Inspection on 09/12/08 for Robert House

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Robert House 27/02/07

Robert House 30/11/05

Robert House 07/07/05

Robert House 15/11/04

Robert House 25/05/04

Robert House 03/03/04

Robert House 18/03/03

Similar services:

Hillview Farm

Dalewood Respite Care

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REACH Upton Court Road

Fairways

Treloar College

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Robert House Robert House Avon Tyrell Bransgore Christchurch Dorset BH23 8EE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joyce Bingham     Date: 0 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Robert House Avon Tyrell Robert House Bransgore Christchurch Dorset BH23 8EE 01425673297 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Fortune Centre of Riding Therapy Name of registered manager (if applicable) Miss Jane Pritchard-Williams Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Service users in the category LD and MD may be accommodated from the age of 16 years. Date of last inspection Brief description of the care home Robert House is one of three student residential units managed by The Fortune Centre of Riding Therapy, a Specialist College offering young adults who have a learning difficulty a 3 year further education course through the media of care and management of horses. This is then transferred to personal development towards independent living. The unit accommodates up to 7 second and third year students in single bedrooms with en-suite facilities. Robert Houses philosophy is to provide an Care Homes for Adults (18-65 years) Page 4 of 30 care home 7 Over 65 0 0 7 7 Brief description of the care home environment for students to develop further daily living/independent living skills. During the working day, students are provided with educational activities on the college campus. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the students who use this service experience good quality outcomes. The purpose of the inspection was to find out how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These include the Annual Quality Assurance Assessment (AQAA) completed by the home, and surveyed comments from seven students and two staff. An unannounced visit to the home took place on 9 December 2008 and lasted 6 hours. During this time we were able to have a partial tour of the premises, including three bedrooms, the lounge, conservatory, kitchen, and laundry. We had private discussions with the director of the Centre, the registered manager, the senior member of staff on duty and two other staff, and contact with all Care Homes for Adults (18-65 years) Page 6 of 30 the students. This was limited as they were at home during the day due to a bout of influenza. We sampled staff and student records, and policies and procedures that relate to the running of the home. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection (CSCI). What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective students needs and aspirations are assessed. They are given opportunity and information to test drive the home, and for the home to form a judgement about their compatibility with others. Written information about the service the home offers is made available, but is in need of updating. Evidence: Robert Houses Annual Quality Assurance Assessment (AQAA) informed us that the Fortune Centre of Riding Therapy (FRCT) provides a person-centred service and learning opportunity for young adults who have been previously excluded from learning opportunities. There is a thorough application and admissions process that the students experience before they commence the residential course, which includes a residential seven day assessment period. Students visit Robert House during their induction and again in the last term of their second year when they have a choice to accept this accommodation. We learnt that Robert House accommodates second or third year students who have previously been resident at Wootton Hall. They are Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: therefore well known by the residential staff team including the teachers and have a fully documented history of needs and accomplishments and goals. As Robert House is attached to the main education centre in Avon Tyrrell the students have had opportunity to familiarise themselves with the facility and spend time there. In the survey returns six out of seven students said they had been provided with enough information about the home to decide whether it was the right place for them. However, three students said they did not have a choice about living at Robert House, and four said they did. The FRCT has also commenced a Transition Information Day during the Spring Term of the second year when parents and students can learn about the next phase of moving on and provide links with external agencies who are there as guest facilitators, including disability employment advisers, local housing officers, and the citizens advice bureau. We spent time speaking with five of the students and met with all seven of them. They told us that they were aware of the house rules before they came to stay, and had not been surprised by any aspect of living there. When the group were asked if they enjoyed living at Robert House they each smiled and nodded. One said, Yes I like it here, I dont want to leave! The home has a Guide for Students/Parents and or Guardians. We commented that it currently does not meet all of the requirements of a service user guide as aspects detailed in the Standards are missing. We were told by a senior member of staff that this is currently being reviewed. