Inspection on 14/07/05 for Skills for Living (38 Forest Road)

This inspection was carried out on 14th July 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Skills for Living (38 Forest... 08/12/08

Skills for Living (38 Forest... 24/01/07

Skills for Living (38 Forest... 10/01/06

Skills for Living (38 Forest... 04/11/04

Skills for Living (38 Forest... 20/07/04

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

CARE HOME ADULTS 18-65 Skills for Living (38 Forest Road) 38 Forest Road Hinckley Leicestershire LE10 1HB Lead Inspector Trisha Gibbs Unannounced Inspection Thursday, 14 July 2005 at 09:00 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 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 Stationary 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. Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Skills for Living (38 Forest Road) Address 38 Forest Road Hinckley Leicestershire LE10 1HB 01455 635818 01455 440890 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Lucy Hogg and Ms Paula Burton Mrs Wendy Elizabeth Smith Care Home for Younger Adults (18-65) 2 Category(ies) of Learning Disability (LD) - 2 registration, with number of places Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No additional Conditions of Registration apply at the time of writing this report Date of last inspection 04 November 2004 Brief Description of the Service: 38 Forest Road is one of three Skills for Living small family homes, for two young adults who have a learning disability and who have additional complex needs and behaviours. The home is a semi-detached house in a road with similar houses and situated near to the town of Hinckley and to a range of facilities. The house has two bedrooms, bathroom, an open plan lounge, dining area and kitchen. There is a pleasant garden with trees to the rear of the house. High staffing ratios are provided, to meet the needs of the young people living there, and in order to promote their independent living skills and community integration. Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection, along with 36 Forest Road, took approximately four hours and was the first statutory unannounced Inspection this year. One resident’s case was fully tracked during the Inspection. The Inspector also looked at related files, observed and talked to the two residents who live in the house, looked at communal rooms and bedrooms and held discussions with three staff members, the Registered Manager and one of the Registered Providers. What the service does well: What has improved since the last inspection? What they could do better: Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 6 No requirements or recommendations were identified during this Inspection. 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. Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Residents’ individual needs are positively assessed on a regular basis. EVIDENCE: The file looked at, contained very good evidence of a full multi agency assessment of need, not only at time of admission to the home, but following this, through regular meetings and reviews. Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 9 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 standard(s) 6,7,9 Residents are enabled to make choices, take acceptable risks, and to have their needs fully met. EVIDENCE: • The file of the young man tracked contained excellent records, charts, documents and action plans, covering all aspects of his daily life. Each care need is fully detailed. Residents also have Person Centred Planning books. One member of staff had just attended a three day Person Centred Planning course, which she really enjoyed, and indicated that this had confirmed for her the importance of motivating and involving residents in the Person Centred Planning process. The two residents who live in the house have very limited, or no verbal communication skills, however the staff team are informed and aware of each individual’s communication system. These include objects of reference, signing and symbols. The residents had just finished breakfast and were preparing for their day’s activities. There was plenty of interaction between staff and residents, and obvious elements of C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 10 • Skills for Living (38 Forest Road) humour and fun. The young man, whose file was tracked, was lively, and eager to get away to his day service. • Care planning material emphasises the need for staff to encourage independence and to respect individual choice and preference, and staff appeared to naturally and automatically interact with residents in a respectful and kind manner. Good solid risk assessments are in place to facilitate the residents to enjoy a normal lifestyle and to access community activities. The home environment is open plan, and residents move around freely. • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 11 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 standard(s) 12,13,15,16,17 Residents are enabled to enjoy a normal lifestyle. EVIDENCE: • The policy of the Skills for Living homes is that residents must be enabled to conduct their day-to-day lives as if they were living in their own home, however challenging or difficult their needs might be. Staff actively assist the two residents to live to ‘normal’ lifestyles and routines. Very good staff ratios are provided to ensure residents constantly receive a high level of support for this. There is a written expectation that residents should be supported to carry out two activities a day. One resident attends the Skills for Living day service, and the other has activities individually planned for her, many of these within the community. • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 12 • On the file of the resident tracked (as with all residents) there are commendable risk assessments that cover all aspects of accessing the community, e.g. walking the shop, ride in the car, bus journey, walk to the common etc. All are tailored to specific behaviours and needs. The Inspector briefly visited the day service that the resident attends while inspecting staff files at the Skill for Living main office. The resident was going swimming that day after eating a healthy, home cooked lunch. The day service works to the same goals as the residential service, involving service users in community activities and resources. • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 13 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 standard(s) 18,19,20 Very good attention is given to the personal and health care needs of the residents. EVIDENCE: • Residents’ care plans contained clear details about their different healthcare needs. Health and social care professionals provide specialist support and regular reviews take place; the outcomes are clearly documented on review sheets and were seen on day of Inspection. The staff team are provided with training and refresher training to equip them to meet the individual health care