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Inspection on 08/12/08 for Skills for Living (38 Forest Road)

Also see our care home review for Skills for Living (38 Forest Road) for more information

This inspection was carried out on 8th December 2008.

CSCI found this care home to be providing an Excellent service.

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.

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Skills for Living (38 Forest Road) 38 Forest Road Hinckley Leicestershire LE10 1HB The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Fiona Stephenson Date: 0 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 28 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Skills for Living (38 Forest Road) 38 Forest Road Hinckley Leicestershire LE10 1HB 01455442243 01455440980 Lucy_hogg@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ms Paula Florance Burton,Ms Lucy Hogg Care home 2 Number of places (if applicable): Under 65 Over 65 2 0 Learning disability Additional conditions: The maximum number of persons to be accommodated at Skills for Living (38 Forest Road) is two. No one falling within the category LD may be admitted to Skills for Living (38 Forest Road) where there are 2 persons within the category of LD already accommodated. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 28 A bit about the care home 38 Forest Road is a small home providing a service for two young adults with a learning disability and additional complex needs and behaviours. It is a semi-detached house in a road with similar houses and is 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 to the rear of the house. High staffing ratios are provided, to meet the needs of the young people and to promote their independent living skills and community integration. Current fee levels are £1,800 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: Three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 28 How we did our inspection: This is what the inspector did when they were at the care home This key inspection included a visit to both 36 and 38 Forest Road on the 8th December 2008. We (the CSCI) arrived at the service at 1.00pm and finished our visit at 5.15pm. The visit was unannounced, meaning that the service was not aware we were coming. The main method of inspection we used is called case tracking. This means looking at the care given to people in different ways. We did this by, - talking to, and observing people who live at the home, - talking to staff, management and the people who own the service, - Looking at care records. We looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sent to us at the CSCI. The AQAA tells us what the provider thinks about the service they provide to people who live in the home. Care Homes for Adults (18-65 years) Page 7 of 28 We also looked at surveys called Have your Say About... . We received seven surveys back from staff that work at 36 and 38 Forest Road. We did not receive any from people who live in the home or from their relatives. We spoke with four members of staff, the new manager, and the providers during the time we visited the home. We also briefly spoke with one of the people who live at the home. We checked all the standards that the Commission for Social Care Inspection has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well The service is homely, and there is a family atmosphere in the house. Care Homes for Adults (18-65 years) Page 8 of 28 The bedrooms reflect the personal preferences of the people who use them. Staff receive excellent training and regular supervision to support them in the work they do. Staff were observed to have excellent rapport with people who live in the home, and very clearly knew how to respond to their needs. Care plans are very detailed; person centred, and support excellent health and personal care. Care Homes for Adults (18-65 years) Page 9 of 28 People living in the home have a rich and varied life, being supported in undertaking a range of activities to suit their needs and preferences. The providers are very conscious of health and safety, and there are good recording systems in place to ensure that health and safety needs are met. The service has good links with other health and social care professionals, and use these to support the needs of people living in the home. What has got better from the last inspection Flooring in the living room/dining room has been replaced, and has improved the appearance of these areas. Care Homes for Adults (18-65 years) Page 10 of 28 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Care Homes for Adults (18-65 years) Page 11 of 28 Fiona Stephenson CSCI Edgeley House Tottle Road Riverside Business Park NG2 1RT Tel: 0115 934 0900 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 12 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 13 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Forest Road live in a home where their needs are well met. Evidence: We checked the assessment records of one of the people who live in Forest Road, and found that there was a good assessment of need, and the staff were able to meet this persons needs. We looked at the Statement of Purpose and service user guide. These documents tell people how the person who owns the home intends to provide care and support to people living in the home. Both documents were written in easy read format using a picture bank. We talked to staff, and looked at the care records, and found that staff knew how to meet the care needs of people living in the home. Care Homes for Adults (18-65 years) Page 14 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The individual needs and choices of each person living at Forest Road are well documented and acted upon by staff supporting people who live there. Evidence: We looked at the care records of people living at Forest Road. We found very detailed records to support the care given to people who live at the home, and care plans which were in a format more easily understood by people who live there. We saw that care records were routinely up-dated to ensure they reflected the changing care needs of people living in the home. We saw that staff have a good understanding of the risks relating to each person who