Inspection on 12/10/06 for Saxonbury

This inspection was carried out on 12th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Saxonbury 30/05/07

Saxonbury 16/11/05

Saxonbury 14/06/05

Saxonbury 21/12/04

Saxonbury 08/07/04

Saxonbury 12/03/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Saxonbury Heathfield Road Freshwater Isle Of Wight PO40 9SH Lead Inspector Neil Kingman Unannounced Inspection 12 October 2006 13:15 Saxonbury DS0000012531.V311024.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 Saxonbury DS0000012531.V311024.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. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Saxonbury Address Heathfield Road Freshwater Isle Of Wight PO40 9SH 01983 755228 01983 755228 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) Islecare `97 Limited Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16 November 2005 Brief Description of the Service: Saxonbury is a residential home providing care and accommodation for up to six younger adults with Learning Disabilities, one of whom is now over sixtyfive years of age. The home is a detached two-storey property situated in a quiet residential area of Freshwater. It offers single room accommodation, one with en-suite facilities. The town centre of Freshwater with its shops and amenities is about three quarters of a mile away. There is off-road parking for several cars at the front of the building, from which there is level access into the home. An average sized garden is provided at the rear with seating available for residents’ use. Saxonbury is owned by South Wight Housing Association and leased to Islecare ‘97 the homes proprietors. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by Saxonbury and brings together accumulated evidence of activity in the home since the last key inspection on 16 November 2005. Part of the process has been to consult with people who use the service; including telephone discussions with a representative of one of the residents, and two social services care managers who visit residents in the home. Two residents completed a care homes survey with help from key workers and four comment cards were received from visitors/relatives. Included in the inspection was an unannounced site visit to the home by an inspector on 12 October 2006. During the visit the inspector toured the building, looked at a selection of records and spoke with the manager and an agency support worker. The inspector returned to the home on 16 October 2006 when there was an opportunity to speak with support workers employed by Islecare. The inspector spent some time with all residents. However, due to their cognitive impairments it was possible to take views from only two of them. The responses from the consultations were generally positive. What the service does well: While only two residents have the cognitive ability to give a view about life at Saxonbury all appear relaxed and happy. In spite of recent staff shortages the home has a core group of experienced and committed staff who interact well with all the residents. The home provides an environment that is domestic in character with a homely, friendly atmosphere. Staff have a good understanding of residents’ needs, including dietary needs, likes and dislikes. According to the manager, staff and a resident who was a able to make comment they provide meals that are greatly enjoyed by the residents. The introduction of the advocacy service to residents has been a positive step towards providing independent support for those who would benefit from it. This has led to the development of a ‘Life Plan’ for one resident. There is common agreement amongst care managers that the home works well with external professionals to ensure the complex needs of the residents continue to be met. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 6 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. Saxonbury DS0000012531.V311024.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 Saxonbury DS0000012531.V311024.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): 2 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. To ensure residents care and support needs are met, a proper assessment is undertaken before they move into the home. EVIDENCE: Pre-admission assessment This inspection provided a rare opportunity to look at the home’s admissions process, since prior to 2006 there had been no new admissions for about eight years. The newest resident moved into the home in August 2006. During the site visit the inspector looked at records relating to the admission, and had earlier spoken at length with the resident’s representative. In discussions it was apparent that the process took several months and followed two trial visits before Saxonbury was judged to be where he wanted to live, and where his needs would be best met. The manager confirmed that the prospective resident’s initial referral to Saxonbury by care management on the mainland had taken place prior to his taking up the manager’s post. However, assessments provided by the placing authority were available for inspection. They were noted to be very comprehensive, setting out in a ‘person centred’ way the prospective resident’s needs and wishes, likes and dislikes etc. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 9 While the standard relating to the pre-admission needs assessment is judged to be well met issues around the process of personal planning are covered under standard 6. Saxonbury DS0000012531.V311024.