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Inspection on 10/03/07 for SCIC - 26 Glebe Road

Also see our care home review for SCIC - 26 Glebe Road for more information

This inspection was carried out on 10th March 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The people living in this home are being supported by a fully committed staff team to lead purposeful and fulfilling lives as independently as possible. They are able to make their own decisions about what they want to do and to take risks in their daily lives. The atmosphere in the home was very relaxed and service users were involved in everyday activities including ironing, preparing a meal, cleaning, going to post a letter and planning shopping activities later on in the day, when they would have 1:1 staff support to do this.Service users talked about the activities they were doing and said they enjoyed being involved. They talked about how they share responsibilities in the home, who likes to cook and who likes to do the "hoovering". They said, "it is good here, we can do what we want and staff help us keep safe" and "I have my own money and I pay for my taxi. "When we go to Get Away Club each Friday we have a beer". Service user`s rights and responsibilities are promoted properly in the care planning process and they are involved in the decisions being made about their future, their safety and their health-care. The service aims to ensure that service users have a good understanding of decisions being made about them and information about life in the home and as part of this all care plans, care records, policies and procedures are available to service users in symbol and large print format. People living in the home are encouraged to see it as their own. It is a very well maintained, attractive home and has very good access to the community facilities and services.

What has improved since the last inspection?

Work has been completed on the new care plan format and all care plans have been up dated it into this new style. An action plan has been put in place by the manager to address concerns raised by service users during the 2006 annual consultation process. Service user`s money is being managed safely for them and this includes an annual audit of their financial documents. In the event of any staff member wishing to report any suspicion of harm or abuse they have sufficient information about how to do this and how to contact the relevant people, and this includes contact details for the manager of the service. Staff said that they have time to complete their administration tasks and this is evident from the excellent records looked at during the visit, which were up-todate, and in good order. Health and safety continues to be managed well and this includes assessment of hot water temperatures at hot water outlets to ensure temperatures are safe for service users. A copy of all accident and incidents that occur are kept in the home.

What the care home could do better:

Although medicine management is generally good the registered manager must ensure that up to date records are maintained of all medicines held in the home and written protocols are obtained for all treatments to be given `as needed` . The work must continue with service users in identifying the needs and wishes in the event of their death.

CARE HOME ADULTS 18-65 SCIC - Glebe Road, 26 26 Glebe Road Stratford On Avon Warwickshire CV37 9JU Lead Inspector Sheila Briddick Key Unannounced Inspection 10th March 2007 09:30 SCIC - Glebe Road, 26 DS0000004468.V324474.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 SCIC - Glebe Road, 26 DS0000004468.V324474.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. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service SCIC - Glebe Road, 26 Address 26 Glebe Road Stratford On Avon Warwickshire CV37 9JU 01789 298709 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) Stratford & District Mencap Mrs Alexandra Louise Arnold Care Home 4 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (1) of places SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. NVQ level 4 The Registered Manager achieve qualifications in both management and care including the Registered Managers Award, by 2005. Learning Difficulty Award The Registered Manager pursues a professional qualification in the field of learning difficulty by undertaking the Learning Difficulty Award Framework level 3 by 2004. Successful completion of above awards The Registered Manager to notify the National Care Standards Commission upon successful completion of the above and immediately in the event that the Registered Manager fails to achieve it or that the Registered Manager ceases, for whatever reason, to undertake the stated training. Age Range of Residents People admitted to the home must be in the age range of 18 to 64 years. 7th December 2005 3. 4. Date of last inspection Brief Description of the Service: Glebe Road is a semi-detached house, which offers long-term accommodation for four adults who have learning disabilities. The current service users are men. The property is rented from a housing association, with staff being provided by Stratford and District Mencap. It is not distinguishable as a care home from the other properties in the road. Car parking is limited. There are gardens to the front and rear of the property. Neighbours have right of way across the back garden, which it was advised does not impact on the service users safety. On the ground floor there is a lounge, kitchen and separate dining room, shower room/toilet, sleeping-in room/office. On the first floor there are four single bedrooms and a bathroom. The house is on the outskirts of Stratford, which is accessible by a regular bus service. The current scale of charging is £598.17. Additional costs that have to be met by service users includes toiletries, chiropodists, outings, holidays, club activities and magazines. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for service users and their views of the service provided. This process considers the care home’s capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Prior to the inspection visit the manager had forwarded to the Commission a pre-inspection questionnaire, a staffing rota, training records and menu records for the home. Service user and relative questionnaires were sent out however none were returned. All pre-requested documentation returned was examined as part of the inspection process and the evaluation included in this report. The inspection visit was unannounced and took place on Saturday, March 10, 2007 at 09.30 am and ended at 1.45pm. The inspection involved: • • • Discussions with three service users and three carers on duty at the time. Observation of working practices and of the interaction between service users and staff. One service user was identified for close examination by reading their, care plan, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for service users. A tour of the environment was undertaken, and home records were sampled, including staff training, health and safety, rotas, quality assurance records and fire records. • I would like to thank service users and staff for their hospitality and cooperation during the inspection visit. What the service does well: The people living in this home are being supported by a fully committed staff team to lead purposeful and fulfilling lives as independently as possible. They are able to make their own decisions about what they want to do and to take risks in their daily lives. The atmosphere in the home was very relaxed and service users were involved in everyday activities including ironing, preparing a meal, cleaning, going to post a letter and planning shopping activities later on in the day, when they would have 1:1 staff support to do this. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 6 Service users talked about the activities they were doing and said they enjoyed being involved. They talked about how they share responsibilities in the home, who likes to cook and who likes to do the hoovering. They said, it is good here, we can do what we want and staff help us keep safe and “I have my own money and I pay for my taxi. “When we go to Get Away Club each Friday we have a beer”. Service user’s rights and responsibilities are promoted properly in the care planning process and they are involved in the decisions being made about their future, their safety and their health-care. The service aims to ensure that service users have a good understanding of decisions being made about them and information about life in the home and as part of this all care plans, care records, policies and procedures are available to service users in symbol and large print format. People living in the home are encouraged to see it as their own. It is a very well maintained, attractive home and has very good access to the community facilities and services. What has improved since the last inspection? Work has been completed on the new care plan format and all care plans have been up dated it into this new style. An action plan has been put in place by the manager to address concerns raised by service users during the 2006 annual consultation process. Service user’s money is being managed safely for them and this includes an annual audit of their financial documents. In the event of any staff member wishing to report any suspicion of harm or abuse they have sufficient information about how to do this and how to contact the relevant people, and this includes contact details for the manager of the service. Staff said that they have time to complete their administration tasks and this is evident from the excellent records looked at during the visit, which were up-todate, and in good order. Health and safety continues to be managed well and this includes assessment of hot water temperatures at hot water outlets to ensure temperatures are safe for service users. A copy of all accident and incidents that occur are kept in the home. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 7 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. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Information about life in the home is available to prospective service users in symbol and large print format, which would enable them to make a decision about living in the home. Service users can be sure that they will have an up-to-date written contract in a style that enables them to understand their rights and responsibilities when living there. EVIDENCE: There have been no new people admitted to the home for some time and therefore outcomes for any new person coming to live in the home could not be assessed. There is currently one vacancy at the home and in the event of a prospective service user wishing to come and live there they would have sufficient information in the statement of purpose and service user guide to enable them to make a choice about living there. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 10 The Statement of Purpose and Service User Guide are in symbol and large print format which would further support a perspective service users understanding of the services in the home. The service user whose care was being looked at had an up-to-date contract on their care plan file, which had been signed by them. The information on the contract was in symbol and large print format, which was appropriate to the service user’s communication, needs and would support the understanding of their contractual agreement with the service. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people living in this home are involved in decisions about their lives and are playing an active role in planning their care and the support they receive to meet identified needs. EVIDENCE: The care plan for the service user whose care was being case tracked was looked at with their permission. The care plan was in the newly introduced style entitled, This is My Service Plan, which has a summary at the front of the care plan in large print and symbol format to assist the service user’s understanding of the content of the document. The service user’s assessed needs had been identified and care plans were in place for each need and an action plan of how the objective was to be achieved. There was clear guidance in the action plan for staff to follow to ensure that needs would be met safely and care would be consistent. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 12 The personal wishes and goals of the service user had also been recorded and there was evidence of discussion about this with them. For example, the service user had discussed their wish to gradually retire from attending a fiveday service activity and information in the care plan showed that staff were planning how to do this with the service user. This included the support they would need in the future to maintain an interesting lifestyle and which services could support the achievement of this goal, i.e. Age Concern. There was clear evidence that a referral had been passed to social services as part of reviewing the service user’s needs on retirement from full day service activity. The care plan is being reviewed with the service user on a regular basis and their views sought on the changes taking place in their life. It was noted that the key worker has identified that the service user should have support from advocacy services and that this should be looked into. This is good practice and the keyworker is to be commended for this forward thinking. Service user meetings are conducted with them on a monthly basis and records looked at show that they are always asked if they know who to talk to if they are not happy and whether they feel they are allowed privacy and time alone. The record shows that home issues are discussed with them and their responses are recorded in the house meeting minutes. A note had been made regarding discussion with service users about the meals that one service user, Wants a change from sandwiches, (packed lunch)”. Suggestions were sought from service users what they would like as an alternative and the record shows how service users made their choices on suggestions, for example, xx gave thumbs up to sausage rolls. Throughout the visit service users were involved in decisions being made about the days activities and routines that were happening. Their views were respected by the staff on duty who gave sufficient information to service users to enable them to make decisions. Independence is promoted strongly within the home and this includes management of service user’s money. The support a service user requires in managing their finances is documented on their care plan. A service user said, I have money when I want and I have my wallet with me. I pay for the taxi myself when I go out. Service users said that they felt safe in the home and staff demonstrated, through care practice, their understanding of individuals needs regarding risk. For example, a service user was ironing their clothes in the lounge and a staff member was very aware that the service user should not be left alone with the hot iron and observed the activity closely, at the same time promoting the independence of the service user. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 13 Care plans show that risks for individuals have been identified and staff have clear information on the care plan how risks can be minimised. Risk assessments are in symbol format, which enable service users to understand the risks they may encounter during their daily activities, and in the community. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people living in this home are supported to make choices about their lifestyle and to develop life skills. Daily activities promote independence and opportunity for people to live ordinary and meaningful lives in the community where they are living. EVIDENCE: At the start of the visit three service users were at home and the atmosphere was relaxed and welcoming. Service users were being involved and supported in everyday activities, which included preparing lunch, ironing, and cleaning their bedrooms and shared areas. One service user had gone to the post box to post a letter to their mother. Service users talked about the activities in the home and made the following comments: I cook sausages and XX does the hoovering. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 15 We all go shopping together, we have had new curtains. Its good here, we can do what we want and staff help us to be safe. We go to Get Away Club each Friday and we have a beer and sometimes I have a whisky. Each service user had planned activities for the day and these were to be carried out on an individual basis with staff that were coming to the home to support service users in their chosen activity. One service user had staff support to go out for lunch and buy a tree for the garden. The service user was also going to book their birthday activity while they were out. Another service user said that they were going out to buy some new CDs at the local supermarket. Daily records looked had confirmed that during the week activities to meet identified needs are regular and support ordinary and meaningful lifestyles. There is significant evidence on care plans and in photographs displayed around the home that service user’s activities are wide and varied and meeting their individual needs regarding maintaining family links and cultural needs. One service user used Makaton signing to say that they liked to visit churches and were very pleased to show the inspector their ‘cross and chain’ which they proudly wore. The menu is displayed in the home and showed that meals provided are wellbalanced and nutritious. All food being stored in the kitchen looked fresh and was well within the use by date. As lunchtime approached service users were involved in the food preparation, for example preparing a coleslaw salad, using the oven to bake jacket potatoes and lay the table. SCIC - Glebe Road, 26 DS0000004468.V324474.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): Standards 18, 19, 20 and 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people in this home receive is based on their individual needs. Staff working in the home have a high regard for promoting the respect, dignity and privacy of service users. Medicine management could be improved upon so that service users can be sure that medication records are up-to-date. EVIDENCE: There was significant evidence on the care plan looked at that the service user’s right to good-quality physical and mental health care is being promoted, including independence when possible. The record shows that as part of promoting their health the service user makes regular visits to a dentist, optician, psychology services, their GP and a chiropodist when needed. A health action plan was in place, which had been assessed by the community learning disability nurse, and there was evidence to suggest that this had been explained to the service user before they had signed it and that a copy would be sent to them. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 17 Service users consent is sought for the management of their medicine. The consent form is in symbol and large print format, which enables the service user to understand why they are having their medicine and what this, will be. One service users said, we see the GP and nurse when we need to, they are nice. When supporting service users staff spoke kindly to them and at a pace and level appropriate for the individuals communication needs, and this included use of Makaton signing. Examination of medication administration records, (Mar Chart), the medicine cabinet and discussion with staff on duty at the time indicate that generally medicine is managed safely for service users. The recording of medicines coming into the home however could be improved upon as it was found that Warfarin tablets held in the home did not tally correctly against the number recorded as coming into the home on the Mar Chart. For example, the record showed that 28 Warfarin tablets had been received and 18 administered, this should have left 10 tablets still to be administered, however they were 27 tablets in the blister pack. Staff explained that the reason for this is that staff do not count the number of tablets already in the home when a new supply is received into the home and recorded on the Mar Chart. Staff on duty at the time made the correct amendments immediately. A good practice recommendation was discussed with the manager by telephone after the inspection visit that all medicines be returned at the end of each administration month and this would avoid then an excess of medicines being kept in the home. Olive oil was being dispensed for a service user, when needed and this was not recorded on the medicine administration record. Staff informed that the nurse had advised this action when it was necessary, a written protocol is necessary however from either the nurse or the GP so that staff have clear guidance of how and when this is to be given. A care plan document has been devised, in symbol and large print format to record the wishes of service users in the event of the death. Staff spoken with were aware of the document and demonstrated an understanding of the importance of identifying and recording service users wishes however the documentation has yet to be completed. SCIC - Glebe Road, 26 DS0000004468.V324474.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): Standards 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 people who live in this home are able to express their concerns and know whom to speak to if they are unhappy or feel unsafe. They are supported by a staff team who have a good knowledge of how to respond to any suspicion of abuse. EVIDENCE: Pre-inspection information received informed that there have been no complaints about the service of the home since last inspection and the commission has received no complaints about the home in the last 12 months. Service users said they felt safe and would know whom to talk to if they were unhappy. Service users have access to a complaints policy, which is in symbol and large print format and includes information about the Commission for Social Care Inspection. Staff spoken with confirmed that they had been provided with prevention of abuse training at various times. They said that Whistleblowing and Protection of Vulnerable Adult information is included in their induction training. An adult protection procedure is in place at the home to inform staff of the appropriate measures to take to report any suspicions of abuse and this includes information for staff on the managers contact details. SCIC - Glebe Road, 26 DS0000004468.V324474.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): Standards 24 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The appearance of this home creates a comfortable and homely environment for the people living there. EVIDENCE: There is a warm and welcoming atmosphere in the home and at the time of the visit it was homely, comfortable and safe. People living there are able to move around easily and freely and to go to their bedroom to rest if they wish. Decor, furnishings and fittings were all clean and to a high standard. There were fresh flowers in rooms and house plants looked well cared for. The house smelt fresh and clean. A service user was happy to show their bedroom, which was clean, and talked about how they help to keep it this way. The bedroom reflected their individual lifestyle and interests. The bedroom had a washing facility and clean linen was on the bed. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 20 The bathroom was very clean and the shower room downstairs also. A service user showed me the laundry, which was domestic in style, clean and in good order. There are established policies and procedures in place for the control of the risk of infection in the home and staff practices during the visit were seen to be safe. Infection control training is included in mandatory training for all staff. The garden looked well attended and the lawn had recently been cut. The staff team are to be commended for the support they give to service users to ensure that the home is maintained to a standard that enables service users to live in comfortable and safe surroundings. SCIC - Glebe Road, 26 DS0000004468.V324474.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): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in this home are protected by robust recruitment practices and supported by a skilled and competent staff team. EVIDENCE: Observation of care practice and discussion with staff on duty at the time determined that positive relationships exist between service users and the people supporting them. Staff were seen to be approachable by, and comfortable with service users, they were good listeners and communicators, using Makaton signing when appropriate and were interested and committed to the work they were doing. Staff spoken with felt they had the skills and experience necessary for the tasks they were expected to do and this included Learning Disability Award Framework training and NVQ. Pre-inspection information indicates that staff can access training in specialist needs including dementia, behaviours that challenge and epilepsy. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 22 There is a rolling programme of assessment of care staff towards an NVQ Level 2 or above and pre-inspection information received in forms that five staff have an NVQ at Level 2 and that three staff are currently working towards the Award. Pre-inspection information looked at indicated that the recruitment of staff is thorough and includes seeking Criminal Record Bureau Disclosures and obtaining two written references. Staff spoken with said they had regular supervision and staff meetings, they said that if they were not present for the staff meeting then they would receive minutes of the meeting. Staff said, “it is really good here, and that everyone is approachable. Since the last inspection staff say they now have sufficient time to write on care plans and other home records. A staff member said that they have recently looked at the way they write diary records and now like to write about, “things that matter to people rather than personal care . This is good practice and further demonstrates staffs understanding of the importance of promoting ordinary and meaningful lives for people and maintaining a record of the lifestyle activities people participate in. Discussion with staff and examination of the staffing rota shows that there continues to be appropriate staff support for the people living in the home. The home is closed during the day most days while service users attend day services, however when service users are at home the manager seeks to provide two staff on duty, usually at weekends, to enable people to get out when they wish to do so. At the time of the visit, as stated above, extra staff came into the home to support individual service users in activities of their choice. Service users knew who was coming in that day to support them and had had time to think and plan their activity. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 23 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): Standards 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. Service users continue to benefit from a well run home. They are able to express their views of the service provision and know that their views will be listened to and acted upon. EVIDENCE: Discussion with staff and the manager, examination of home records and observation of care practices demonstrated that the service is managed by a competent and skilled manager who fosters an atmosphere of openness and respect with service users, their friends and that staff feel valued and their opinions matter. Service users were consulted on during 2006 on life in the home. This was called My House Survey 2006 and the document was in symbol and large SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 24 print format. Service users had responded that generally they were happy and sometimes, not sure. For example, to the question, ‘Do you know what it is written in your care plan?’ One service user had responded that they were not sure and another service user had responded, yes, it is a nice place to live, I get what I need and am happy with the people who I live with. Service users were asked if there was anything else they wanted to do that they were not doing. One service user indicated two things that they would like to do; the first was to go to the pub and cinema more often and secondly I would like to learn how to dial 999. There was evidence on the service user’s personal file that support was being given to them to learn how to dial 999 and staff had discussed how opportunity could be made for the service user to go to the pub and cinema more often. Health and safety management in this home is to a high standard and all records relating to this were up-to-date and in good order. Safe practices were observed in the home and records showed that this is further promoted through training for staff in manual handling, food hygiene, first aid, fire safety and infection control. Pre-inspection information received shows that maintenance of fire fighting equipment, electrical appliances and central heating systems takes place on a regular basis. Excellent systems are in place for ensuring that food hygiene is maintained and monitored, this includes recording fridge and freezer temperatures and cooked meats. Risk assessment has been completed for safe working practices and these are reviewed regularly. Risks from excessive hot water temperatures have been assessed and monitoring checks of water temperatures are taking place routinely. Fire safety management includes regular testing of fire alarms and emergency lighting and all records relating to fire safety management were up-to-date and in good order. A record is maintained in the home of any accident or incident that happens to a service user. All records seen during this visit were stored securely and in good order. The staff ‘sleep-in’ room has been re-arranged and now provides more desk space. SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 25 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 4 2 X 3 X 4 X 5 4 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 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 2 3 3 X 4 X X 4 X SCIC - Glebe Road, 26 DS0000004468.V324474.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13.2 Requirement The registered manager must make arrangements for the ensuring records of all medicines held in the home are up to date and that all treatments to be given ‘as needed’ have a written protocol as agreed with the GP or Community Nurse for this action. This includes treatment for ‘softening’ earwax with Olive Oil. Timescale for action 30/04/07 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. 2. Refer to Standard YA7 YA20 Good Practice Recommendations The registered manager should continue to establish the wishes of service users (and their relatives) in the event of death. It is recommended that all unused medicines be returned to the Pharmacy when the new supply of medicines is received. DS0000004468.V324474.R01.S.doc Version 5.2 Page 27 SCIC - Glebe Road, 26 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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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