Inspection on 22/11/07 for Repton Drive

This inspection was carried out on 22nd November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Repton Drive 07/12/06

Repton Drive 09/05/06

Repton Drive 28/11/05

Repton Drive 06/09/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Repton Drive 13a Repton Drive Gidea Park Romford Essex RM2 5LP Lead Inspector Jackie Date Unannounced Inspection 22nd November 2007 10:00 Repton Drive DS0000060783.V355266.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 Repton Drive DS0000060783.V355266.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. Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Repton Drive Address 13a Repton Drive Gidea Park Romford Essex RM2 5LP 01708 750957 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) glebe.house@theavenuestrust.co.uk The Avenues Trust Ltd Sarah Georgia Symes Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2006 Brief Description of the Service: 13a Repton Drive is a six-place care home for adults with severe learning and physical disabilities, situated in a residential part of Romford. Opened in December 2004, it is a purpose built bungalow set behind detached houses, a short walk from bus routes into Romford town centre. There are six, single, bedrooms, each with ensuite toilet, shower, and wash hand basin. There is an additional communal shower, and bathroom. The kitchen/diner is domestic in nature, as is the utility room. A conservatory has been added, which is accessed via the lounge, and this adds to the communal space. There is parking to the front of the building, and a small enclosed garden to the rear. The home provides 24-hour personal care, with health needs being met by visiting professionals, or staff accompanying service users to outpatient clinics. All areas of the home have full disabled access, and two bedrooms have fixed overhead tracking for specialist hoists. The Avenues Trust, a registered charity, which operates other similar homes in the area and in Kent, runs the home. At the time of the visit two ladies and three men were living at the home. The basic charge per week for each service user is £1485-48. This information was provided at the time of the last visit. Information about the service provided is contained in the service users guide. Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 10 am. It took place over 7 hours. This was a key inspection and all of the key inspection standards were tested. Staff were asked about the care that service users receive, and were also observed carrying out their duties. Where possible service users were asked to give their views on the service and their experience of living in the home. All of the shared areas and 3 bedrooms were seen. Staff, care and other records were checked. Relatives, social workers and healthcare professionals were contacted and asked for their opinions of the service. At the time of writing this report feedback had been received from 3 relatives. Any feedback subsequently received will be taken into account for future inspections. Staff supported 1 of the service users to complete a feedback form and feedback forms were received from 6 staff. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received on 6th November 2007. Information provided in this document also formed part of the overall inspection. The inspector would like to thank the service users and staff for their input during the inspection. What the service does well: Staff have received the training that they need to provide a good service to the service users. Service users’ cultural and spiritual needs are met. One service user’s bedroom strongly reflects her culture. Information is made available in photographs and pictures to help the service users to understand it and also to help them make choices. Service users are being involved in the day to day running of the home. Staff said: “The service is doing very well with PCAS (Person Centred Active Support). Service users are going out in the community, going out for day trips and shopping, plus places of interest. Also, service users enjoy the activities organised in-house and in the community.” Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 6 “The manager always makes sure that staff were aware of information concerning service users. Regular supervision and training of staff ensures that the best service is provided to all service users.” “My manager is very supportive, she helps me out always if there is anything Im not sure of. The service is good at equal opportunities, promoting independence, and trying to integrate service users to the community.” “The service meets the needs of each individual and allows individual choices. Repton Drive is a thriving care home. A lovely place to work. A place were staff work very well as a team.” Relatives said: “We’re very happy with the care. They are very good. She is happy since she moved into this home. It is good that they care about her culture. We do not have any concerns or complaints.” “The home is great. Im so happy that my relative is there. It has got better. The manager is very helpful, caring and nice. The staff are great and make us feel so welcome. They keep me informed.” “I am grateful for all that the staff do. He is always well dressed and clean. The staff are thoughtful. They are also good to me, with cards and flowers on Mothers Day. Im lucky to have him in such a lovely place.” What has improved since the last inspection? What they could do better: The manager and staff team continue to develop the service for the service users and to meet each person’s needs. The requirement from the previous inspection has been met. There are not any requirements from this visit. Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 7 It was suggested to the manager that she uses the Key Lines of Regulatory Assessment (KLORA) to assist the service to identify and evidence the excellent quality of the service provided. 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. Repton Drive DS0000060783.V355266.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 Repton Drive DS0000060783.V355266.