Inspection on 12/11/07 for Principle House

This inspection was carried out on 12th November 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Principle House 26/03/07

Principle House 20/02/06

Principle House 15/11/05

Principle House 07/02/05

Principle House 21/09/04

Principle House 29/03/04

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 Principle House 95 Ringwood Road Walkford Christchurch Dorset BH23 5RA Lead Inspector Maxine Martin Key Unannounced Inspection 28th November 2007 9:40 Principle House DS0000031699.V354891.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 Principle House DS0000031699.V354891.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. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Principle House Address 95 Ringwood Road Walkford Christchurch Dorset BH23 5RA 01425 277707 01425 277026 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) Principle Care Ltd Mrs Lisa Trepka Rudkin Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing levels must be calculated using the Residential Forum`s `Care Staffing` model (published 2002) 26th March 2007 Date of last inspection Brief Description of the Service: Principle House opened in August 2002. It is registered to provide accommodation and support to six adults who have a learning disability. The home is situated in Walkford, Christchurch, on the main road through the town. It is a family style home and similar in appearance to the other houses in the road. All six bedrooms are single with en-suite facilities. There is a large lounge / dining room, separate kitchen and a garden to the rear of the house. There is an area for parking at the front of the house. Accommodation is on two floors. There is also an office and staff sleep-in room. Local shops are within walking distance and there is a bus route into the neighbouring town of Christchurch. Fees range from £1055.47 to £2305.73 per week. Fees are assessed on an individual basis and according to the needs of the service users. This information was confirmed in January 2008. Readers of this report may find it helpful if they have any queries about fees to contact the Office of Fair Trading WWW.oft.gov.uk. The manager had copies of the last report available within the home. The report of this inspection is available from enquiries@csci.gsi.gov.uk. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection was undertaken in line with the Care Standards Act 2000 and following the Commission’s Inspecting for Better Lives guidance. The service was informed twenty-four hours before the inspection due to the needs of the residents. The inspection took place on Wednesday 12th December 2007, all of the key standards were inspected it commenced at 09:40 and lasted seven hours. During • • • • • • • the fieldwork inspection the following was undertaken; Discussions with residents, staff and management. Care practice observed, Two residents’ experiences were case tracked, Five residents were observed living within the home. Premises inspected and environmental matters considered. Records, files, policies, medication and financial systems reviewed. Detailed feedback and discussions was held with the manager. Pre-inspection information was taken from the Annual Quality Assurance Assessment (AQAA) completed by the manager, the last inspection report of the 26th March 2007, three feedback surveys received from residents, four relatives or advocates, three staff and four health/social care professionals. Direct quotes from these feedbacks will be included in the body of the report. The service history also informed the outcomes of this inspection. The manager advised that for the purposes of this report the individuals prefer to be called residents. The inspector would like to thank all parties who contributed to the inspection for their flexibility and responsive support. What the service does well: The service continues to ensure that detailed assessment and planning is undertaken and that individuals are actively involved in care planning and provision. Feedback received from relatives/advocates included: “..looks after expertly the …needs…they always give choice and care” “I think they are doing an excellent job” Residents are supported to be fully involved in a range of appropriate activities that meet their needs and enhances their quality of life. They are fully involved in the decision-making and the planning process. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 6 One professional feedback said in relation to what the service does well: “ Support individuals to achieve their full potential” Staff feedback received included: “I feel the client always come first, their individual needs and requirements” Resident’s continue to take part in a range of activities, which support their identified needs and enable them to be involved in their local community. A wide range of day care activities is facilitated. A health professional stated: “ Individual packages of care…use of local community services and resources...use of local community” The home continues to support individuals with a range of complex needs. Feedback included: ”Support service users with challenging behaviour..update protocols and risk assessments accordingly.” One relative commented: “ they are doing a great job the individuals always seem happy and staff have time for everyone” What has improved since the last inspection? At the end of the last inspection there were four requirements. One of these has been achieved. The other three related to training in which the service has made significant improvements. The requirement at the end of this report reflects that development as well as reinforcing the ongoing need for all staff to be trained in key areas. The registered manager states in the AQAA: “We have increased spending and time on training” This was validated in the records of staff training and feedback from staff. The service is implementing and developing appropriate procedures to ensure that they are consulting with residents and key individuals to support quality assurance. An overview summary of actions as a result of consultation would support these developments. The service has improved the range of foods available and has identified an ongoing plan to include residents further in menu planning and food Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 7 preparation. Residents health is monitored and a range of health activities are offered to support healthy living. 