Inspection on 19/09/06 for Scotia Heights

This inspection was carried out on 19th September 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Scotia Heights 02/10/09

Scotia Heights 17/09/08

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

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

CARE HOME ADULTS 18-65 Scotia Heights Scotia Health Care Ltd Scotia Road Burslem Stoke on Trent ST6 4ET Lead Inspector Peter Dawson Key Unannounced Inspection 19 September 2006 09:00 Scotia Heights DS0000064684.V310701.R02.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 Scotia Heights DS0000064684.V310701.R02.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. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Scotia Heights Address Scotia Health Care Ltd Scotia Road Burslem Stoke on Trent ST6 4ET 01782 829100 F/P 01782 829101 TBA 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) Scotia Health Care Ltd Mr David Joseph Price Care Home 60 Category(ies) of Physical disability (60) registration, with number of places Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Registration. Brief Description of the Service: Scotia Heights is a purpose-built specialist nursing home providing 60 beds for young adults (18-65) with a neurological diagnosis. The new registration was approved on 10th February 2006 and admission of residents commenced shortly afterwards. Occupancy will be phased approximately over a 12 month period. Ultimately there will be 3 - 20 bedded units each with a Unit Manager. The 20 bedded units will each divide into two smaller units of 10 beds each. The objective is to provide care for people with a neurological diagnoses and a physical disability. There will ultimately be a 20 bed respite unit offering facilities for comprehensive nursing care and a variety of activities tailored to individual needs. Whilst these are outline objectives the units will develop and evolve to meet the needs of residents rather than have defined areas of category. The environmental facilities are excellent. – All bedrooms are for single use, spacious, have en-suite facilities including shower and all bedrooms have TV and telephone points. There is ample room to negotiate moving equipment as required. There are 12 lounges and 6 dining areas providing high-quality accommodation furnished and equipped to the highest standards and allowing small group living areas. Corridors are wide and spacious with recessed seating areas and there are rooms for visitors and meetings. All facilities, including kitchen, laundry and office accommodation is spacious, bright, well equipped and pleasing in presentation. No expense has been spared in building and equipping the home at a cost of £5million. The home is located in a well populated area in the northern part of Stoke on Trent. Is on a main ‘bus route and easily accessible by car or public transport to the Potteries towns where all communal facilities can be accessed. The home is located next to a modern leisure centre offering excellent facilities. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Scotia Heights was registered and opened in February 2006 to provide 60 places for young adults with a neurological diagnosis and high physicial dependency needs. Phased admissions commenced shortly afterwards. Weekly placement fees are £650 - £1900. This is the first inspection of the home. At the time of the inspection there were 6 permanent and 3 respite people in residence. There have been several short-stay/respite care placements in the interim period. The inspection was informed by completion of the Pre-inspection questionnaire provided by the home and written feedback from 5 residents, 5 relatives and a Care Management placement officer. The inspection was carried out by one inspector who had discussions with residents and most staff on duty including the Manager and Deputy Manager. There was an inspection of the physical environment, concentrating upon the one 10 bedded-unit currently in use. Records relating to the inspection process were seen. Care and support staff spoken with were very positive about their work. Clearly enjoying the excellent working environment and feeling positively involved in a new venture. All felt they were contributing to establishing a new service providing high quality care. Staff morale was high. Residents spoken to were very positive about the excellent environment, flexibility of routines and the care and support from staff. Residents had settled well and quickly into the home. Those spoken to were aware of the procedures for making complaints but all were satisfied with the care they received. In written feedback direct to the Commission 5 residents and 5 relatives stated high levels of satisfaction. Comments were clear and definitive they included: “It is early days for Scotia Heights but staff in post so far have done everything possible to help my son settle in and have always sought advice when appropriate, this is a well organised home”. “I cant praise Scotia Heights enough, staff are fantastic, I always feel so welcome when visiting. They always have time to talk to me when I ring, my son is so happy there and well looked after, I can’t thank the staff enough they are like family to us”. A respite care resident commented: “I think that Scotia Heights is a fabulous nursing home, my stay there was the best time of my life, the staff are lovely, helpful, caring and understanding. But most of all they make you feel independent, my care needs were all met gracefully, you simply couldn’t ask for a better place to stay”. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 6 The comments received both verbally and in writing supported observations during the inspection of a high quality service applying the principles of care to meet complex needs and provide a quality of life experience. A Care Management Social Worker from another local authority commented: “My service user has complex needs and I have been impressed at the creative approach staff use and also their effective communication”. What the service does well: What has improved since the last inspection? What they could do better: Count of medication would improve the audit trail of medication. Further staff training required to ensure one first aid trained person is on duty at all times. Care Management assessments should be obtained prior to admission and a detailed social history available. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 7 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. Scotia Heights DS0000064684.V310701.R02.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 Scotia Heights DS0000064684.V310701.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1–5 The quality of this outcome is good This judgement is made using the available information and a visit to the service. Information is available prior to admission but could be improved. Pre-admission assessments are carried out and are detailed, but Care Management assessment not always available. Pre-admission introductory visits are good. EVIDENCE: There is a statement of purpose and service users guide available in the home and provided to all prospective residents. A computer printed single sheet paper gives scant information and reproduces photos which do not do justice to the actual building and facilities. This may be the only visual impression available to some prospective residents. A more professional printed guide would do justice to the excellent facilities offered and the cost involved in establishing the home. This could increase the number of referrals for admission. In written feedback to the Commission one resident said that “very good information was available” prior to admission – another said “I was promised information but it didn’t arrive”. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 10 In care planning information seen there were good and comprehensive preadmission assessments recorded by the home prior to admission. In relation to an admission from another home in the same group, little information had been provided and no dated or new Care Management assessment provided. In other instances this had been provided. It was clear from discussions with residents and staff and from records seen, that introductory visits had been made prior to people moving into the home. This applied also to respite care which has been provided for many people This in itself allows time and choice for decisions about more permanent admissions. The resident transferred from another home he had been transported several times from the Birmingham area prior to admission for days or overnight stay to allow him to “test-drive” the home. Another resident who had not been into respite or permanent care previously was seen at home on several occasions by staff who also visited him at his college course near to his home. He and his family had some reservations about “care” but fears were allayed in a sensitive, slow introduction without pressure. He has ultimately become a permanent resident having settled well. He spends weekends with his family allowing a “shared-care” situation. Contract are provided by funding authorities, although these were not seen on this visit. Scotia Heights DS0000064684.V310701.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 9 & 10 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. Care plans are good and comprehensive. Social histories/Care Management assessments should be obtained in all instances. There is good evidence of participation and decision making by residents. Responsible risk taking is enabled. EVIDENCE: The care planning format is good and certainly records an holistic approach to care planning information. Care plans were sampled and reflected assessed needs in detail. There are details of required personal care, risk assessments for moving and handling and other resident activity. Personal risk assessments had been completed for residents prior to their recent visit to Blackpool to ensure that all aspects of potential risk for a day out had been considered. Plans contained waterlow assessments, sexual needs, behaviour charts, continence assessments and personal needs assessments. There are daily notes provided for all residents at the end of each of the two staff shifts. Care Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 12 plans are reviewed on a monthly basis and signed by residents. One does refuse to sign but he asks for his daily notes to be read to him. There is daily recording of all activities – internal and external and recreational therapy reports. Each resident has named nurse/key worker. A care plan inspected relating to a resident moving from another home in the same Group (Birmingham) contained little information from the previous home (notes on 2 sheets) and there was no social history or CCA by the funding authority. This area could be improved. The social history had been provided only by the resident and was questionable in some areas. Residents spoken to said that they freely made decisions affecting their daily lives and their chosen lifestyles were accommodated. In written feedback one resident said that decision making was “excellent and always from choice”. Another said “I am able to go shopping, cinema, pubs or places I choose”. Two residents have advocates to advise and act on their behalf. They are invited to reviews. Two residents have communication needs and communication boards used to assist them. A resident profoundly deaf was seen communicating well with staff about her choice of activity. The wishes of a resident restricting the amount of personal care he is given are respected although he is encouraged to sustain his personal hygiene by verbal, humorous and other means. There is a policy relating to confidentiality. Records are secure but easily accessible to residents or others of their choice only be agreement. Scotia Heights DS0000064684.V310701.