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): 1,2, 3, 4 & 5. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Appropriate information is gathered on a prospective service user prior to their moving into the home and this gives staff a picture of the individual’s needs and how to meet these. Prospective service users and their relatives can spend time in the home to find out what it would be like to live there and to enable the service user to make a choice about living in the home, within their capacity to do so. Service users have contracts/statement of terms and conditions and therefore have detailed information about the service that they are entitled to. EVIDENCE: The organisation has an admissions procedure that includes the gathering of information and assessments. It also contains details of how a prospective service user would be introduced to the home. A new service user moved into the home earlier this year. The file of this person contained information from his previous placement, from other professionals and also comprehensive assessments that had been carried out by the manager. This assessment included healthcare, social needs, mobility and cultural needs. The person Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 10 visited the home on several occasions before he moved in. He therefore had the opportunity to meet other service users and staff. He was also given a copy of the Service Users’ Guide, which has pictures and symbols to make it easier to understand. The Service User Guide is kept up to date and contains pictures to make it more accessible and easier for service users to understand. Each service user has a detailed care plan that contains information about what they can do, their likes and dislikes and what help and support they need. The staff team know service users well and know what they can do, their likes and dislikes and what help and support they need and can meet these needs. Most service users are unable to comment on what it is like to live in the home, but they all appeared to be happy and relaxed. The service users have individually written contracts between themselves and the provider. The contracts were available at the home and copies were seen in service users’ files. Therefore service users have details about the service that they are entitled to. Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10. People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Service users’ care plans and risk assessments contain good information to enable staff to safely meet their needs. They are developed with the individual and contain photographs and pictures to make them easier to understand. This exceeds minimum standards. Service users are consulted about what happens in the home and are actively encouraged to participate in all aspects of life in the home as far as they are able. This exceeds minimum standards. EVIDENCE: Avenues Trust is committed to the concept of Person Centred Active Support (PCAS) and each service user has an individual person centred plan covering all of the necessary areas. These include communication, behaviour, environment, personal care and health, domestic, family and personal relationships, cultural, and social interaction. The plans highlight a need for Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 12 service users to actively participate in all aspects of their daily lives and to encourage service user choice and control within their lives. The plans give a good picture of who the person is, what they can do and what they like. For example, “I am Catholic but do not practice my religion. If I go to my room and close the door it means that either I want to be alone or I am upset. You should give me some space and then ask me if I am okay”. “I like shopping, cowboys and Indians and hats. I don’t like apples or spiders.” Two care plans were examined. These contained a lot of information about the individuals needs, likes and dislikes. They also had photographs and symbols throughout to make them more user friendly. The plans clearly described how to support the person and what good support would be like. There was sufficient information available for staff to work with the service users and both plans show that staff know the service users well and that they are working to meet individual needs and to provide a more person centred service. The plans seen had been reviewed and were up to date and planning meetings are held every six months with relevant people being invited. The degree to which some of the service users can be involved in the development of the plan is very limited due to their profound learning and communication difficulties. However all of the service users have a copy of their plan and this contains photos and symbols to help them to understand it. One service user has signed his plan and another likes to look through her plan and recognises herself and other people in the photographs. Each person has a large ‘my plan’ on the wall in his or her bedroom. Service users have helped to do these and they show what their wishes are for 2007. Daily recordings are made about what each person has done and support that they have been given. This information is used as part of the review process and to identify ongoing and changing needs. From observations and discussions with staff it was evident that service users are consulted about what happens in the home and in their lives. For example there are photographs of a service user, who has a profound learning disability, helping to paint his bedroom. Service users are also offered choices as far as possible and assisted to make these. Further information about choices can be found in the lifestyle section of this report. The staff team are to be commended for their commitment for the service users to be supported to participate in the running of the home and for giving them real choices as far as possible. Also for the development of the accessible information that they have produced to assist service users. There are risk assessments in place. These identify risks for the