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. Principle House DS0000031699.V354891.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 Principle House DS0000031699.V354891.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): 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and based on the last report of March 2007, as there have been no new admissions to the home. Taken from report of 26th March 2007 “Service users can be confident that the home will meet their aspirations and needs because the manager ensures people are supported with a thorough assessment prior to moving in. Service users have opportunity to visit and spend time in the home, helping them to make informed decision about whether they want to live there before moving in” EVIDENCE: Since the last inspection no new residents have moved in, they have had oneperson return that they were providing ongoing support to. Therefore this return is viewed as part of the ongoing care plan. Additionally files inspected reflected that generally the service undertakes very detailed assessments of individuals and encourages residents to be involved in every aspect of care planning before moving in. Principle House DS0000031699.V354891.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, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their needs are fully assessed and that they are involved in decision making which balances rights and risk, consequently they have a lifestyle that they are happy with. They know about the information that is held confidentially and are respectfully supported in their daily lives. EVIDENCE: Two residents files were inspected in detail, daily logs, house meetings and other related documentation was considered during the inspection. All the files had detailed individual plans and reflected the involvement of the individual as well as family/advocates. A range of appropriate health and social care professionals including; social workers/care managers, community nurses, speech and language therapist, psychiatric staff were regularly involved in the planning process as well as the ongoing care provision. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 11 Files contained Essential Life Plans for individual residents. It was also noted that the reviews were produced in easy read and pictorial format to support the involvement of all parties. Resident’s permission had been sort in the use of pictures, this had been identified at the last inspection as an area for continued development. In the AQAA the manager confirms commitment to ensuring residents are involved in the decision making process as far as possible. In the last twelve months the home has introduced a questionnaire that they feel has been useful and in discussion on the day it was agreed that this type of activity also supports the quality assurance and development of the service. Feedback received from a staff survey stated: “ I feel the client always come first, their individual needs and requirements” Resident’s complaint logs were also viewed that evidenced appropriate responses, as well as the involvement of residents in the raising service issues relevant to the services development. A separate record sheet of resident’s complaints has now been developed. During the inspection residents were regularly given choice about daily activities and any changes in activities. The home continues to undertake risk assessments and management in conjunction with appropriate outside agencies. Risk management is an area in the AQAA that the service recognises they need to continue to develop. One feedback received from a health professional supported the need to do this. All files were stored in line with confidentiality policies and observed practice evidenced respectful responses to individuals. Files contained statements where permission had been sort from residents in matters relating to their daily care and using of information. Principle House DS0000031699.V354891.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 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported appropriately to develop in response to their identified social, health, dietary and cultural needs. Resident’s take an active part in their local community and keep contact with family and friends. Rights and choices are always taken into account in an effort to ensure a quality of life that supports the individual and enables them to experience a lifestyle they prefer and benefits them. EVIDENCE: Records contained reference to a wide range of activities including: college, social events, holiday’s, shopping trips, bingo, horse-riding, orienteering, boating all of which are appropriate to identified individual needs. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 13 The home has a day care manager who co-ordinates the day activities and each resident has a weekly plan of activities that they are supported in as required. On the day of the inspection one resident was at college and then out to the gym. Two residents had been Christmas shopping and in the afternoon one person was taking part in craft activities within the home. Files and daily logs evidenced a wide range of activities undertaken by all residents appropriate to their needs. Staff confirmed that residents regularly undertake a range of activities within the local community. Equally records and feedbacks confirmed the involvement of family, friends and advocates. In the AQAA the manager states that residents are supported in a range of activities and the plan over the next twelve months is to continue these as well as increase staff training in diversity. Another plan is to involve residents more in menu planning and food preparation. Feedback received in response to ‘what the service does well’ - included: From health professional’s; “ Support individuals to achieve their full potential” “…is supported to live the life they choose..” A record of the holiday residents went on last year was seen, which included feedback from the individuals to allow for planning of the next one. In discussions with the manager it was suggested that collating the results of this survey in a format that actions could be seen would also support the quality assurance systems within the home. All four feedbacks received from family or advocates were very positive about the care of the individual and also reflected positive relationships with the service. During the inspection menus were seen which evidenced a range of balanced meal’s available. The fridge and cupboards contained a range of food in line with a healthy eating regime. Fridge items were labeled and dated appropriately. This was a recommendation at the last inspection and progress has been made. Principle House DS0000031699.V354891.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 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported in a way that ensures their rights are respected in all aspects of their personal and health care. The service involves outside agencies, where necessary, to ensure all needs are met enabling residents to be confident in the care they receive. Resident’s needs are met by current medication procedures, however a review of these in light of new legal presidents would ensure ongoing safety is maintained and residents are safe guarded. EVIDENCE: Care planning documentation and files contain clear details of how residents are to be supported. Very specific details were recorded that ensured that care staff are clear about how the individual wants to be supported. Regular reviews and consultation with all parties ensures that any changes in care needs are identified and promptly responded to. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 15 Records detailed the involvement of a range of health care professionals. All residents have regular contact with the GP; in discussions with the manager if this was not the case the home would ensure a yearly check up for residents. Feedback conferred that generally health care needs are appropriately identified, advice sought and actions taken to meet these needs. One feedback from a care manager stated: “ All health care needs are regularly monitored and supported to attend any necessary health care appointments” The needs of the residents require the home to work closely with a range of health care professional’s, which was evidenced in the files and logs. Risk assessments and behaviour management plans are undertaken by a multidisciplinary team when appropriate. In discussions the manager advised how they are regularly adapting the environment and care plan for one individual who has very complex health care needs. The care plan and records confirmed that the service is endeavouring to respond to this individuals needs and to be creative to ensure their welfare. The homes medication procedures were inspected. At the last inspection a recommendation was made regarding adherence to the Royal Pharmaceutical Societies (RPS) guidance. The home continues to undertake secondary administration with a full risk assessment in place for this procedure. There were no errors found in medication during the inspection and the home operates a very detailed administration and record system. Since the inspection the registered manager has been advised to set up one drug in line with the ‘controlled drugs guidance’. Discussions were held with the manager regarding the latest detailed guidance that has been produced by the RPS and recent developments in a legal case over medication administration. Discussions were held with the manager about consulting with the Pharmacy Inspector, as this would support the service in developing procedures in line with national guidance. The manager also advised that this matter has been put on the agenda with the providers and management team. This matter is now made a requirement in view of the recent legal developments. Principle House DS0000031699.V354891.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 and 23. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Residents are involved in decisions about their life, which supports their rights and choices. They are actively supported in an effort to protect them however, further consideration should be given to strategic planning for re-occurring incident’s between residents to ensure all rights are considered and residents well-fare maintained. EVIDENCE: The home has the appropriate policies and procedures in place, which support protection. Staff are trained at induction and part of the ongoing training plan. The staff member responsible for day activities has also taken on the role of co-ordinating the staff’s training. A training matrix has been developed which enables clear information of the current staff status. Residents continue to have weekly house meetings, records seen reflect open discussion and the opportunity to voice choices and opinions. All feedback received indicated that residents felt able to raise issues and were aware of who to contact to do this. The service has a client complaints sheet in place. Feedback from the resident’s holiday last year had been taken into account in planning this year. Observed practice was very positive where residents appeared very relaxed and able to raise their views openly. Feedbacks received from residents were generally positive in relation to knowing who to speak to and how to make a complaint. Records of complaints from residents were