Inspection on 29/05/08 for Rookery Radstock Satellite

This inspection was carried out on 29th May 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Rookery Radstock Satellite 42 Redfield Road Midsomer Norton Bath BA3 2JP Lead Inspector David Smith Announced Key Inspection 29th May and 2nd June 2008 10:00 DS0000071151.V364565.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 DS0000071151.V364565.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. DS0000071151.V364565.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rookery Radstock Satellite Address 42 Redfield Road Midsomer Norton Bath BA3 2JP 01761 438610 01761 438611 doreenpaisley@priorygroup.com www.prioryeducation.com Priory Education Services Ltd Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Doreen Diana Paisley Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000071151.V364565.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 4. Date of last inspection N/A Brief Description of the Service: The Rookery Radstock Satellite is operated by Priory Education Services Ltd, which is part of the Priory Group. The home is situated in the town of Midsomer Norton, approximately eight miles from Bath City Centre and the town of Frome. This home provides a specialist service for adults aged between 18 and 30 who are on the Autistic Spectrum. Each person who lives in the home will have already achieved a degree of skill reflecting their ability to live semi-supported in the community. A move to this service will be part of a planned programme of support to more independent living arrangements. The home is a large detached property, with a garden and car parking spaces to the rear. There are four bedrooms, one on the ground floor and three on the first floor. None of the bedrooms are en-suite, although there are two large bathrooms which are shared between the four people living in the home. It is within walking distance of the town centre and has easy access to bus routes. The home is supported locally by ‘The Rookery’ in Radstock, which is the main Priory service in this area. This home is approximately two miles away form The Rookery Radstock Satellite and it is important to understand the close relationship between these two services and the support The Rookery provides to this new Satellite service. The current fee level ranges from £98,236 to £104,123 pa, depending on the support needs of each young adult. DS0000071151.V364565.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an announced visit to the home as part of the first Key Inspection of this service, since it opened in January 2008. However, we gave the home less than twenty-four hours notice of our intention to visit. We gathered information through discussions with young adults who live in the home, the Senior Support Worker and other support staff. Interaction and communication between staff and young adults was also observed during the course of our visit. Care plans and associated records were examined together with Risk Assessments, accident and incident reports, medication administration, records relating to house meetings, staff meetings and health and safety records. We also viewed all communal areas of the home and one individual who lives in the home showed us their own room. The home was provided with their Annual Quality Assurance Assessment (known as AQAA, pronounced as ‘aqua’) prior to our visit. The AQAA was completed and returned to us on 29/05/08. This inspection was completed with a meeting with the Registered Manager and examining staff personnel records at The Rookery in Radstock on 02/06/08, where these records are currently stored. What the service does well: The young adults spoken with said they chose to move into this home and have been well supported by staff to achieve their goals. The staff team have a firm commitment to support each individual to benefit from the services and support available to them to enable them to move to more independent living arrangements. The records in respect of care planning and reviews for the young adults are detailed and well maintained. This ensures a safe and accountable service for each person who lives in the home. The ethos of the service is very clearly defined and remains focused on positive outcomes for each individual who lives in the home. DS0000071151.V364565.R01.S.doc Version 5.2 Page 6 Professional expertise is sought when necessary in order to ensure a specialist approach of support is promoted for each individual. The home offers attractive accommodation. This provides individuals with a homely environment, which is well maintained. What has improved since the last inspection? 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. DS0000071151.V364565.R01.S.doc Version 5.2 Page 7 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 DS0000071151.V364565.R01.S.doc Version 5.2 Page 8 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 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a thorough and tailored process of information sharing, assessment and visiting which enables each individual and their family to make an informed decision about where to live. EVIDENCE: The home has both a comprehensive Statement of Purpose and Referrals and Admissions Policy. These provide clear information regarding the range of services and support the home is able to offer. These documents also clearly describe the expectations placed upon individuals who wish to move into the home, especially their desire to progress to more independent living arrangements. Each individual is expected to have already demonstrated a degree of skill reflecting their ability to live semi-supported in the community. A move to this service will be part of a planned programme of support to enable individuals to move on to less supported environments or to live independently in the community. DS0000071151.V364565.R01.S.doc Version 5.2 Page 9 Each person who currently lives in the home has moved here from The Rookery in Radstock. The young adults spoken with said they were asked if they wished to move into this home and had the opportunity to visit before they made their decision. Each individual said they were happy, they had chosen to move into this home and liked living here. Each person also had a ‘Transitions Meeting’ prior to their move. The records of these meetings show that various issues were discussed such as the ethos of this new service, the ‘house rules’, health and safety procedures, finances and budgeting, planning for the day of their move and who was to support each person’s move into the home. The care records for each individual show that comprehensive assessments are carried out by professionals on behalf of the home, which included psychiatry, educational therapy, occupational therapy and speech and language therapy. Care plans also contain extensive historical records, including the Funding Authority Community Care Assessments and various independent reports. The home’s assessment process is generally carried out over a three-day period, although this can be longer if this is necessary. DS0000071151.V364565.