping safe, healthy and happy wherever possible. The home has written policies and procedures for the handling of peoples money. Care plans included information about the skills people have with money and any support that may be needed. Wherever possible people are encouraged to take responsibility for their own money and support is offered when requested. Primrose House DS0000003780.V363987.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): Quality in this outcome area is good. 24,28,30. This judgement has been made using available evidence including a visit to this service. People who use the service live in a safe, comfortable and well maintained home. Improvements made to the kitchen and office area has given people better facilities to develop their skills and safer arrangements for storing personal information. EVIDENCE: Primrose House is situated close to all the local facilities within the small town of Ivybridge. People using the service can if they choose walk to local shops or catch a bus outside the home into Plymouth City Centre. There is also a local train station, which some of the residents have used as an alternative to the homes transport. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 22 During the inspection residents were busy either attending local day opportunities, shopping or enjoying a leisure activity. Due to the location of the home most were able to come and go independently or with minimal support from staff. Within the home people organised themselves with their daily routines and were able to access all parts of the house independently to do their washing, ironing or other daily chores. The residents spoken to said that they enjoyed being able to go out and use the local shops and leisure facilities independently without always having to rely on the staff for support. Primrose House is bright and spacious, and room sizes are adequate for the number of people accommodated. This has in the last 12 months been further improved by the extension to the kitchen area. This change has had a big impact on the home allowing everyone to participate in the planning of meals and snacks, whilst also enjoying improved space in this busy part of the home. Residents spoken to were very pleased with the changes to the home and the new facilities provided. The dining area in the home is quite small although residents said this doesn’t cause a problem as people are usually out during the day and it is only used for breakfast and the main evening meal. The communal sitting room has recently been decorated and is used by residents who are at home in the day and when relaxing together in the evenings and weekends. Staff use the communal sitting room during the night, as there is no separate sleeping accommodation. Discussion took place with the manager about the restrictions this could impose on residents who may wish to use this part of the home during the late part of the evening or night. All parts of the home seen during the visit were found to be clean and well maintained. Primrose House DS0000003780.V363987.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): Quality in this outcome area is good. 31,32,33,34,35,36. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the needs of people who use the service. This is evident from the positive relationships, which have been formed between the staff and residents. Staffing levels reflect the needs of the people using the service, and rotas are flexible to fit around the lifestyle of individuals. The staff team support each other and share skills and knowledge with colleagues. EVIDENCE: Discussions with the manager and details provided on the daily rota confirmed that two members of staff are always on duty during the busy times of the day (mornings), and when all residents are at home. As most people are able to go out independently staffing levels are increased dependent on planned activities or the assessed needs of individuals as agreed with Social Services. Two staff are always on duty at weekends. There are times when staff are working on their own and the home has a lone working policy to ensure that Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 24 staff know who to contact and procedures to follow if a difficult or emergency situation should occur. The home has a small, consistent staff team who know the residents well and have a good understanding of their daily care and support needs. Throughout the inspection staff were observed interacting with residents in a sensitive and respectful way. There was plenty of laughter in the house, and all residents appeared to enjoy the company of the staff and others living in the home. Discussion with outside agencies and information provided by the home confirmed that Primrose House supports people with complex care needs particularly Autism and Aspergers Records confirmed that staff attend a range of specialised training courses such as; Challenging Behaviour/Learning disability, Autism and Aspergers and Mental Health awareness. These courses offer a basic introduction to the subject and have been provided by the Plymouth Learning Disability service. Information sent to the Commission prior to the inspection stated that two of the five staff have completed a NVQ2 in care and one is registered to begin this training. The provider must ensure that all staff working in the home have sufficient skills and knowledge to adequately meet the needs of the people they care for. At the last key inspection improvements had been made to ensure that the homes recruitment procedures were robust and protected people using the service. The manager said that since this time there have been no new members of staff and no use of agency staff. A sample of staff records were looked at and these were found to be in good order with information about recently attended training and staff appraisals. Staff spoken to said that the small staff team work closely together, share ideas and offer support to each other. One staff member said that although there are times when they work alone there is always someone to contact if there should be a problem. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 25 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): Quality in this outcome area is good. 37,38,39,40,41,42. This judgement has been made using available evidence including a visit to this service. People who use the service and the staff have access to the manager who provides an informal and open style of management. The service is planned to be user focused EVIDENCE: Primrose House is a small care home, which is owned and managed by Mrs Cheryl Nurse. Mrs Nurse has a nursing qualification and has many years experience of working with adults with a Learning disability, particularly those with Autistic Spectrum Disorder. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 26 A representative from the Learning Disability service said, ‘ Cheryl and the staff at Primrose provide very good care to the people using the service and have supported them to develop their skills and lead a more independent lifestyle within the local community’. Throughout the inspection residents were observed as being comfortable and relaxed within their home and were able to go about their daily routines independently or with help from staff when requested. There was plenty of interaction between staff and residents and everyone was encouraged to partake in discussions and express their views. A senior member of staff has worked hard to develop the homes care planning and review procedures. She was interested and open to ideas about how the home should further develop this information to ensure the inclusion of people who use the service and detail of long term goals and wishes. It was evident that the home regularly liaises and consults with residents’ their families and other agencies about issues concerning the home and specific care arrangements. However, the home does not have a system for gathering this information as a means of analysing the quality of the service or outcomes for people who live there. The homes fire log was seen and all fire records and checks were found to be up to date. Training records confirmed that all staff were due to attend updated fire training. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 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 X 26 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 3 2 3 3 3 X Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 28 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 YA18 Regulation 12 Requirement People who use the service must be able to make decisions about their daily routines including the times they go to bed. Any restrictions relating to these arrangements specific to the home must be documented within the homes Statement of Purpose Any arrangements which may restrict an individuals’ choice/ freedom must only be agreed as part of their individual care plan and included all those involved in their care. Timescale for action 05/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 29 No. 1. Refer to Standard YA6 Good Practice Recommendations The manager should ensure that the homes care planning system is person centred and describes how a person wants to live, or work towards their dreams and wishes. This should involve the individual and include an action plan, which sets out the steps required to achieve these goals and the key people involved in this process. 2. YA28 Staff working in the home should be provided with adequate facilities when sleeping in. These facilities should not affect the people living in the home or impose any restrictions on resident’s rights and choices when using the communal parts of the home. The Provider should ensure that the current training available to staff is sufficient in content and frequency to demonstrate that the home can meet the needs of the people who use the service. The home should have a continuous self- monitoring/ quality assurance system, based on seeking the views of service users, their families and other agencies to measure success in achieving the aims, objectives and Statement of purpose of the home. 3. YA35 4. YA39 Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Primrose House DS0000003780.V363987.R01.S.doc Version 5.2 Page 31 - 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!