and personal needs of the two residents. The Provider Manager of the home is a Registered Learning Disability Nurse who, along with other professionals, regularly delivers health care, and medication training to staff. During the Inspection, copies of information sheets and special quizzes delivered during training sessions were seen, in addition to training certificates. • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 14 • The resident who was not tracked on this occasion, looked healthy and happy and had lost weight since the last Inspection. She was more relaxed but still alert. A member of staff sad that her medication had been changed, following a review and that this had had a positive affect. A separate medication file is maintained for each resident. Medication is stored in locked cabinets. The file includes commendable detail about all medication being administered. The Registered manager undertakes monitoring check at least once a week, ensuring that medication systems are being adhered to. An individual travel pack containing all current medications is made up for each resident and ready to take out with them when they go out. A member of staff explained clearly the medication systems for the resident tracked. • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 15 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 standard(s) 22,23 Residents’ views, as far as possible, are sought, and they are kept safe. EVIDENCE: • Although the two residents do not engage verbally, each is able to communicate with staff through individual communication systems. The staff on duty told the Inspector that each resident is able to demonstrate through their behaviour and expression whether they were unhappy about a situation. One member of staff said that she consistently tries to teach a new signs to residents even though the process of learning and using them can take along time. There was very good evidence in care planning documents that staff are expected to be vigilant in observing responses and behaviours in order to actively make sure and that residents are happy and satisfied with the service provided. Much attention is given to staff awareness about Adult Protection and there are good clear Procedures in place to respond to allegations and complaints. Training and refresher sessions are regularly provided to support the Procedures. Evidence of this was a seen on staff files and this is commendable. • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 16 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 standard(s) 24,30 Residents enjoy living in a comfortable and colourful home. EVIDENCE: • The house the residents live in is a pleasant two-bedroom semi detached one. The small scale home offers the two residents a quiet and individualised way of living, and this contributes to their personal development. The two residents are familiar with each other and were observed to be comfortable and confident in their surroundings. The house has a good-sized lounge with dining area, an open plan kitchen. (Recently redecorated with new work surfaces and cupboards.) The two bedrooms have laminate wood floors and are nicely painted and furnished to suit individual needs. Each has personalised features. There is a garden at the back of the house and staff described to the Inspector work that was being undertaken to improve the garden space between the two Skills for Living houses. (i.e. number 36 and 38.) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 17 • Skills for Living (38 Forest Road) • The house was clean, pleasant and fresh throughout. Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 A well-trained and competent staff team provides care for the residents. EVIDENCE: • Skills for Living staff teams are provided with a commendable standard of training and development sessions. Training programmes, with dates, are provided for staff at the beginning of the year and they are expected to attend. Training Days deliver different essential areas of training and these are certificated. Staff are also systematically progressed into NVQ 2/3 having completed their induction and foundation programmes. A more recently appointed member of staff at 38 Forest Road who did not have a care background said that she really appreciated the training provided to her, and that it gave her confidence to do her job. She said she ‘really loves’ her work, and was able to list training she had attended. A young senior care worker on duty also spoke in a confident knowledgeable manner about meeting residents’ needs. • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 19 • On completion of their probationary period, a confidential questionnaire is given to staff members seeking feedback on the service being provided. They are asked, among other things, about what they think could be done better, and there were good examples of staff suggestions being listened to and acted upon by the Provider Managers. This is commendable. Staff personnel files contain checklists and details confirming sound recruitment practices. Files also contain details of training attended. Supervision and appraisal sessions are regularly provided to staff. • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 The service provided to residents is subject to rigorous monitoring systems. EVIDENCE: • The Registered Manager of the three Skills for Living residential homes, along with the two Provider Managers, monitors the performance of the home through informal and formal systems. They arrive at the home frequently on an unannounced basis. Checklists were seen evidencing that not only are physical standards subject to monitoring, but also resident happiness and satisfaction. Relatives and staff are routinely invited to give feedback. Managers frequently referred during the Inspection to developments planned for the service as a result of their regular monitoring and review. C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 21 • Skills for Living (38 Forest Road) • Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x x x Standard No 22 23 ENVIRONMENT Score 3 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 4 x 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 4 x x x x Standard No 31 32 33 34 35 36 Score x x x x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Skills for Living (38 Forest Road) Score 4 4 4 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x x x C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 23 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 Regulation NONE Requirement Timescale for action 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 NONE Good Practice Recommendations Skills for Living (38 Forest Road) C51 C01 S1670 Skills for Living (38 Forest Road) V237082 STAGE 2 140705.doc Version 1.40 Page 24 Commission for Social Care Inspection The Pavilions, 5 Smith Way Grove Park, Enderby Leicester LE19 1SX 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. 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