service users and staff and indicate ways in which the risks can be reduced to enable the service users’ needs to be met as safely as possible and to enable service users to be as independent as possible. Risk assessments seen were detailed and had been reviewed to ensure that they are up-to-date. This means that risks can be reduced and that the service users’ needs can be met as safely as Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 13 possible. Any restrictions, for example the laundry door is locked, have all been reviewed and signed by the manager. The reasons for this are recorded and have been agreed with the individuals concerned as far as is possible. Service users’ records and other information are stored in a lockable cabinet in the office and staff are aware of issues of confidentiality. Staff awareness of confidentiality issues is checked as part of the monthly monitoring visits carried out by the service manager. Repton Drive DS0000060783.V355266.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): 11, 12, 13, 14, 15, 16 & 17. People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The service users are supported to take part in activities, to be part of the local community, to celebrate their own cultures, special occasions and milestones in their lives. Service users are supported to keep in contact with their relatives and relatives are made welcome at the home. This exceeds minimum standards. Service users receive a nutritious diet that meets their individual and cultural needs and preferences, they are offered a variety of choice in their diet and are encouraged and supported to be as independent as possible. This exceeds minimum standards. Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 15 EVIDENCE: Most service users have profound disabilities and very high support needs. They are extremely dependent on staff. However they are encouraged and supported to do as much as they are able to. Care plans also include ways in which service users are encouraged to be as independent as possible and to maintain the skills and mobility that they have. For example one service user can make toast and help with the laundry; another can dust and wash up. On the day of the visit a service user, who has physical disabilities, was sweeping the kitchen floor. All of these tasks are undertaken with staff support and encouragement. Service users are also supported to take part in a variety of activities both in the home and in the community. For example going to the theatre, cinema, pubs, local park and shopping. Some service users have aromatherapy and physiotherapy. Each person has an activity timetable with pictures to help them understand what they are going to do. They also have larger photographs to assist service users to choose what to do. Art and craft sessions form part of the activities within the house and examples of this were displayed around the home. There were also lots of photographs of service users doing activities and visiting places. For example decorating, a trip to the London Eye and the aquarium, helping in the garden. All of the service users went on holiday this year, feedback from staff and photographs seen suggest that they enjoyed these. One service user went swimming for the first time. Therefore the service users are participating in more activities and having a more interesting and fulfilling lifestyle. The staff team continue to develop appropriate activities that service users can participate in both in the home and in the community. One service user is a Hindu and her key worker has gathered information about this religion so that staff are able to support her to maintain her cultural identity. In the past she has been to Trafalgar Square for cultural celebrations and staff said that she had enjoyed this. She also has appropriate music and DVD’s which she enjoys watching. Most of the service users have contact with their families in varying degrees. One service users’ parents visit regularly and take her out, she also goes home to visit. Another service user’s sister visits. This relative does not live locally and staff took him to meet her near to where she lives so that they could have a day out together. Staff supported the service user during the course of this. The relatives of another person visit monthly but at times find the journey difficult so staff sometimes go and pick them up to make it easier for them to visit. A service user had photographs of her birthday party, which her relatives had attended. Relatives said that they are made very welcome when they visit. A relative also said that it was very nice that she received a mother’s Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 16 day card and flowers. Therefore the service users are actively supported to maintain their contact with their families and this exceeds minimum standards. There is a varied menu that encourages a healthy diet and takes account of individual and cultural preferences. For example curry and chapatti’s are included in the menu. One of the staff comes from Ghana and does cook Ghanaian food. Photographs have been taken of various foods to assist service users to make choices about what they would like on the menu. The menu is displayed in picture form on the wall in the kitchen and there are larger photos to help service users choose meals. Each service users’ plan contained information about their dietary needs and support they need at mealtimes. One plan states “I like a hot drink before I go to bed”. “I don’t like apples”. Two of the service users have input from the dietician and any recommendations from the dietician are followed. The Inspector joined the service users at lunchtime and staff were observed to give each person the support that they needed. Lunch for that day was assorted sandwiches and service users were offered choices as to what they wanted to eat and to drink. Each person was shown white and brown bread and encouraged to choose which they wanted. Then a selection of sandwich fillings was put in front of them and again they were encouraged to choose. They were then assisted