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 – 17 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. Personal development and educational opportunities are available on an individual basis. This is a new home but the social needs of the diverse group have been successfully managed. The accent upon external activities and socialisation is good. Flexible routines and food provision were reported to be good. EVIDENCE: Personal development is central to the homes philosophy. Residents said that they made choices about their personal and social lives and were supported in those decisions. Educational courses have been accessed by 2 residents, one at Blackfriars College Newcastle for 5 days each week another at Burslem College where courses in drama, arts and crafts were taken. The latter was the choice of a respite care resident. Transport and support is arranged as required. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 14 The home has recently appointed a Life Skills Co-ordinator to concentrate upon further development of activities and social development. All activities are recorded on a daily basis and the input of residents in making choices is paramount. The usual range of indoor activities are provided and reported to included games, quizzes, arts, craft, karoke, bingo, pool, gardening, baking, jigsaws, daily newspapers, TV, DVD, CD, grooming and beauty. Residents are very strongly encouraged to engage in external activities. Educational opportunities are mentioned above but other links with the community are promoted as a means of social inclusion. These include, local leisure centres, theatre, cinema, dining out, shopping and bowling. Residents make daily choices. On the day of inspection two resident were attending evening football match at Port Vale. Residents recently made a decision to go to Blackpool for the day. This was planned and arranged and photographs support the verbal account given by residents of an enjoyable day out clearly enjoying all the facilities the resort had to offer. Residents and staff spoke amusingly about the day’s escapades. A respite care resident who took part and has skills in photography, artwork design and considerable humour, had recorded the event in Newsletter form which was available to visitors in the reception area of the home. Another recorded event was a karoke evening involving all residents and staff in various poses of musical and social disorder. Events were planned, captured and available as records of enjoyment and subsequent discussion. There has been a mixture of residents of age, orientation, disability, personality and diverse interests. Some are permanent residents, many have been for respite care but all seem to have engaged well together and enjoyed some quality of life together. Staff have clearly promoted this extremely well. Individual external activities are provided for all. This may often be visits to local stores/supermarkets but provide normalisation of routines and the vital external component for this group. Behavioural traits of some residents can sometimes take hostage in these situations but they are clearly dealt with in a calm and professional way by staff who ensure the continued dignity of the person. Residents have choice of lifestyles and are assisted in their choices. Routines are flexible to accommodate resident need. Mealtimes are totally flexible, there are no stated times for breakfast or supper. Residents were seen arriving for breakfast mid-morning on the day of inspection. A resident confirmed he prefers to socialist/watch TV until the early hours and then rise late. Good interactions and engagements between residents and staff were observed during the inspection and evidence that they were treated with respect. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 15 A resident in written feedback said “Staff are polite and when not busy they sit and talk to you”. Residents spoken to said that food provision was good, there was choice and they enjoyed their meals. The home promotes a healthy lifestyle and diet. Fresh fruit is readily available at all times and posters indicated good daily eating regimes. Scotia Heights DS0000064684.V310701.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 - 21 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. Support and nursing care is provided in a sensitive and flexible way taking account of residents choices and their stated limitations in accepting personal care. Health care issues, including diagnoses, treatments and specialist support are well documented and clear to staff providing care. The medication system is safe, but count of medication required. EVIDENCE: The home provides nursing care for young adults with a neurological diagnosis/high physical dependency needs. There are currently 9 people in residence as the home has only been open for only 6 months. There are diagnoses of Cerebral Palsy, Huntington’s Disease, MS and Friedreich’s ataxia at this time requiring a range of interventions from health care professionals. Apart from GP’s and Consultants - speech & language nurses, CPN’s, Huntington’s and MS Nurse Specialists have been involved in care. Records relating to a resident with complex needs were inspected. A diagnosis of Cebral palsy and aggressive behaviours presented a care plan to address to monitor and deal with the behavioural aspects. The person also weighs only 4 Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 17 stones, has a high waterlow score and poor dietary intake. Good tissue viability is maintained with specialist mattress and cushion and encouragement for bedrest p.m. The resident resists personal hygiene care, including bathing. This is documented in care plan records and staff take opportunities to encourage, persuade cajole as they are presented with some success in providing the necessary basic care. There was original refusal of hoist which made care virtually impossible, but this has been overcome with appropriate staff input and now accepts regular use of the hoist. The resident refuses to sign care plans but asks for daily notes to be read regularly. There was evidence of good continence assessments and