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. The home ensures that the service provided to each individual takes into account their personal preferences, supported by both written information in care plans and risk assessments which are subject to regular review. Individuals are consulted on, and participate in, all aspects of life in the home and know that information about them is handled appropriately and their confidences are kept. EVIDENCE: We examined the care plans for each of the young adults living at the home. These records are stored in the ‘Working File’ and include detailed care planning documents, which describe the support each person requires. Each care plan has been regularly reviewed. Reviews are attended by each individual, their family members, staff and a representative from the Funding DS0000071151.V364565.R01.S.doc Version 5.2 Page 11 Authority. Each review meeting is clearly recorded and the outcomes acted upon and used to update or change care plans. These records are supplemented with daily records for each individual, which give an overview of each day. Individuals continue to attend either University or college courses as well as cooking, cleaning and socialising within the home. Each young adult continues to be supported to make informed choices. Staff work closely with each individual to ensure they are aware of the choices available to them. During our visit the young adults clearly decided how they intended to spend their day, with one individual attending their university course after speaking with us and another doing some food shopping in the town following a visit from their father. Due to the nature of the service, each person is encouraged to participate in all aspects of life in the home. For example there is a cleaning rota for each person, they are expected to keep their own rooms clean and tidy and to do their own laundry. There are regular house meetings, which each young adult is encouraged to attend. They are able to discuss any issue in relation to the service and the records show that each person who lives in the home does generally attend each meeting and contributes to the discussions. Each individual has a number of Risk Assessments to ensure they are supported to take risks as part of their lifestyle. There is an index of risk assessments in each person’s care plan, which includes the date by which each assessment should be reviewed. Each person’s care records are stored securely within the home. Each care plan describes who can have access to the personal information contained within it. The manager and individual sign this agreement. This is good practice. DS0000071151.V364565.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 good. This judgement has been made using available evidence including a visit to this service. Each individual has opportunities and appropriate support to develop, access leisure and educational facilities both locally and in the wider community and to maintain relationships with their family and friends. Each person’s rights and responsibilities are recognised in their daily lives. A healthy and balanced diet for each individual is promoted. EVIDENCE: Each person who lives in the home is engaged in a variety of educational and leisure activities. The staff team are committed to ensuring that each individual benefits from the services and support available to them, to enable them to achieve their goal of moving towards independent living. DS0000071151.V364565.R01.S.doc Version 5.2 Page 13 The daily plans and records for individuals show that they go to the local shops, go to the pub, the cinema and use public transport. Individuals do not require staff support to access the community and therefore go out alone or occasionally as a group, as they did recently to celebrate one young adult’s birthday at a local pub. Staff spoken with confirmed they continue to support each person to make informed choices in relation to their educational courses or how to make use of their leisure time. The home is supported by an Education Co-ordinator and Skills for Life Coordinator. One is primarily responsible for coordinating and planning external courses, whilst the other oversees the opportunities within the home. These members of staff work closely with each young adult, their families and keyworkers and provide feedback to the clinical team at the monthly meetings of each person’s progress. Three people who live in the home are currently nearing completion of their University or College courses. One individual will then have completed a three year Arts Degree and two individuals their National Diploma in Games Development. The future plans for these individuals have already been discussed during their most recent reviews and they will be leaving the home during the summer months. One individual is preparing for a move into their own home (under ‘Supported Living’ arrangements) and the other two young adults are preparing to study at Universities nearer their family homes. The individuals we spoke with are pleased with the level of support they receive from the staff team. One person said they would not have been able to successfully complete their course without the help and guidance they have had from staff. Each young adult is supported to develop and maintain personal relationships, both within and outside of the home. Regular contact is maintained with friends and family through a variety of methods such as telephone, e-mail, letters, cards and text messages. Visitors to the home are welcomed and one individual’s father was visiting when this inspection visit commenced. Individual’s rights and responsibilities are made clear and confirmed in writing. The ‘house rules’ and the ethos of the service have also been discussed with each person in detail during their ‘Transition Meeting’ described earlier in this report. Each young adult is provided with their own weekly food budget. They are then encouraged to plan and cook their own meals. Discussions with the individuals DS0000071151.V364565.R01.S.doc Version 5.2 Page 14 who live in the home and staff members show this is working well, with the young adults eating a variety of food and often eating as a group. There are two dining areas, one in the kitchen and one in the lounge. The people who live in the home said they generally prefer to eat in the dining area within the kitchen. DS0000071151.V364565.R01.S.doc Version 5.2 Page 15 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. Individuals are supported in their preferred manner and their personal and healthcare support needs are well met. The policy relating to administration of medication ensures each person’s welfare and safety. EVIDENCE: Each person’s care plan describes support or guidance they may need in relation to personal hygiene or personal care. These care plans are regularly reviewed, as described earlier in this report. Each individual is registered with a local G.P. practice, dentist and opticians. There are annual ‘OK Health Checks’ completed for each person, which is a thorough check on all aspects of their health care needs. Daily records show that members of the staff team provide support in making appointments as appropriate. DS0000071151.V364565.R01.S.doc Version 5.2 Page 16 The young adults who live in the home are provided with support from a wide range of professionals either employed by or contracted to Priory in line with their individual needs and which forms part of their overall individual care programme. This support includes, speech and language therapy, occupational therapy, and neuro-logistic programming (NLP). A Consultant Psychiatrist and a Specialist in Aspergers Syndrome and Autistic Spectrum Disorder are contracted by Priory to provide support to the home and each of the young adults. These professionals attend therapy meetings where each young adult’s progress is discussed and any concerns or changes in needs are acted upon. Contact with each health care professional is clearly recorded and forms part of each persons’ care plan. The home uses the Lloyds Pharmacy monitored dosage system of medication administration and this is well managed. A Senior Support Worker oversees medication administration within the home. Each individual keeps their own supply of medication in a safe in their bedroom and there are Risk Assessments in place to support this practice. At present, staff dispense each person’s medication, although there are plans to support individuals to self medicate as part of their transition to more independent living arrangements. The medication records examined were complete, with no gaps. Staff members have signed the records appropriately. Staff members are provided with ‘Safe Handling of Medicines’ training as part of Priory’s’ ‘Foundations For Growth’ training programme. In addition to this staff explained that accredited training is to be provided by Norton Radstock College and this course will commence shortly. DS0000071151.V364565.R01.S.doc Version 5.2 Page 17 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 is good. This judgement has been made using available evidence including a visit to this service. Individuals are supported to communicate their views and they can be confident that they will be listened to and their views acted on if necessary. Clear policies and procedures are in place in order to protect individuals from the likelihood of abuse, neglect and self-harm. EVIDENCE: The home has a formal Complaints Policy, an Adult Protection Policy and a Whistle Blowing Policy, which staff can use in confidence to raise any issue or concern they have regarding the service. Families and other people involved with the home are also provided with a copy of the home’s complaints procedure. There have been no complaints or concerns raised since the home opened. However, at present the home does not have their own complaints log, should such an event occur, as all records relating to concerns and complaints are currently stored at The Rookery in Radstock. We would advise that the home must develop its own recording system for concerns and complaints and ensures that this is made available at future inspection visits. The home may also wish to consider keeping a record of any compliments as part of this process. DS0000071151.V364565.R01.S.doc Version 5.2 Page 18 The home has clear guidelines and Risk Assessments for supporting service users who are distressed or presenting behaviours which may be perceived as challenging the service provided. There are behavioural strategies in place, known as ‘Reactive Plans’, which form part of each young adult’s care plan. Their purpose is to protect individuals from abuse, neglect or self-harm. They are well written within the principles of ‘Team Teach’, the behavioural approach used within the home (which is accredited by the British Institute Of Learning Disabilities). The behaviour plans examined describe known behaviours, triggers and explain how staff should respond to these. If any physical interventions form part of a behaviour plan, there is a clear description of the interventions which staff may use and when to consider using them. The home has a policy relating to Physical Intervention and Restraint and the Department of Health Guidance on Restrictive Physical Interventions is also used in the home to guide care planning, risk assessing and staff practice. Staff are provided with formal training in responding to challenging behaviour using the ‘Team Teach’ system. They are also provided with Protection of Vulnerable Adults training and are subject to Enhanced Criminal Record Bureau Disclosures (generally known as ‘CRBs’) prior to starting work in the home. The home maintains thorough records of each accident, incident or other significant event which occurs in the home. We are always notified of significant events together with any other concerns regarding individuals who live in the organisation’s other home and are confident we would be advised of any such event at this home. DS0000071151.V364565.R01.S.doc Version 5.2 Page 19 