to make their own sandwich. As previously stated most service users have profound learning disabilities and in some cases physical disabilities and therefore need lots of support to do this. They were all supported patiently and given encouragement. Service users were also offered a choice of hot or cold drinks. Tea bags, coffee and juice were shown to them and they were encouraged to choose which they wanted. They were then assisted to make their drink. To make this safer and easier for the service user hot water is poured from the kettle into a small metal flask with a screw top. Service users can then, with staff assistance, hold the flask and pour hot water into their cups. It was also noted that service users were offered drinks throughout the course of the day and in the afternoon some of them made cookies, which they later had with a drink. Service users receive a nutritious diet that meets their individual needs and preferences, they are offered a variety of choice in their diet and are encouraged and supported to be as independent as possible. The staff team are to be commended for their efforts to enable service users to make choices about what they eat and drink and also in enabling them to participate in preparing their food and drink. Repton Drive DS0000060783.V355266.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): People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Service users receive personal care that meets their individual needs and preferences. The principles of respect, dignity and privacy are put into practice. Care is taken to ensure that service users are nicely and appropriately dressed and this exceeds minimum standards Service users receive good quality health care. Service users receive their medication as prescribed and this is safely and appropriately administered by staff that have been trained to do this. EVIDENCE: Most service users require a lot of support with their personal care and details of the help that they need and how they prefer to be supported are in their individual plans. The plans also contain information on how to recognise what a service user wants or needs. For example “when I slide down the wheelchair I am either uncomfortable or my pad needs changing”, if I pull at my clothes I would like to take them off or change them”. In one person’s plan it states how to make that person comfortable at night and includes “I like the light to be left on as darkness is quite frightening”. This shows that the staff team know the service users well and that they aim to provide individuals with a Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 18 good quality of care that meets their needs. On the day of the visit service users seen looked clean and well dressed. On the morning of the visit there were two male and one female staff on duty. One of the female service users needs the support of two staff at times. This was discussed with staff and the female worker confirmed that another member of staff joined her when transferring the service user but then left whilst personal care was being provided. Thus maintaining the service user’s dignity. It was also noted that staff always knocked before entering service users’ rooms. Service users’ personal care needs are well met. All of the service users go to the local doctor and specialist help is received when needed. Staff take service users to all of their medical appointments. Service users’ files have details of health care issues and show that service users have regular access to health care professionals. Each person has a Health Action Plan. The plans seen were up to date and contained good information about individual health care. Service users’ health is monitored and staff are very alert to changes in mood, behaviour and general well being. If there are any concerns the GP is called. On the day of the visit staff were concerned about one service user and therefore he was seen by the GP. Follow up appointments were also made the same day. As previously stated two of the service users have input from the dietician. Records are kept of medical appointments and these show that service users have checks from the optician, dentist and when needed the chiropodist. Also that health concerns are followed up. Service users also have regular medication reviews. Therefore service users’ health care needs are being well met. None of the service users are able to self medicate and medication is administered by staff that have been trained and deemed capable to do this. This is usually a senior or a shift leader. Copies of staff medication assessments were available on file. A new member of staff confirmed that he had received medication training and was in the process of being assessed by the manager. Medication is stored in an appropriate lockable cabinet in the main office. Most of the medication is in blister packs and any that cannot be stored in this way are kept in separate baskets for each individual. Each basket has the service user’s name and photograph on it. Avenues Trust medication policy was developed in consultation with one of the Commission’s specialist pharmacist inspectors and a copy of this was available in the home. Examination of the MAR (Medication Administration Record) found that these had been appropriately completed and that the medication file contained photographs of each individual and a description of how their medication needed to be administered. Guidelines were in place for PRN (when required) medication so that staff are clear as to when and how to administer this medication. These had been approved by the GP. All of this is good practice. Medication is checked as part of the monthly monitoring visit undertaken by the organisation. Service users’ medication is appropriately stored and administered. Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. There is a user-friendly complaints procedure that would be followed in the event of any complaints being made. Staff have received adult protection training to ensure that they are clear about what constitutes abuse and what to do if abuse is seen or suspected. This gives service users a greater protection from abuse. Service users’ finances are appropriately managed and monitored and this lessens the risk of financial abuse. EVIDENCE: Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 20 The organisation has an appropriate complaints procedure and is available in a user-friendly format. This is included in the service user guide and displayed in the home. However due to the degree of their disability it is unlikely that most of the service users would be able to make a complaint without support. Service users are able to demonstrate if they are unhappy with anything through facial expressions, behaviour changes or vocalisation. In discussions with staff they were able to demonstrate an understanding of this non-verbal communication. The Commission has not received any complaints or concerns about this service since the last inspection and none were recorded at the home. Feedback from relatives was very positive. A relative said, “the manager and staff are great, I am so happy that my son is there”. The organisation has produced a detailed adult protection policy that tells staff the actions to take in the event of abuse/suspected abuse being discovered. The home has an open culture and staff and relatives feel able to raise any concerns that they might have. Staff understand what restraint is and the use of any equipment that may be used to restrain individuals such as bed rails and wheelchair belts is decided within a risk assessment framework. Staff have received protection of vulnerable adults training. They are aware of what constitutes possible abuse and of the action that needs to be taken. This offers more protection to service users who are unlikely to be able to indicate that they have not been treated appropriately and are relying on other people to keep them safe. All of the service users need help with their finances and most do not have the capacity to understand about the concept of spending or saving money. Some service users’ financial affairs are managed by their families. The manager is appointee for others. The local authority still has appointeeship for one service user. Records are kept of financial transactions. Regular checks are made by the manager to ensure that these are correct. The cash held for two of the service users was checked at the time of the inspection and was found to be correct. Appropriate receipts were on file. The organisation carries out financial audits and the service manager checks service users’ monies as part of the monthly monitoring visits. Cash is securely stored in security tagged bags. These are checked at each handover. The shift leader holds the keys. Therefore systems are in place to ensure that service users are protected from financial abuse and that service users’ finances are appropriately managed and monitored. Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The service users live in a clean and comfortable home that has suitable aids and adaptations for their needs. The staff team continue to work with the service users to make the environment as homely as possible and to reflect individuals’ likes and cultures. EVIDENCE: The home is purpose built, and was opened in late December 2004. The communal space consists of a large kitchen/diner, small lounge, laundry room and a garden. A conservatory has been added to increase the communal area. There are photographs displayed around the home and staff continue to work with service users to make it as homely and comfortable as possible. The building is accessible for wheelchair users throughout. In the last 12 months the kitchen, lounge, laundry and three of the bedrooms have been decorated. Staff and service users have been involved in the decorating. Each service user has a single bedroom that is suitable for his or her needs. All of these Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 22 have an ensuite toilet, shower and washbasin. Two have overhead tracking for specialist hoists. Bedrooms are personalised according to individuals likes and one service user’s room has been fitted with sensory equipment. Another service user’s bedroom has been decorated to reflect her culture and she went shopping with staff to buy things for her room. She has pictures of her God on the wall. Service users’ rooms have photographs of them and their relatives displayed. The staff team are to be commended for their efforts to establish service users interests and cultural needs and to reflect these in personalising bedrooms. Also for their efforts in involving service users as far as possible. There is a separate bathroom, with an assisted bath, and a separate toilet and shower and these are suitable for the service users needs. Since the last inspection the family of a service user that lived in the home before her death arranged for the garden to be landscaped in memory of their daughter. The garden is now accessible and a nice area for service users. One of the service users likes to help in the garden and there are photographs of him doing this. The kitchen is appropriately equipped and is clean. Food was appropriately labelled and stored. Checks are carried out to ensure that the environment meets the necessary standards of hygiene and that service users’ food is prepared in line with good food hygiene practice. At the time of the inspection the home was clean and free from offensive odours. There is an infection control policy and in addition to hand washing facilities each room has an alcohol gel dispenser. Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Service users are supported and protected by the organisations recruitment practice. Staffing levels are sufficient, and staff receive the necessary training, supervision and support, in order to meet service users’ current needs and provide a good service for them. Service users are supported by a staff team that know them well and who are committed to providing a good quality service. EVIDENCE: There are usually three staff on duty during the daytime shift and two waking staff during the night. From discussions with staff, observations on the day of the visit and from examining rotas it would appear that staffing arrangements and levels are sufficient to meet service users’ assessed needs. Some agency staff are still being used but recruitment is ongoing and it is hoped that the Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 24 vacancies will soon be filled. Three regular agency workers are used and they have all been working at the service for some time. Therefore service users receive a consistent service from a staff group that are aware of their needs and how to meet them. Staff retention has also improved. The staff team have experience of working with people with learning disabilities. Staff on duty said that they had received training since they started work in the home. This has included induction, adult protection, manual handling, food hygiene, first aid, back care, valuing diversity, the Mental Capacity Act and understanding challenging behaviour. A staff training record was available and this showed courses completed and those that staff were booked to attend in the coming months. Staff have a personal development plan. Staff were clear about their duties and responsibilities towards the service users. Some staff have completed NVQ level 2 or 3 and one member of staff has now qualified as an NVQ assessor and will be assessing team members. Other staff have submitted applications to join the NVQ programme and have been placed on the waiting list. Therefore the staff team are receiving ongoing training to enable them to meet service users needs appropriately. The organisation operates an appropriate recruitment procedure. Jobs are advertised, application forms completed and interviews held. Staff records are held centrally at the organisations head office in line with an agreement made with the Commission. The files seen in the home contained evidence that the necessary checks had been carried out. Therefore the recruitment procedure offers safeguards to service users. Staff are receiving regular supervision and staff meetings are being held each month. This gives staff the opportunity both collectively and individually to discuss work practice, any concerns and the development of the service. Feedback from staff was that they can raise issues or suggestions and that these are welcomed and listened to. Repton Drive DS0000060783.V355266.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): People using the service experience excellent quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The home is very well managed and provides a safe environment for the service users and this exceeds minimum standards. The registered provider monitors the service appropriately to check the quality of the service provided to service users. The service users are benefiting from the management and development of the home. EVIDENCE: Since the last inspection the manager has been registered with the Commission and has therefore been assessed as having the necessary skills, qualifications and experience to manage the service. The manager has experience of working with people with learning disabilities and has completed Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 26 NVQ 3 and the Registered Managers Award. Since the manager has been in post the requirements from previous inspections have been addressed and there are not any requirements from this inspection. Staff feedback that the service continues to improve and that they are involved in developing the service. Staff said, “she will always help us and is always there to support us. It is a pleasure to work for her. She always goes the extra bit to run a good and happy home. The manager always makes sure that staff were aware of information concerning service users. The service is good at equal opportunities, promoting independence, and trying to integrate service users to the community.” Therefore the service users are benefiting from a well run home. The manager communicates a clear sense of direction and staff are aware of the standards that are expected of them. She also promotes equality and diversity issues and is aware of good practice issues. A representative of the organisation carries out monthly unannounced monitoring visits to the home and a report on this visit is left at the home and a copy of this sent to the Commission. The reports cover the necessary areas and indicate any action that is needed. The service manager and the home manager review the progress of the service regularly and an action plan is agreed. Stakeholder questionnaires are sent to appropriate people to get feedback on the quality of the service provided. Therefore the quality of the service provided to the service users is monitored by the organisation. The staff team carries all of the necessary health and safety checks out regularly. For example fire call points are tested weekly, as are hot water temperatures. Fridge and freezer temperatures are tested daily. Appropriate servicing is carried out on the fire system and fire equipment. Fire drills are carried on a monthly basis. Appropriate service and checks are also carried out on equipment and services. For example gas safety and portable appliance testing. A safe environment is provided for the service users. The manager is to be commended for providing an excellent role model for staff in the home and for working with others within the organisation to significantly improve the quality of service that the people who live at Repton Drive receive. Repton Drive DS0000060783.V355266.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 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 4 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 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 4 4 4 4 3 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 4 3 X X 3 X Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action 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 Standard Good Practice Recommendations Repton Drive DS0000060783.V355266.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. 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