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 and 9 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While opportunities for residents to make decisions and choices in their lives are determined by assessment and recorded in individual personal plans, they lack a ‘person centred’ approach and need to reflect best practice in this area. Additionally, opportunities have been limited because of recent staff shortages. Residents are enabled to take control over their lives. Any limitations are identified in the assessment process and recorded in their personal plans. They are encouraged to be as independent as possible and to take sensible risks, which enhance their enjoyment of life. EVIDENCE: Personal plans – Each resident has an individual personal plan. The inspector viewed a sample of two plans. The intention was to look at the outcomes for residents in general by assessing the information and support, which helps them to express Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 11 their views and lead the lives that they choose. The sample included the newest admission to the home, and a long standing resident who has good verbal communication. In terms of what the home does well in respect of personal plans the long standing resident has a separate ‘Life Plan’ drawn up with the help of his advocate. The document is very person centred and covers information about such areas as: Relations Home Day services (and what he does at them) Mobility Likes and dislikes Diet preferences Interests etc. In addition there is a Health Action Plan, containing information, which is person centred. In contrast to the Life and Health Action Plans this resident’s personal plan produced by the home was seen to contain information dating back to 2001, which was neither current nor relevant to his present needs. As seen at previous inspections of Saxonbury the model used for all residents’ personal plans is an adapted ‘older persons’ model, which places an emphasis on ‘care’ rather than ‘support’. This model is especially inappropriate for the resident admitted this year, who is significantly younger than the others and, according to the manager and support workers, has no care needs. The inspector noted that information in his personal plan was not person centred, and was very much ‘care’ orientated. There is therefore a requirement for the home to review its personal planning process, to ensure that each plan takes a ‘Person Centred’ approach to the recording of information, and is appropriate to the age and needs of the individual. Decision making Information in personal plans and discussions with the manager and staff on duty provided evidence of them respecting residents’ rights to make decisions. There are varying limitations with residents’ verbal communication and in the main staff learn the various non-verbal signs, which enable them to understand the wishes of those who have communication difficulties. However, it was apparent during the site visit and in discussions with the new resident’s representative that his preferred method of communication was a Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 12 form of Makaton signing, which encourages speech by linking signs with words. Currently at Saxonbury there are no Makaton users amongst the staff group. It is strongly recommended that the home identifies staff, to undertake a course in Makaton signing. This would benefit the home by enhancing the skill base in the staff group, providing a more effective means of communicating with certain residents and meeting the changing needs of residents. Each resident has a key worker in the staff group who provides the additional personal help and support they require. Based on the residents’ decisions and preferences key workers for e.g.: Arrange horse riding. Take them shopping. Arrange hairdressing. Take them out for meals, entertainments etc. It was understood from discussions with the manager and staff that the arrangements work well when there are sufficient staff to undertake the tasks; an issue dealt with later in the report. While four of the six residents maintain links with family the Advocacy Trust has been very much involved with the home. The manager confirmed that representatives of the service visited Saxonbury over several weeks to spend time with the residents, identifying their skills and involving them with arts and crafts. One resident has an advocate who provides him with independent support. Residents do not have the cognitive ability to manage their own finances and need staff to assist them. During the site visit the inspector looked at the system in place and found it to be satisfactory. Risk taking – The inspector noted specific risk assessments on the sample of residents’ personal plans. Risks are identified, and to what degree. Guidance is given for staff on what to do to reduce the risk. A manual handling risk assessment, clearly designed for use in an older persons’ service was noted in the new resident’s file. This reinforces the need for all areas of personal plans to be reviewed. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, 15, 16 and 17 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and supported to take part in a range of activities appropriate to their age and individual likes and dislikes. However, recent staff shortages have limited their opportunities for community links, especially in the evenings and at weekends. The home has not demonstrated that residents have an option of a minimum seven-day annual holiday outside the home, which they help choose and plan. They are supported to maintain regular contact with their families. Routines in the home promote independence for the residents who have unrestricted access around the home. They are offered meals they enjoy, which are varied and healthy. EVIDENCE: Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 14 Education and occupation The manager and staff said the home explores different activities to stimulate and challenge the residents. Their assessed needs are such that seeking jobs for them is not appropriate. Education and training is limited to that which is offered through the day services they attend throughout the week. The newest resident to the home has been enrolled on an essential skills course at the college but is still undergoing the process of assessing his skills and understanding. It was understood from his key worker that horse riding is currently being explored as his chosen activity. Helping this resident to take part in valued and fulfilling activities is seen by the inspector as a priority for the home. Community links, social inclusion and relationshipsA weekly programme of activities ensures that