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, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Rookery Radstock Satellite provides a homely, comfortable and safe environment for young adults to live in. EVIDENCE: The Rookery Radstock Satellite is a large detached house, which blends in well with the local community. It faces the main road and has a large rear garden which contains a car parking area and a large garage outbuilding. The accommodation is arranged over three floors. On the ground floor there is the entrance, hallway, one individual’s bedroom, kitchen (with dining space), utility area, toilet, spacious lounge and additional dining area. On the first floor there are three bedrooms and two bathrooms, which the individuals share. On the top floor of the home is the room used for staff who sleep-in, which is also used as office space. DS0000071151.V364565.R01.S.doc Version 5.2 Page 20 We did view all of the communal areas of the home and one individual showed us their own room. All areas of the home were clean and tidy when we visited. Each person who lives in the home is included on the rota to make sure the home is cleaned regularly. Each individual is also responsible in keeping their own room tidy and laundering their own clothes. The home is tastefully decorated, with all of the fixtures and fittings of a good quality. Each person is encouraged to bring personal items, pictures and photographs to help personalise their own room. Discussions with people who live in the home confirm that they are enjoying living in their new home. They feel in general they have the items they need, however they would like either a larger fridge and freezer, or an addition to the one they have, as this would help with adequate space to store their food. DS0000071151.V364565.R01.S.doc Version 5.2 Page 21 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): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person that lives in the home is supported by a cohesive and effective staff team that is committed to providing a good service. The home’s recruitment policy promotes both young adults’ rights and their safety. The clarity of staff roles and responsibilities along with staff training and supervision helps to provide a consistent approach to the support of staff and individuals. EVIDENCE: A small, cohesive staff team supports individuals who live in the home. Staff generally work alone, although time is allocated for a thorough handover from one staff member to another. The home has developed a ‘Lone Working’ policy and Risk Assessment to promote the welfare and safety of staff who work in the home and the DS0000071151.V364565.R01.S.doc Version 5.2 Page 22 individuals who live here. There are clear procedures for staff to follow should there be an emergency or if they require additional support. Staff spoken with said they enjoy working with the individuals who live in the home and feel well supported in their roles. The staff team demonstrate a strong commitment to providing a good level of support to the young adults, which is evidenced by the progress they continue to make. Staff were observed interacting extremely well with people who live in the home and those spoken with demonstrated a good understanding of the support needs of each individual. The individuals we spoke with said they are well supported by staff and feel the staff team do help them to achieve their goals. The home has a robust recruitment policy. The personnel files examined contained a photograph of each staff member, documents confirming their identity and eligibility to work in the UK, copies of application forms, interview questions and answers, health assessments, contracts of employment, at least two satisfactory references and enhanced Criminal Record Bureau Disclosures. The staff team meet regularly and clear records of each meeting are kept. These show that a variety of topics are discussed and that attendance at these meetings is generally good. The home provides a number of training opportunities for staff. The ‘Foundations for Growth’ programme is accessed and completed ‘on line’ by all staff. This has a number of units including fire safety, food hygiene, infection control, equal opportunities, ethnicity and user involvement. The home also accesses external courses to provide staff with additional knowledge and skills. Clear records are kept on each staff members training record of their progress in completing each of the training modules within the ‘Foundations for Growth’ programme, together with details of any external training courses they have attended. The home has made significant progress in supporting staff to gain a National Vocational Qualification (known as an ‘NVQ’). The information provided on the home’s AQAA confirms that over 50 of the staff team has now attained an NVQ. Each staff member has a ‘Management and Support Development Contract’, which describes clearly the scope, purpose and frequency of supervision meetings. A form developed by the home is used to record each supervision meeting. DS0000071151.V364565.R01.S.doc Version 5.2 Page 23 The supervision records examined show that in general staff are being supervised in accordance with their support contract. However, some staff are not and do have some significant gaps between supervision meetings and this must be improved. DS0000071151.V364565.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and individuals benefit from the ethos, leadership and management approach of the home. Young adults’ views are central to the review and development of the service. Each person’s rights and best interests are promoted by the home’s policies, procedures and record keeping. Each person is generally provided with competent and accountable management of the service and their health, safety and welfare is promoted and protected. DS0000071151.V364565.R01.S.doc Version 5.2 Page 25 EVIDENCE: The Registered Manager, Mrs.Paisley, has been employed by Priory for approximately three years and has managed The Rookery in Radstock for two and a half years. She is a Registered Learning Disability Nurse, has attained an Advanced Certificate in Special Education (Autism), NVQ Level 4 and is also a qualified NVQ Assessor. She undertakes periodic training to maintain her knowledge and update her skills and level of competence. She remains based at The Rookery (Radstock) but visits this Satellite home three to four times per week. One Senior