seen, after discussions with the manager a new separate complaints sheet has Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 17 been devised which should enable clearer records of responses. The home has a detailed complaints procedure, records of previous external complaints evidenced an appropriate response. Feedback from relatives and advocates was very positive and all said they were kept fully informed and had no problems with communication. Ongoing Regulation 37’s are sent to the Commission and it is noted there are regular incidents within the home due to the complex needs of some of the residents. During the inspection discussions were held with the manager about the point at which a situation should be dealt with under the safe guarding procedures or not. This was particularly in relation to re-occurring incidents between residents. Since the inspection the manager has compiled a draft ‘Strategy for client conflict’ in an effort to ensure all rights and needs are balanced appropriately and safe guarding procedures are considered. Also training is ongoing in relation to adult protection please see sections on staff and management. The home continues to utilise the skills of a range of professionals to ensure that individual plans are in place regarding issues related to behaviour and other related matters. Feedback from health and care professionals in relation to what the service does well said: ”Support service users with challenging behaviour…update protocols and risk assessments accordingly” The manager sought advice regarding a CRB check on a relative who may need to stay at the home at some point in the future and this is in line with the individual’s care plan. Advice was given for the service to undertake their own CRB, as they do with all staff/personal. A requirement was made at the last inspection, regarding prevention of harm and safe guarding adults. Significant improvements have been made. The manager advised that nineteen staff have completed a training course on Crisis Prevention Intervention, including five out of the six night staff. That each course requires six people to run so some new staff may not have completed it yet. The manager advised that all new or untrained staff are told not to physically intervene until they have completed this training. The service confirmed their ongoing commitment to ensure all staff complete this course and similar training as soon after they start work within the service. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, homely, safe environment that reflects their choices and enables them to be involved in daily activities in the home and the community. EVIDENCE: The house is situated within a residential environment and enables residents to integrate into the local community. All communal areas and two bedrooms were seen during the inspection which were clean and reflected individual choice. One resident’s room was being refurbished it was noted that the radiator covers were not present. The manager advised they had been removed for the decorating. Since the inspection a copy of the order form for new ones has been received. The resident explained how they had chosen the colour for the refurbishment and how they were happy with their room. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 19 The home has a maintenance person who was present on the day of the inspection. Maintenance records were viewed and it was noted that a few had not been signed off, which would enable a clearer audit trail of these matters. Since the inspection the manager has devised a new format for recording maintenance matters, which will support clearer record keeping in the future. Also copies of records now signed off have been submitted to the commission. P.A.T testing and fire servicing have been undertaken, there had been a delay in the PAT test but this was due to the electrical company and documentation viewed at the inspection confirmed that this matter was in hand. This has seen been completed on the 19th December 2007. The next environmental health inspection is due in September 2008. The garden area is well kept and from records well used in the summer time. The day/training/finance officer has an office area in a converted garage area in the garden. The kitchen was clean and well presented; strategies had been put in place to ensure safety whilst balancing resident’s rights to take part in food preparation. Fridge/freezer recorders were up to date. The home continues to have a rolling programme of maintenance both renewing old and repairing items that get damaged. Residents appeared very relaxed and at home within the environment Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s needs are generally met by competent, well-trained and supervised staff which ensures their safe quality of life. Continuation of the improvements in training would ensure that at all times residents needs are met by appropriately skilled staff. EVIDENCE: Since the last inspection the service has invested time and resources into improving training. This was confirmed in that one member of staff is now dedicated to ensure all staff training. A training matrix has been developed which enables an at the glance summary of the current status of all staff. Fire scenario training is now also included at the staff meetings as well as induction and specific training courses. Minutes of meeting seen confirmed the scenario training. Eight staff have just completed a course through an independent provider, ten were booked to go but two were sick on the day. In relation to NVQ, again progress has been made in that seven people now hold an NVQ 2 or 3, four are nearly completed and six are enrolled to start. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 21 Even though the staff teams work across the organisations three homes, the manager advised that they usually try and keep to about nineteen staff in this service. Therefore improvements have been made towards the NVQ required levels. The manager advised that some staff are currently undertaking the Learning Disability Qualification (the LDAF), two have completed, four in progress and five are booked to start. Two recruitment records were seen which evidenced appropriate employment procedures, which follows on from the last inspection. Staff files also contained evidence of supervision and positive comments were noted in the feedback to staff. Frequency of supervision was generally good although not all staff had received the required six sessions a year. This was discussed with the manager at the inspection who confirmed this is an area that will be addressed. This was identified in the feedback from staff, which, on the whole was very positive, but reflected views on the need to ensure staff are fully supported. Three staff spoken to on the day advised they felt well supported and one commented that they had never been trained as much as they had in this position. Continued improvements in training and supervision frequency will ensure that staff have the appropriate skills to continue to support the residents appropriately. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s are supported in a service where their needs and views underpin daily life. The service is provided to promote their welfare and in their best interests, which ensures they have a standard of life they are involved in choosing. EVIDENCE: The manager is experienced, appropriately qualified and committed to improving the quality of life for the residents. Feedback received spoke positively of the care provided within the home and effective communication systems. Practice observed was of good relationships between residents, staff and management. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 23 Significant improvements have been made in relation to training especially in the area of fire safety and safe guarding guidelines, however this needs to be finalised to ensure that staff are appropriately skilled to undertake their role. The manager has now attended a course on fire training by an outside provider on 28th November 2008, which will support training other staff. The management team ensure that health and safety matters are adhered to and any developments that arise are immediately risk assessed and action plans implemented. Building standards and checks are undertaken as required, fire evacuations are completed and fire scenarios discussed to support staff awareness. Accidents and incident records are kept and the regulation 37 notices submitted as required. During the inspection a matter relating to fire evacuations and one resident who may refuse to leave the building was discussed. The manager consulted with Dorset Fire and Rescue and has put in place a risk assessment-evacuation plan for this person. Quality assurance is an area that the service has also developed, in that they undertake regular discussions with residents about care provided and service developments. This was evidenced in records and feedback received. Discussions were held about quality assurance audits and collation of information they already have to enable clear action planning. The mission statement of the service outlines a process of ensuring consultation is undertaken with all parties regarding the service. All these processes inform the overall quality development of the service and the implementation of a summary of these would support quality. Residents financial systems were reviewed and balances found to be correct. It was recommended that two members of staff sign when financial transactions take place. Since the inspection the manager has submitted ` a new residents reconciliation sheet’ which requires two staff signatures. In discussions it was also suggested that a summary of individuals financial management procedures would support care practice. This was drafted during the inspection. The manager was very proactive during the inspection in responding to and discussing areas that the service needs to or could improve in. Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 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 4 13 4 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes, but significant progress has been made so adjusted accordingly. 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 YA20 Regulation 13 (2) Requirement The registered provider must review the ongoing practice of secondary dispensing in the view of up dated guidance from the Royal Pharmaceutical Society and legal developments. The registered provider must ensure that all staff are appropriately trained as required by regulations and guidance in core areas such as fire, safeguarding adults, nonphysical intervention. That the current progress made in achieving this is maintained. Timescale for action 03/03/08 2. YA32 18 (1) a 24/04/08 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 Refer to Standard YA23 Good Practice Recommendations The registered person and manager need to review the recently developed ‘Strategy for client conflict’ in an effort to balance the rights and risk of all residents and ensure DS0000031699.V354891.R01.S.doc Version 5.2 Page 26 Principle House 2. YA32 their safety in line with adult protection procedures. 50 of all care staff in the home should obtain a care NVQ Level 2 or above. This recommendation remains however; significant improvements have been made at the time of this inspection. 3. YA36 The manager should ensure that all staff receive at least six supervision sessions each year, which are clearly recorded. Improvements have been made, this recommendation is included for the fourth time Financial transaction should have two staff signatures to ensure safety for all parties. 4. YA42 Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Principle House DS0000031699.V354891.R01.S.doc Version 5.2 Page 28 - 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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