the lives of the long-standing residents are as varied and interesting as possible, although this only applies to daytime activities. These activities include: aromatherapy. Shopping trips and several day services. It was clear from discussions with the manager and staff that recent staff shortages have all but eliminated opportunities for evening and weekend activities. The manager said that the lack of qualified drivers in the current staff team has been an additional obstacle to overcome. However, it was understood that all newly recruited staff, but not yet started, are able to drive the home’s people carrier. One resident confirmed both verbally to the inspector and in his response to the care homes survey that he would like to go out more, especially at weekends, but staff shortages prevented it. Four of the six residents maintain contact with their families. The manager supports them to visit family away from the home if required. All four responses to the relatives/visitors survey indicated staff welcome them in the home at any time, and enable them to visit the residents in private. The inspector spoke with the representative of the newest resident who confirmed that his family visits regularly and takes the resident for trips out away from the home. Leisure activities As outlined above the inspector noted limitations with the opportunities for residents to access leisure activities, e.g., staff shortages and lack of drivers. It was evident that limitations extended to residents’ option of a minimum seven-day annual holiday away from the home. At the last key inspection it was understood that due to residents’ physical, health and behaviour reasons it was not appropriate for residents to holiday away during 2005. This year they have not holidayed away, nor have they had a break locally, due, according to Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 15 the manager to staff shortages. This was highlighted in discussions with one of the care managers whose client had specifically requested a holiday on the mainland. During the site visit the inspector noted one resident engrossed in an artistic activity in the lounge. Staff confirmed that efforts are made to ensure there are materials to occupy residents while they are at home. Daily routines Bedrooms were seen to be well personalised and reflect residents’ different interests and preferences. Staff respect their privacy and were seen to knock before entering their rooms and to address the residents by their preferred names. During the site visit the inspector observed the interactions between staff and residents. Staff showed understanding, patience and respect for their privacy. Residents are free to access all areas of the home and the grounds. The inspector noted the requirement relating to the safety of a tree in the front garden had been addressed. This was especially important for one resident who likes to spend much of his time in the garden quite near to the tree. While not all residents have the cognitive ability to assist with housekeeping tasks they are encouraged to undertake minor domestic activities within he scope of their capabilities. Meals – During the site visit the inspector had an opportunity to observe the lunch being eaten by residents, the evening meal being prepared and to speak with the support worker who was preparing it. Given the size and domestic character of the home the staff take turns to cook the meals. This seems to work well and certainly, according to staff and one of the residents able to make comment, the meals are greatly appreciated. This support worker confirmed that while she regularly worked in the home she was employed by the BNA and had not undertaken food hygiene training. It is important that all staff called upon to prepare and cook high-risk foods have the necessary food hygiene training appropriate to the task. All staff spoken with considered the meals were well received by the residents. They said they knew through several years experience what they liked and needed in their diet. Menus were seen as varied and nutritious, with plenty of fresh food, including vegetables. The inspector noted that fresh fruit was available. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Staff provide flexible but consistent support for residents and are responsive to their changing needs. They encourage residents to make choices, which reflect their individual personalities. Residents’ healthcare needs are assessed and key workers enable and support them to receive healthcare checks at appropriate intervals. Medication is securely held and appropriate records maintained. EVIDENCE: Personal support – At the time of the site visit all six residents were in the home at some points during the day. Staff confirmed, and the inspector observed that they all were generally in good health. The inspector noted that they were dressed differently, as one would expect, according to their ages and preferred tastes. Daily recording on personal plans showed there is flexibility around times for getting up and going to bed and it was noted that respect for dignity was an important issue, especially for two residents who value their privacy. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 17 The home’s vehicle is a people carrier adapted to take a wheelchair. Staff (those authorised to drive it) are able to fully support residents to go out for appointments, shopping, day services and leisure activities. Healthcare – Records showed that residents’ health care needs are regularly addressed. They receive checks from the GP, dentist, optician and specialist health care professionals. All health care needs of the residents are identified in their personal plans. The manager said that all residents are registered with the local Brookside clinic where there are several GPs. Both care managers confirmed in discussions that staff had a good understanding of residents’ healthcare needs, and kept them informed of important events affecting their well-being, via the advocate in on case. Medication The inspector looked at the home’s arrangements for residents’ medication. Records showed that medication is administered by staff who have been trained and deemed competent by the manager. At the time of the site visit medication for residents was securely held in appropriate facilities, and records relating to its safekeeping and administration were found to be in good order. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home treats residents’ complaints seriously and responds appropriately. The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: Complaints The home has a formal complaints policy and procedure, which is included in the Service User’s Guide. Information about the complaints procedure entitled ‘Seeking Your Views’ is conspicuously displayed on the wall where visitors sign into the home. In a general sense residents’ cognitive impairments made it difficult to gauge their understanding of what to do if they had a concern, although one, more able than others could voice any concerns via advocacy and indicated he would speak with senior staff or the manager. This was confirmed in discussions with social services care management. Three out of four responses to the relatives/visitors survey indicated they were aware of the home’s complaints procedure. The manager agreed to forward a Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 19 copy of the home’s service user’s guide to one relative, as it may have been an oversight prior to him taking up the post of manager. The pre-inspection information about the home, which was forwarded to the Commission prior to the site visit, confirmed that there had been no complaints since the last inspection. The home has a complaints register and in discussions with the staff group it was clear that support workers know how to recognise the non-verbal signs that would point to a resident being unhappy. Adult protection The home has an adult protection policy and procedure in place, which has this year been reviewed and updated to link with the local authority guidance. Islecare has produced a one-page adult protection summary guidance as a reminder for staff on the reporting procedures. In discussions with care support workers it was clear they were confident about reporting issues of concern without delay. Since the last key inspection of the home an adult protection referral had been made to social services. Appropriate action taken by the home has demonstrated that this standard is being met. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s premises are suitable for its stated purpose. They are comfortable, safe and well maintained. On the day of the site visit the home was clean, hygienic and free from unpleasant odours. EVIDENCE: Premises Saxonbury is a home similar to and in keeping with others in the community. In general terms it is suitable for its stated purpose, in that, it is accessible, as all residents occupying first floor rooms are mobile; safe and well maintained. Bathing and toilet facilities are suitable for the needs of the residents. All bedrooms are for single occupancy; two being located on the first floor and four, one with an en-suite facility, on the ground floor. The home has a goodsized lounge and separate dining room with adequate seating. The kitchen is quite large and well equipped. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 21 The premises generally are bright, airy and comfortable. All residents were happy to show the inspector their rooms, which looked to reflect their personalities. There is level access from the dining room to an enclosed garden at the rear, which is mainly laid to lawn and includes seating for use by the residents. The building is owned by South Wight Housing Association who, according to the manager have recently carried out a survey to identify maintenance issues, which will be addressed over the coming months. Cleanliness The inspector toured the building with the manager and noted all areas to be clean, tidy and free from unpleasant odours. Support workers undertake the domestic tasks; an arrangement that seems to work well in what is essentially a domestic style setting. There is a separate utility room where the laundry is carried out, away from food preparation and eating areas. The home’s pre-inspection information confirmed that policies and procedures were in place for the control of infection and safe handling of any clinical waste. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has an experienced and effective staff team with sufficient numbers to support residents’ needs, some, but not all of the time. Staff have the necessary skills and experience to meet the needs of the people who live there, with 60 qualified at NVQ level 2 or above. The home needs to ensure that records kept in the home contain sufficient information to demonstrate that the recruitment procedure is robust. EVIDENCE: Staffing levels At the time of the inspection the home employed five support workers. During the afternoon of the inspector’s first visit the staff team comprised the manager and a bank support worker. Staff rosters showed that staffing is maintained at minimum levels, supported by bank staff and sufficient to ensure residents’ safety, but having no flexibility to be responsive to their social needs. Overnight there is a support worker sleeping in, and one waking, employed to meet the specific needs of an individual resident. The manager Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 23 confirmed that due to recent staff shortages it had been difficult to meet minimum levels. However, three new support workers had been recruited, and were awaiting the results of security checks before commencing work in the home. Both the care managers spoken with felt there were always sufficient numbers of staff on duty at the times they visited the home. Staff recruitment It was clear from records that several support workers had left the service since it was last inspected. The manager confirmed that apart from those recently interviewed but not yet started only one new support worker had been recruited in that time. The inspector looked at the records relating to this