Support Worker assumes management responsibility for this home on a day-to-day basis, and this approach appears to be working well. The management approach is open and positive, with a clear sense of direction and leadership. Staff spoken with said their views are listened to, and that they are well supported by the management structure. Additional support and advice is always available from the main service if this is required. Communication between the two homes is good. The management team, who oversee both homes, meet each week. This meeting is used to discuss management issues, progress of young adults and the progress in addressing any issues within the services. There are also monthly meetings, which the clinical team and the home’s management team attend. These are used to discuss the progress of each young adult and these remain an important element in ensuring individuals are ready to move from the home and assessing their current support needs should they be moving to a supported living environment. The views of the people who live in the home are sought together with the views of families and others who are involved with the home. The house meetings, described earlier in this report, remain a key part of this process. The organisation also conducts regular ‘Quality Reviews’, with each young adult being asked to complete a satisfaction survey as part of this process. There are efficient management systems and structures in place to ensure the home runs effectively. The quality of record keeping in the home is generally good, with all records required during our visit easy to access and stored securely when not in use. The home has a number of policies and procedures, which are designed to ensure it complies with the law and remains aware of good practice guidelines. Full details of each policy were provided by the Manager as part of the AQAA she completed for us as part of this Key Inspection process. DS0000071151.V364565.R01.S.doc Version 5.2 Page 26 There are recording systems in place to support Health and Safety within the home, which are generally being used consistently. Fridge and freezer temperatures are recorded each day and the home has external contractors who have surveyed the home and developed a Risk Assessment for the control of Legionnaires Disease. The safety of the home’s electrical circuits, gas appliances, heating system and portable electrical appliances were all tested in January 2008. The home also has health and safety meetings regularly to discuss issues within the home and to develop and review an action plan to ensure health and safety remains a high priority. We examined the fire log, which shows that tests on the alarm system are carried out each week and each person who lives in the home, and staff members, take part in regular fire drills. The home’s Fire Risk Assessment was not available for inspection in the home, although we did see this document when we visited the home prior to completing the registration process. We did view a copy of this document at The Rookery in Radstock on the second day of this inspection, however this must be kept in this home and be made available for inspection. Priory ensures the home is audited, and a representative of the organisation conducts monthly visits. During these visits individuals who live in the home are spoken with and a number of records are inspected. The reports of these visits at present cover both this home and the main service, The Rookery in Radstock and copies are not currently kept in this home. We did view the reports completed since this home opened on the second day of the inspection at The Rookery in Radstock, where these records are currently kept. Whilst these reports are detailed, they must be made clearer to reflect which part of the audit refers to this satellite service and which refers to The Rookery and a copy must then be kept in this home. The Risk Assessments to support safe working practices in the home are currently limited. As this home has only recently opened, the management team should continue to improve the risk assessment framework as the service develops or when new or additional risks are identified. This would promote the welfare and safety of both young adults and the staff team. DS0000071151.V364565.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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 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 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 2 2 DS0000071151.V364565.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? N/A 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 YA22 Regulation 22(8) Requirement To ensure a safe and accountable service is provided to each person who lives in the home, a formal record of concerns and complaints must be implemented and kept within the home. To ensure all staff are supported to provide a safe and responsive service to the young adults, they must be provided with regular formal supervision. The home must ensure the health, safety and welfare of each person who lives in the home. (This relates to the current Fire Risk Assessment being kept in the home.) 4. YA43 26(4)(5) To ensure a safe and accountable service is provided to each person who lives in the home, the records of auditing visits must be made clearer and kept within the home. 02/08/08 Timescale for action 02/08/08 2. YA36 18(2) 02/06/08 3. YA42 13(4) 02/06/08 DS0000071151.V364565.R01.S.doc Version 5.2 Page 29 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 YA20 Good Practice Recommendations The home should ensure all staff complete formal medication administration training. This would support the planned developments in medication administration for each person who lives in the home. The home should consider developing a record of any compliments, to help evidence positive outcomes for the young adults who live in the home. The home should consider providing additional fridge and freezer space to ensure individuals have sufficient space to store their own food. The home should continue to improve the risk assessment framework as the service develops or when new or additional risks are identified. This would promote the welfare and safety of both young adults and the staff team. 2. YA22 3. YA24 4. YA42 DS0000071151.V364565.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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