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students are supported through a variety of means to develop their ability and confidence in expressing their wishes and making supported choices, within the context of the homes environment and the Centres goals. Evidence: The AQAA informed us that each student at Robert House has an Individual Learning Plan (ILP) that is developed from their Pen Profile and Baseline Assessments. This is discussed with their Transition Guide at weekly tutorials when their Life Maps are developed. They each sign their ILP to confirm their understanding and agreement to the ILP. The weekly tutorials form part of the feedback process. Three learning plans were sampled on the day of the inspection and found to be comprehensive but not upto-date. The senior on duty was able to tell us that the plans for each student had in fact been updated in October 2008 but had not been placed in their files. The most recent for one student on file in the office was dated December 2007, another one was January 2008. The daily notes that are normally returned for typing to the main office Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: had not been collated back into the file for well over a year. The last summary in some cases was July 2007. We were told that the nominated member of staff had been on long term absence and this administrative function had fallen down as a result. A record of risk assessments and goals were located on each file. Some were personalised. Others were repeated as a common feature with more than one student e.g. crossing roads, care with gardening and recognising coins. The location of Robert House as part of the daytime educational centre and in a very isolated position in the forest is a limiter to the independence of students in making their own way out of the Centre to local facilities. Annual reviews take place involving the student, parent/guardian, Connexions personal adviser, Social services, FRCT Director and relevant third year staff. Staff comments from the inspection process indicate that more choice and freedom could be given to students in their third year to assist them to be equipped for life when they leave the Centre. More than one expressed concern that the students live in an inflexible and rigid time structure, with a week packed full of hard work with the horses that leaves little free time for their social life to the detriment of developing their life and social skills. When the students were asked about this they commented that they like being with the horses, and would not want to change it. Each of the students survey returns scored full marks for their ability to decide on what they do each day. However when this was broken down into daytime, evening and weekends, two students felt they had no choice about what to do at weekends and one felt there was no choice at all in the evenings. The other students agreed there was choice at all times. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students are supported to engage with the community and take part in activities of their choice. Their rights and responsibilities are respected, although significantly steered by the staff into a full programme of activities during their College terms. Evidence: The AQAA informed us that students are encouraged to develop their own potential by identifying their individual interests and linking them with relevant courses and appropriate activities in the community. In particular in their third year they are paired with a Transition Guide who works closely with the student to prepare them for moving on at the end of the course. We discussed this aspect with two members of staff who confirmed that this happens organisationally. They expressed some concern that the students are very focused on horse care and that the majority of their time is spent with the horses and around equine activities which is their own choice. However, we Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: were told this does not prepare them well for independent living after College when the majority will not have a great deal of contact with horses. We briefly talked with the students about this and they confirmed their love of the horses and not wishing to change any aspect of the timetable. We were told by the staff that the students work all week sometimes very early in the mornings and rostered to work with late night horses, every other Sunday and every Saturday morning which leaves little free time for the students to appreciate normal time that has not been purposefully shaped for them by someone else. We saw that the students who were not unwell with the flu came in with the shopping and were assisted by the staff to unload and plan and prepare the meal for the evening. The students told us that the meals are fine and they get plenty to eat. Those who were able to told us what their favourite meals were. We were shown the laundry facility where students are supported to undertake their own personal washing and drying. The AQAA informed us that the students have been involved in organising a coffee morning in Burley, taking part in the Burley pantomime, Hazelhurst Ride, Burley Youth forum and Shout About which was effective in persuading the local council to continue the local Cango community bus service. The FRCT has expressed their need to continually review how to expand students understanding of their rights and responsibilities, whilst balancing the needs for learning and protection, against the risks involved. Weekly house meetings are fitted into the student timetable and this assists with feedback on their developing skills of daily living and social activities. Students have used public transport to travel to work experience and attend courses at Brockenhurst College (digital photography, computer skills, street dancing). We saw that students have gained qualifications in food hygiene, first aid, British sign language as well as horse related ones. The FRCT has become a recognised centre for OCN qualifications where students can obtain accreditation in literacy, numeracy and communication. Students told us of their trips home during the term and also at term ends, and contact with their families by letter/cards and also by telephone. They were happy to speak about the centres restrictions in the use of mobile phones and expressed agreement with this. We were told that third year students have the responsibility for keeping their mobile phones safe at all times. We saw that students had keys to their own bedrooms and staff only entered after receiving permission of the student, so respecting their personal space. One staff member said Robert House provides a happy, positive environment where individual needs are met. Care Homes for Adults (18-65 years) Page 15 of 30 Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students receive supervision and support with personal care, emotional and health care needs in ways they want and that work towards promoting their independence. Self medication is encouraged for those who are able to have the responsibility. Support is provided for those who need it. Evidence: The AQAA informed us that the FRCT Health Care Team is headed up by a specialist nurse who is also a