management. Around 50 of residents required continence aids and assistance. The majority of residents require 2 staff to assist with person care. There are 2 Moving & Handling trainers and adequate equipment available. In the event of specified life-saving treatments a resident has requested DNR. This has been referred to the GP and PCT for verification. A resident with total hearing impairment communicates with communication and picture board quite adequately and 2 staff are commencing BSL sign language course. Several residents are wheelchair users and the home is suitably adapted in all areas. The corridor areas are particularly wide and there is easy access to bedroom and communal areas. Medication is supplied to the home by Co-op Pharmacy in bottle form at this point. There were no gaps on MAR sheets and recording of the receipt and disposal of medication was good. A count of medication is not always completed, this was noticed in the supply of Lorazepam – it was not possible to check the current stock as cumulative totals had not been completed. This should be done to complete the audit trail of medication. Scotia Heights DS0000064684.V310701.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The quality of this outcome is good. This judgement is made using the available information and visit to the service. The complaints procedure is readily available to residents and visitors and this was confirmed by residents in discussions and written feedback. There has been Vulnerable Adults training for all staff. EVIDENCE: There is a complaints procedure posted in the reception area of the home for residents and visitors. It is clear and fairly concise, meeting the requirements of Regulation 22. One resident in written feedback felt that the complaints procedure could be shortened, but it does seem adequate and concise. The procedure will be read and interpreted to the particular resident. Another resident confirmed in writing that he was aware of the complaints procedure and would know who to speak to if they had any concerns. No complaints have been received by the home since opening or by the Commission. There has been staff training in Vulnerable Adults issues and the reporting of suspected abuse. This has been carried out by the Regional Manager. There is a copy of the Vulnerable Adults procedures in the home. Scotia Heights DS0000064684.V310701.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 – 30 The quality of this outcome is excellent. This judgement is made using the available information ad a visit to the service. A purpose built home to a high specification presenting excellent facilities and high quality interior fittings throughout. The home meets and in some areas exceeds, the National Minimum Standards. EVIDENCE: The home was purpose-built, completed and opened in Feburary 2006. The cost was £5million and provides excellent facilities and meets all the National Minimum Standards. The building is totally accessible for people with a physical disability. All areas are bright, pleasant and spacious. Furnishings, fittings and décor are to a very high standard, tasteful and co-ordinated. Bedrooms are all for single use and have en-suite with shower. There are TV and telephone points in all bedrooms. Corridor areas are wide, bright and have recessed areas. Access to bedrooms and communal areas is excellent. Bedrooms and bathrooms having split-doors which allow good and easy access for wheelchair users. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 20 The kitchen and laundry areas have been fitted with high quality installations usually found in quality hotels. The reception and office areas are similarly bright, spacious and well furnished. It is clear that economies have not been made in any area of the building, furnishing and fittings. The result is a pleasant, welcoming, comfortable home. Residents are clearly impressed with the facilities. In written feedback a relative said that “Sky TV is needed and also computers” In fact there are TV points in all bedrooms which residents can use for their own TV, but installation and rental of Sky TV must be the responsibility of the resident. The owners make no restrictions upon such installation. A computer for resident use has actually been ordered and will be paid for by the home. The building is maintained by an employed maintenance person. Individual bedrooms were seen to have sufficient space to accommodate items brought from home e.g. TV, CD, Freeview, computers etc. All rooms occupied by permanent residents were well personalised reflecting their individuality. Recently a resident was found on the floor next to his single bed recently. A double bed has been provided as there is sufficient room and this has resolved the problem. There are 6 bathrooms all with assisted facility, in addition to showers in all en-suite areas. There are additionally 12 toilets located at strategic points near to communal areas. There is a fully equipped therapy suite for residents. All areas of the home were clean and hygienic at the time of the inspection. There were no mal-odours. Sluicing facilities are provided on each floor. Scotia Heights DS0000064684.V310701.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 – 36 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. There is a good mix of staff with clear responsibilities and adequate training provided for staff who have all been recruited over the past few months. The small staff group are well-motivated and enjoying the exciting prospects a new specialist home presents. Recruitment procedures ensure protection of residents and staff supervision is in place. EVIDENCE: It has been difficult to assess the numbers of staff required on an ongoing basis due to the fact that since opening the number of residents over the past six months has intermittently increased from 6 to 9 residents. Other admissions are in the pipeline. Residents have hitherto occupied only one of the six 10 bedded units. A further unit (of 10 residents) is due to open with further planned admissions about to be arranged. Staff recruitment has kept ahead of the required minimum numbers for residents as admissions have proceeded. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 22 Staffing has been provided with a minimum of 540 care hours per week which more than covers the required levels. The mixture of permanent, temporary and respite residents has proved successful. There are presently 12 nursing staff (including Manager) and 13 care staff. Seven care staff have NVQ2 or above providing 54 of care staff presently NVQ trained. The objective is for all to be trained. There are 2 moving & handling trainers which is an important factor in providing care in this home. Induction has taken place on an ongoing basis and all statutory training has taken place with the exception of first –aid training referred to in Standard 42. There is a Clinical Team Manager who is Deputy to the Registered Manager and presently one Unit Manager (three are proposed when full to cover the 3 proposed units of 20 beds). There is presently a good mix of staff including age, qualification, experience and gender. Opportunities were taken to input training in the days following registration when staff were in place and residents had not been admitted. Planned training includes Tracheotomy care, MS Nurse Specialist training, Huntington’s Association, Muscular Dystrophy and Basic Life Support training. There are ancillary staff including administrator, housekeeper, chef manager and maintenance. Supervision is in place for staff at all levels. Recruitment procedures were inspected from a sample of staff files. All required documents and checks had been obtained prior to employment. The recruitment of staff has continued with the opening of the second 10 bedded unit. Scotia Heights DS0000064684.V310701.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 - 43 The quality of this outcome is good. This judgement is made using the available information and a visit to the service. The home is well managed, staff are well motivated and morale high in this new venture. A range of systems and policies and procedures are in place to safeguard residents. Requirements in relation to Health & Safety are met. The only action required is further first aid training for staff. EVIDENCE: The Registered Manager was recruited 12 months ago prior to completion of the building. He is a registered nurse and has considerable experience in managing care in similar settings. He has been involved in the appointment of all staff and therefore been able to ensure an appropriate mix of staff skills, experience and compatibility. Discussions and observations during the inspection evidenced this view. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 24 The Manager has recently completed the required Registered Managers Award and has the required qualifications to run the home. The Manager takes a positive lead in the home and creates an open atmosphere for discussion. He has clearly defined standards and will readily take action to ensure they are upheld. The Manager is supported by the Regional Manager of the Company who makes regular visits and available for consultation as required. The Manager delegates duties/responsibilities to other staff – the Deputy Manager who has responsibility for clinical issues, the administrator, housekeeper and other operational support staff. All are clear about their areas of responsibility. Required policies/procedures relating to the running of the home are in place and available to all staff. There are monthly staff meetings when staff have the opportunity to make formal input into the running of the home. Supervision is in place for staff at all levels. Feedback from residents is sought in daily discussions and meetings. Several people have spent periods of respite care at Scotia Heights and their views actively sought at the end of the respite period. Records inspected were accurately completed and to good professional standards. There are 2 moving and handling trainers in the home. All staff have received appropriate training from them. Fire records inspected showed that all required drills and checks had been carried out. Some residents prop open bedroom doors. The inspector was concerned about the safety aspects of this but discussions with the Fire Officer concluded that the building was built to HTM84 standards (Engineering Solution). There are compartmentalised fire areas, which with adequate staffing levels, risk assessments and evacuation plans - allow bedroom doors to be propped open without presenting a fire risk. There are only 2 people first aid trained. Further training is required to ensure there is a trained person on duty at all times. The Manager will arrange for further training. All equipment and installations are new and arrangements in place for service contracts to maintain them as required. All required incidents have been reported to the Commission under Regulation 37 as required. Scotia Heights DS0000064684.V310701.R02.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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 LIFESTYLES Standard No Score 11 3 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 2 x 3 3 X 3 3 2 3 Scotia Heights DS0000064684.V310701.R02.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 Accurately record count of medication to complete audit trail. Timescale for action 20/09/06 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 YA42 YA6 Good Practice Recommendations Qualified First Aid trained person must be on duty at all times. Care Management assessments should be obtained from all funding authorities prior to admission. Social histories must be provided. Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 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. Extracts may not be used or reproduced without the express permission of CSCI Scotia Heights DS0000064684.V310701.R02.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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