Inspection on 03/07/07 for Primrose House

This inspection was carried out on 3rd July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Primrose House 18/06/08

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 09/07/2008.

CARE HOME ADULTS 18-65 Primrose House 2 Moor View Western Road Ivybridge Devon PL21 9AW Lead Inspector Wendy Baines Unannounced Inspection 3rd July 2007 10:00 Primrose House DS0000003780.V333776.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.V333776.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.V333776.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 C A Nurse Mrs C A Nurse Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 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.V333776.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is a summary of a cycle of Inspection activity at Primrose House since the last inspection visit. For the purpose of this report the term ‘service user’ will be used to describe the people who use the service. 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 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; time was spent with the service users and the inspector was able to talk with, and observe the staff on duty. A sample group of service users 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 service users, and questionnaires were sent to their advocates, care managers and other specialist services. This approach hopes to gather as much information about what the experience of living at the home is really like, and 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 allows service users who wish to develop their skills and independence to access facilities in the community with minimal support from staff. Service users are of a similar age and are encouraged and supported to lead and active and fulfilled lifestyle. Friendships are encouraged within and outside the home and service users are supported to maintain their contacts with family and other important people in their lives. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 6 There is a small and consistent staff team who have a good understanding of each individuals needs, and work hard to support and encourage service users to make choices about their daily routines and lifestyle. Due to the small size of the home staff are able to monitor any changes in health and make relevant referrals and contact with specialist Learning Disability services when required. As part of an independent lifestyle service users are encouraged and supported to make decisions about their medication, finances and other matters concerning the home and their care. Questionnaires returned by relatives of people living at the home indicated that they are satisfied with their experience of the home and the care provided. Two representatives spoken to from the Learning Disability service and Social Services said that Primrose House provides a ‘ very caring’ environment, where people are encouraged and supported to lead a ‘ full and independent lifestyle within the local community that they live’ What has improved since the last inspection? The manager and staff have continued to review and improve the policies, procedures and practice in the home to ensure that they meet the standards and address any outstanding requirements. Consultancy support has also been purchased to assist with employment, staffing and recruitment issues, which will further protect service users and provide a more professional and quality service. Since the last inspection the home has had a large extension to the original kitchen. Service users now have more space to use the kitchen independently or to assist in the preparation of snacks, meals and drinks throughout the day. The extended kitchen area has also provided space for a small staff office. This has provided staff with a quiet area to work, make telephone calls as well as ensuring that service user records can be stored safely. A lone working policy has been developed to ensure that all staff are aware of who to contact and procedures to follow if a difficult or emergency situation should occur. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 7 The standard of vetting and recruitment has improved with appropriate checks now being carried out for new staff, providing better protection for service users. Staff training relating to risk has provided staff with the skills, confidence and greater understanding to allow service users to make choices and take risks as part of an independent lifestyle. 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.V333776.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.V333776.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. 1,3,5. This judgement has been made using available evidence including a visit to this service. The homes admissions procedure ensures that the assessed needs of service users can be met. Service users 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 service users would have a full assessment prior to the placement being agreed and would be given the opportunity to visit the home to view their room and meet the other service users and staff. All service users had a written contract and information about the home and services provided. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 10 One service user 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’. Feedback from Social Services included ‘ The staff at Primrose have a really good understanding of the needs of the people they care for, any service users I have been involved with have settled really well and now enjoy a more fulfilled life’’. Primrose House DS0000003780.V333776.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. 6,7,8,9,10. This judgement has been made using available evidence including a visit to this service. The home now has a more clear and consistent care planning system in place, which provides staff with the information they require to satisfactorily meet service users needs. Service users are supported to make choices and take risks as part of an independent lifestyle. EVIDENCE: The care plans and records relating to three service users living in the home were looked at during the inspection. The information included good information about each individuals needs. Any risks identified were documented and all care plans had recently been reviewed. Care plans included information about how each service user communicates and it was evident through discussion and observation that staff were able Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 12 use this knowledge and understanding to encourage service users to make choices and be as independent as possible. It was evident within records and through discussion with staff and other agencies that some service users had expressed an interest in considering their long- term plans and possible future move from Primrose and into a more independent setting. Individual care plans included information about the current needs of service Users but did not in all cases document long- term goals and future needs and aspirations. The home has supported service users to access advocacy services when requested or if they feel that independent advice is necessary. 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 service users 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. During the first morning several of the service users spent time in the kitchen planning a birthday celebration and writing the shopping list for the week. Although staff were involved and offered support when required it very much felt that the service users were able to make their own decisions about their home and lifestyle. The manager said that there have been occasions when opportunities have had to be restricted for a short period of time following an episode of difficult behaviour. Advice was being sought from the specialist learning disability services regarding this issue. All staff had received recent training and advice regarding the need to allow people to take risks as part of an independent lifestyle. The manager said that this advice had helped reduce the anxiety of staff when supporting people with complex care needs. She said that staff were now more aware that as part of the caring role it is also really important to listen to service users and allow them to make real choices and have control over their lives. All records inspected were found to be well maintained and up to date. Since the last inspection a small office has been added as part of an extension to the kitchen area. When complete this will also include new filing cabinets for the safe storage of service user records. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 13 Primrose House DS0000003780.V333776.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. 11,12,13,14,15,16,17. 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. Social, educational, cultural and recreational activities meet individual expectations. EVIDENCE: Primrose House is located within easy access to the shops and facilities in the small community of Ivybridge. Most of the service users currently living in the home are able to access opportunities outside the home with minimal support. The atmosphere in the home on the day of the inspection was warm and welcoming. Service users were either getting ready to go out for the day or having a relaxing breakfast and chat in the dining room. Several service users Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 15 were writing the shopping list with particular attention being given to the food required for a birthday celebration. All of the service users spoke about the various leisure activities they enjoy either on their own or with others in the home. One service user had enjoyed a recent trip to the Plymouth Aquarium and another said that he enjoys going with a friend to the theatre to see musicals and concerts. Staff were supporting one service user to keep up a daily fitness routine and to plan a bike ride for the day. All of the service users have their own individual activity plan for the week and for some this includes attending to their own chores within the home. Throughout the week staffing levels are dependent on these individual arrangements. The manager said that due to the recent modernisation of day services it has been necessary for the staff to spend more time supporting service users to explore new leisure and educational opportunities. The staff spoken to said that staff support has been crucial at this time as most of the service users have found the changes very difficult. Service users 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 within the local community. Feedback from family included ‘ We are able to visit at any time and as often as we like, we are made to feel very welcome’ Service users 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 service users who wished to were able to prepare their own breakfast, packed lunch and snacks. 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.V333776.R01.S.doc Version 5.2 Page 16 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 service users are well met with evidence of good multidisciplinary work taking place on a regular basis. EVIDENCE: Current service users are able to attend to most daily personal care tasks with minimal support. Discussion and records confirmed that they may need support in the way of prompts, guidance, and reminders about issues relating to daily personal care and hygiene. Service users choose their own daily routine, shop for their own clothing and make decisions regarding their appearance. During the inspection service users were seen busy planning for their day and attending to daily tasks and household chores. Staff were observed supporting service users in a sensitive and respectful manner. Daily records confirmed that service users are supported and encouraged to attend routine health checks and to use local health facilities where possible. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 17 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. Service users 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.V333776.R01.S.doc Version 5.2 Page 18 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 adequate. 22,23. This judgement has been made using available evidence including a visit to this service. Systems in the home ensure that all service users are listened to and any concerns or complaints are dealt with promptly and appropriately. Staff are able to recognise and discuss issues relating to abuse but do not have sufficient training to ensure that they act appropriately should they witness or be informed of an incident of abuse. EVIDENCE: No complaints have been received by the Commission or the home since the last inspection. It was very obvious through observation that service users are very involved in discussions regarding the home and their care and most are able to voice their concerns verbally. Staff have a good understanding of each individuals communication methods and were able to respond promptly and sensitively to non-verbal forms of communication. Service users spoken to said that they would know who to speak to if they had a concern and felt that all the staff would listen to them. Information received by the home highlighted that consideration would be given to providing a complaints procedure to service users in an ‘easy read’ format. This would ensure that all service users are able to understand the Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 19 procedures to follow should they have a complaint about the home or any matter concerning their care arrangements. Staff spoken to were aware of different forms of abuse but had not received sufficient training relating to the protection of vulnerable adults and locally agreed procedures for dealing with reports of abuse. The Registered Manager said that she was due to attend a local Adult Protection training course and would then provide this training to the staff. Care plans included guidelines for staff about how to manage and support service users who may present difficult and challenging behaviour. Records confirmed that staff attend a range of specialised training opportunities to ensure that they have the skills to meet service users specific needs, these include; Challenging Behaviour/Learning disability awareness, Autism and Aspergers, and Mental Health awareness. The manager said that she had liaised with the specialist learning disability services to request support for service users when they are faced with difficult situations away from the home and without staff support. She hoped that this would further assist service users to be independent and to maintain and increase the opportunities available to them in the local community. The home had written policies and procedures for the handling of service users money. Care plans included information regarding service users money skills and the type of support required. Wherever possible service users are encouraged to take responsibility for their own money and support is offered when requested. Staff were observed supporting service users to attend to daily tasks and routines independently, whilst offering advice and guidance on keeping safe, healthy and happy wherever possible. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 20 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. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, comfortable and well-maintained home. Improvements made to the home have ensured that service users have sufficient communal space to develop their independent living skills and to ensure that information about them is kept safe. EVIDENCE: Primrose House is situated close to all the local facilities within the small town of Ivybridge. Throughout the inspection all the service users were busy either attending local day opportunities, shopping or enjoying a leisure activity. Due to the location of the home most of the service users were able to come and go independently or with minimal support. Within the home service users 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. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 21 Service users spoken to said they enjoyed living at Primrose House and liked being able to go out and use the local shops independently. Primrose House is bright and spacious, and room sizes are adequate for the number of service users accommodated. There is an attractive garden and patio area, which is used in the summer for BBQs. Since the last inspection the home has had a large extension to the original kitchen, which has included the total refurbishment to this room and the addition of a small staff office. Service users now have more space to use the kitchen area independently or to assist in the preparation of meals and snacks during the day. The service users appeared to enjoy this busy part of the house and the interaction with the staff team. All service users spoken to were very pleased with the changes to the home and the new facilities provided. The new office now provides staff with a quiet area to work and make phone calls and also ensures that service user records can be stored safely. In addition to the extension to the home one of the service users bedrooms had been redecorated since the last inspection. All parts of the house seen during the inspection were found to be clean and well maintained. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 22 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 service users’ support needs. This is evident form the positive relationships, which have been formed between the staff and service users. Since the last inspection the standard of vetting and recruitment has improved with appropriate checks now being carried out providing more protection for service users. EVIDENCE: Discussions with the manager and details provided on the rota confirmed that two members of staff are always on duty during the busy times of the day (mornings), and when all service users are at home. As most service users are able to go out independently staffing levels are increased dependent on the activity or 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 with service users and since the last inspection the manager has developed a lone working policy to ensure that staff know who to Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 23 contact and procedures to follow if a difficult or emergency situation should occur. Staff demonstrated a good understanding of service users needs and have continued to attend a range of courses to further develop their skills and knowledge. The manager said that all staff have benefited from support by the specialist learning disability services regarding issues relating to risk, and allowing service users to make choices as part of an independent lifestyle. On the second day of the inspection several members of staff came into the home to meet with the inspector before attending an Autism and Aspergers training day. The staff spoken to said that they had plenty of opportunities for training and this included NVQ and specialist training provided by health and the Learning Disability services. Staff records confirmed that training needs are discussed and documented as part of staff induction and on-going appraisals and copies of certificates were held on individual files. Dates had not always been recorded to show when staff had attended a course and there was not a clear system to identify when training needed to be updated. Since the last inspection improvements have been made to ensure that the homes recruitment procedures are robust and protect service users. A sample of staff records were seen and those relating to staff recruited since the last inspection included all the necessary checks and recruitment information as required in the standards. The home has a small and consistent staff team who know the service users well and have a good understanding of their needs. Due to the size of the home the staff work closely together and have plenty of opportunities for discussion. Staff spoken to said they felt well supported by their colleagues and the homes manager. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 24 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. Service users and staff have access to the manager who provides an informal and open style of management. The manager has demonstrated an awareness of the areas in which the home needs to improve and has been well supported by the staff team to meet the standards and to provide a more professional and quality service to the people they care for. 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.V333776.R01.S.doc Version 5.2 Page 25 A representative from Social Services said that Mrs Nurse and the staff at Primrose House have been ‘ hugely successful’ at supporting people to live in the community and to live an independent lifestyle when at one time this may have been considered very difficult for those individuals. Throughout the inspection service users 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 service users and everyone was encouraged to partake in discussions and to express their views. It was noted by the inspector that one service user had settled into the home really well and was now very happy and confident with their peers and staff. The manager and staff have continued to review and improve the policies, procedures and practice in the home to ensure that they meet the standards and address any outstanding requirements. Consultancy support has been purchased to assist with issues relating to management of the home, employment, staffing and recruitment. These changes are in the early stages, but from the recent records seen it was evident that over a period of time records and processes in the home will be improved and further enhance the safety of service users and quality and professionalism of the service. It was evident that the home regularly liaises and consults with service users, family and other agencies about specific situations and care issues. They have also in the past collected feedback by using questionnaires. 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 individuals. The homes fire log was seen and all fire records and checks were found to be up to date. There had been a recent, routine visit from the fire department and no recommendations were made. One new member of staff had not received Fire safety training as part of their induction and staff records did not clearly show that fire training is updated on a regular basis as required. Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 26 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 X 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 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 3 3 3 X 3 3 2 3 3 2 X Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 27 NO 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 YA42 Regulation 18 Requirement The Registered Manager must ensure that staff are sufficiently trained in all aspects of Fire safety and this training must be updated on a regular basis. Timescale for action 20/10/07 2 YA23 18 The Registered manager must 20/01/08 ensure that staff receive relevant training in issues relating to adult protection and have the skills and information needed to act appropriately should they witness or receive information about an incident of abuse. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000003780.V333776.R01.S.doc Version 5.2 Page 28 Primrose House 1 Standard YA6 The Manager should ensure that if the home places any restrictions on a service user that these restrictions are discussed and agreed as part of a multi-agency process. The restriction should then be recorded and reviewed as part of the care plan process. 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. There should be an action plan which sets out the steps required to achieve these goals and the key people involved in this process. Staff training plans should have dates when the training was completed and a projected date for when the training needs updating. 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. 2 YA7 3 4 YA35 YA39 Primrose House DS0000003780.V333776.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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.V333776.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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