Counsellor. The team also includes another nurse and a physiotherapist. Occupational Therapy is resourced through the NHS. The team supports students to manage their own health care needs according to their ability. Each of the students require some help/prompting with personal care such as washing and dressing. They each have their own bedroom with ensuite toilet and shower facility. The key worker system and groups that regularly operate also support the students with their daily emotional needs and learning support. Lockable, wall mounted drug cupboards were seen in each of the bedrooms and a central drug cupboard was located in the admin office. At the time of the inspection it had come to light that a member of the bank staff had purchased some over the Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: counter remedy for flu that contained paracetamol. The recording of administration that had been entered in a diary was unclear about amounts of administration and intervals and had run over more than one page. The Head of care was present and used this as an opportunity to teach the students the importance of checking amounts and being sure of not exceeding defined doses. The senior member of staff agreed to purchase a drug book for recording administrations and ensure all staff had retraining in introducing non-prescribed medication. We found from the four personal files sampled that individual health support was well defined and kept in modular format but questions remained about their dating. Records of specialist reviews are kept and any medical and dental events. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A variety of means are provided for students to express themselves, and they are supported to communicate their concerns. They are protected by a multi-disciplinary team and robust procedures that ensure their health and protection. Evidence: The Aqaa informed us that the group and transition guide system followed by all the students and the multi-disciplinary staff working alongside students encourage them to communicate their fears and concerns. We were told that regular weekly house meetings are held and during the inspection observed the interaction between the staff and the students. Good humoured banter took place and much supportive encouragement. We also witnessed staff ensuring the students had fully understood the reason for the inspection and the discussion questions they were being asked. We observed that the staff members advocated for the students in some areas to do with social time and relaxation. When asked, the students expressed satisfaction with the time off they have and emphasised they like being with the horses. The only complaints they raised were to do with aspects of their rooms which is covered in the section on the environment.The students told us in the surveys that each of them knew who they could speak with if they were unhappy about anything, and six of the students knew how to make a complaint. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: The Student Guide contains a brief complaints procedure and it was pointed out to the Senior that the stages and timescales for responding to a complaint should be clarified. The college has child protection policies and procedures in place (for Adults and Children) and a named Child Protection Officer who is also Head of Health Care. We spent some time speaking with her about her role and the values of the FRCT and the protocol for safeguarding. At least two incidents of a serious nature have taken place that required outside investigation and support. One is still not yet brought to conclusion. Some incidents have occurred within the FRCT since the last inspection that have not always been notified to the Local Authority under adult protection safeguarding. It has lead to the service reviewing their safeguarding procedures and giving greater priority to communicating with the local lead agency on safeguarding. Policies on protection, prevention of abuse and whistleblowing were available. However, the policy on whistleblowing is in need of review (last reviewed in 2003). We were told that all staff are given training in recognising types of abuse and whistle blowing. Of those sampled on the day of the inspection only two of the four staff records demonstrated specific training in protection issues. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students living at Robert House benefit from being involved directly in the domestic routines and in the decisions about how the home is run. The home offers a comfortable environment close to the College but with the disadvantages caused by its location deep in the Forest. Evidence: Robert House is situated in Bransgore and is attached to the main college building at Avon Tyrell. We were told that originally it was staff accommodation. It has its own front door and students can also access the main building through a fire door on the first floor. We talked with the students in the conservatory. It also has a comfortable lounge. The kitchen is equipped with relevant facilities but we were told the oven and hob is small for the numbers involved and is dated. We were told the kitchen is due for upgrading shortly. The room used for drying items next to the laundry has hazardous pipework that has not been safely boxed in. We were invited by three of the students into their bedrooms and they said they were very pleased with their rooms. Each had been personalised with their own posters and pictures and toiletries. Three of the students drew attention to problems with their en-suite facilities; one with a shelf missing and no second glass cupboard door; another with poor odour coming from the shower drain that had been reported for some time but not resolved; another with a Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: crumbling bedroom wall and broken shower head. The senior member of staff agreed to highlight these items for urgent action. We learned from the students that the Avon Tyrell site experiences a significant number of power failures attributed to the mains connectors, that has an impact on Robert house. This has been taken up with the local supply board and we were told should shortly be resolved. The students expressed concern about this as it has disrupted their meals and evening activities. Evidence was supplied of the providers communication with the Power distributor who has confirmed the need for their reinforcement of the network in this location. The location of Robert House was highlighted by the staff as a factor in making use of public transport difficult. Furniture and fittings were good quality. The institutional shape of the building with a long corridor and rooms leading off it is hard to make into a homely environment. However, none of the students complained about this. By the early evening the main ground floor corridor was strewn with stable dirt as people came and went in their work clothes. We were assured by staff that this would be improved when the cleaners arrived later on. Survey returns from five of the students said the home was sometimes fresh and clean; two said always. The fire log book was inspected and and found to be up-to-date. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are deployed in sufficient numbers and have appropriate skills to meet the needs of the students living at Robert House. Recruitment procedures are generally robust, ensuring the safety of the current students living within the service. Evidence: We noted from the AQAA that the FRCT employs 86 staff in total and potentially 59 staff involved in care can be rostered on a shift at the home. In practice there is a core group who undertake residential shifts at the home. The students engage with all the staff during the day at the two daytime locations and over their first and second years at the College. Five of the students said that the staff always treat them well, and two said they sometimes do. Four students said the staff always listen and act on what they say, and two said they usually do, and one said they never do. We inspected four staff records and spoke privately with four of the staff, and the registered manager and director. Records are maintained of all recruitment checks, including references, ID information, supervision and police checks. We noted that the check made through the CRB is relevant for staff working with adults and recommended that this should be adjusted as the home is registered to admit those from 16 years of age. We were unable to locate adequate records of induction training, and the homes AQAA Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: was incomplete in relation to the number of staff who have completed induction training. Subsequent to the inspection we received a breakdown of training courses that named staff had attended. Achievement has been made in training staff in equine issues and general care and health and safety, including protection from abuse, safeguarding, risk assessment, first aid. We noted from the AQAA that only 9 of staff had achieved equivalent of National Vocational Qualification (NVQ) level 2 when the Standards anticipate 50 . A staff member indicated that training has greatly improved recently, with staff having more input into the training that is required. We were told they have, good support and queries are followed through. There is rarely a staff shortage. It is a happy working environment where all the students needs are met. The staff expressed very positive attitudes about working at Robert House, and upheld the values of independence and supported care. Some felt the students are on overload as they work very hard, and the less able take longer to do tasks. The desire was expressed to be able to spend more time with the students in their third year teaching and training them to engage with adult life skills, such as changing a light bulb, filling out forms, rather than the high focus on equine care. There was overall reluctance to fully endorce some of the rules imposed by the FRCT e.g in relation to tuck (and use of that term) in their rooms, and the compulsory use of title and surname when students address the staff. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, safety and welfare of students living at Robert House is promoted. The students would benefit from more committed management who could prioritise the issues needing attention at Robert House. Evidence: The day to day Manager of Robert House has been registered manager for several years and is experienced in the field of management and learning disability. She is also functioning as manager of two other residential establishments, all three separated from each other by a few miles. We were told that in addition she has developed a wider responsibility within the educational field and as a result has some time constraints in the day to day residential management. The FRCT has recognised this situation requires some resolution and a trial period of six months has been offered to another Senior Officer to assess her performance in this role. This Officer assisted throughout the inspection. However we met with the Registered manager and had some clarifying discussion with her about the purpose of the monthly monitoring visits Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: required by the legislation. We also drew attention to the lapse in record maintenance and some uncertainty surrounding the most up-to-date ILPs and staff updates. Internal audits are conducted by the FCRT and an annual review is completed that defines their goals for the following period. We were told that the students views are fed into this process but the home has not yet formally published the results of student and stakeholder surveys that are required to be a component of the Service User Guide. The AQAA provided information about the homes policies on Health and Safety and the servicing and maintenance of the homes fixed equipment. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 13 Arrangements must be made to train all staff in safeguarding and protection measures, to prevent service users being harmed or suffering abuse, or being placed at risk of harm or abuse. in order to ensure that students are not harmed or suffer abuse, or placed at risk of harm or abuse. 31/03/2009 2 24 23 the provider must attend promptly to repairs and maintenance matters detailed in this report. to ensure all parts of the home occupied by the students are in safe working order. 31/03/2009 3 32 18 The provider must ensure that all staff employed to work with students in a residential setting receive training appropriate to the work they perform. 31/03/2009 Care Homes for Adults (18-65 years) Page 28 of 30 to demonstrate that the staff team is competent to meet the students individual assessed needs. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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