individual. While the majority of recruitment records were found to be in order there was no record of when the Protection of Vulnerable Adults (POVA) clearance had been obtained. Therefore, it was not possible to confirm from the records that clearance had been obtained before the support worker commenced work in the home. Staff training, development and competencies The inspector looked at the staff training plan for 2006, which gives details of training completed and scheduled. The manager and staff confirmed the content of the training programme, which includes all statutory subjects. Islecare provides a good in-house training package for staff, which also includes other service related subjects, e.g., autism, epilepsy and sexuality. However, as described under standard 7 of the report there is a strong recommendation that identified staff have access to Makaton signing as an additional means of communication. The support workers spoken with had worked in the home for several years and were experienced and valued members of staff. They were very clear that refresher training was ongoing. The manager said that staff had completed some elements of the Learning Disabilities Award Framework (LDAF) training but had not completed the full package. The pre-inspection information showed and the manager confirmed that currently 60 of the staff group have achieved the NVQ at level 2 or above. However, it has to be said that currently there are only five support workers in the group. Both care managers spoken with were very complimentary about the skills of the staff, especially their ability to meet residents’ needs. Saxonbury DS0000012531.V311024.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, 39 and 42 - 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 by a fully qualified manager, who has been in post for about ten months and is currently undertaking the process for registration. The home has developed effective quality assurance systems for measuring its performance based on seeking the views of residents, representatives and stakeholders. The home’s policies, procedures and staff training generally ensure as far as is reasonably practicable, the health and safety of the residents and staff. However, in order to fully meet the standard all staff involved in the preparation of foods must have the appropriate food hygiene training. EVIDENCE: Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 25 Management – The manager has over twenty years experience of working in the care sector, six of which have been with people with learning disabilities. He was appointed to the post at Saxonbury in December last year and is undergoing the process towards registration. As regards qualifications he has achieved the NVQ at level 4, and also the Registered Managers Award (RMA). Staff spoken with regarded the home as being well run. They confirmed that the manager was approachable and supportive, and even with the staff shortages staff morale was generally good and the moment. Quality assurance The home is relatively small and domestic in scale. In discussions with the manager he outlined the steps taken to monitor the quality of service at Saxonbury and produced some documentary evidence: • • • • • • • • • Key worker system Quality assurance feedback from residents/representatives. New quality assurance methodology (just introduced). Annual service audits by a representative of the Company. Annual care/support reviews involving residents, families, advocates and social services. Regular contact with families/representatives. Staff meetings and supervisions. Monthly statutory visits to monitor the conduct of the home. Investors in People Award. The responses from residents in the care homes survey were quite positive, the only negative issue being staff shortages. The views of visiting relatives and care managers were generally positive. Health and safety All support staff undertake statutory training, which includes health and safety awareness, manual handling, fire training, appointed persons and infection control. While staff employed by Islcare receive training in food hygiene it is important where agency staff come in to prepare food that they also have completed the training. The home’s pre-inspection information confirmed that policies and procedures were in place to ensure safe working practices in the home. Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 26 A sample of records was viewed, including fire logs, accidents, risk assessments, gas and electricity inspections, and public liability insurance, all of which were found to be in order. Saxonbury DS0000012531.V311024.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 x 2 3 3 x 4 x 5 x 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 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 2 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 2 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 2 x Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No 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 YA6 Regulation 15 Requirement Timescale for action 31/12/06 2. YA34 19 Sch 2 To review the personal planning process, to ensure that each plan is appropriate to the age and needs of the individual. Records kept in the home must 17/11/06 contain sufficient information to demonstrate that the staff recruitment procedure is robust. To ensure that all staff involved in the preparation of foods have the appropriated food hygiene training. 31/12/06 3. YA42 13 Saxonbury DS0000012531.V311024.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 YA7 YA35 Good Practice Recommendations To access a course in Makaton signing for identified staff. Benefits: • Enhances the skill base in the staff group. • More effective communication with resident(s). • Meets the changing needs of residents. To ensure that residents have the option of a seven-day annual holiday away from the home. 2 YA14 Saxonbury DS0000012531.V311024.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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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