lives there, and have put the necessary action in place to reduce risks associated with each person. During our visit we observed staff being very mindful of how a person might react to events, and ensuring that action was taken to reduce the possibility of Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: challenging situations. Care Homes for Adults (18-65 years) Page 16 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Forest Road have a rich and varied life. Evidence: We looked at the life plans of people who live at Forest Road. These showed us people experiencing a rich and varied social life. People go to the day centre to learn life skills, and to undertake sporting activity. They go on a range of activities including bowling, swimming, visits to the pub, and enjoy trips out to places like Skegness, Blackpool, Drayton Manor, Twycross Zoo and Conkers. We saw that staff are sensitive to the needs of people living at the home. They were aware of the preferences of people in terms of where they prefer to sit in the home, and when they like to have company or be alone. We saw staff talk to and interact well with people who live there. Staff also were aware of how to effectively communicate with each person. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: We arrived whilst lunch was being prepared and saw two people living at the home having a healthy lunch of tuna, jacket potato and salad. They enjoyed their meal. We saw the menu for each person who lives at 36 and 38 Forest Road. The menus are all very similar, but there are adaptations to ensure the individual needs of each person are being met as detailed in their care plan. The menu provides a balanced and healthy diet. People who live in 36 and 38 have a takeaway each week, which they pay for themselves. Care Homes for Adults (18-65 years) Page 18 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at Forest Road have excellent personal and healthcare support. Evidence: We looked at the personal and healthcare records of people who live at Forest Road. We saw that they have good access to healthcare services to meet their personal and healthcare needs. On talking to staff as well as looking at the records, we found that staff act quickly on concerns they have about peoples needs, and these prompt actions have resulted in a better quality of life for those concerned. We looked at medication management and found that staff are administering medication appropriately to people who live at Forest Road. We also looked at how medication is stored and this was stored safely. We saw staff records and these showed us that staff have undertaken training in the administration of medication. We were informed that only senior carers are given permission to administer medication to people who live in the home. Care Homes for Adults (18-65 years) Page 19 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at Forest Road can be confident that their concerns are listened to and acted upon, and they are protected from abuse. Evidence: We looked at the complaints procedure and saw that this was written in a format, which is more helpful for people living at Forest Road to understand. We saw very good interaction between people who live in the home, and staff who support them. We were told in the AQAA that the views of people living in the home are important, and that the service wants to get it right first time. We saw by looking at staff training records, and by talking to staff that staff have a good understanding of safeguarding policies and procedures. Staff know what to do if they suspect that a person who lives in the home is being abused in any way. We also saw by looking at staff records, and by talking to, and observing staff that they understand how to work with challenging behaviour. The AQAA told us that people who live in the home have their own bank accounts. Staff support people living at Forest Road in being responsible for their money. We checked the financial records of one person living at the home, and found robust recording of money transactions. Care Homes for Adults (18-65 years) Page 20 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Forest Road live in a homely, comfortable environment. Evidence: We looked at the communal areas of the home and the bedrooms of people who live there. We found the communal areas to be nicely decorated and homely. The bedrooms were decorated to reflect the personalities and preferences of the people using them. The AQAA told us about the maintenance and renewal programme for furniture and fittings in the home. It also told us that fire safety systems are checked and updated, and we saw that the home was well maintained. The outside of the home is not looking as well maintained as the inside of the home. We were informed that the outside of the building is not the responsibility of the Skills for Living company; it is the responsibility of the landlord they rent the property from. We were told that they have asked the landlord in writing to improve the front of the property but he has not done this so far. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The number, and skill mix of staff provide excellent support for people who live in the home. Evidence: We talked to staff and saw them supporting people who live in the home. We saw very good interaction between staff and people who live in the home, and staff demonstrated a very good understanding of the needs of people living there. We saw excellent levels of staff support, with people living at the home having one to one support during the day. The AQAA told us that one to one support is given from 7.00am to 10.00pm. We looked at the seven responses to our Have your say survey. These were from staff that work at either 36 or 38 Forest Road. All staff said they were supported well to do their job, through induction training, on going training relating to the job they do, and through regular supervision. The owners told us that the three quarters of the staff have either a minimum of a Level Two, National Vocational Qualification in Care or are working towards this level or above. We looked at a sample of staff records, and saw that all the necessary checks were made to safeguard people who live at the home. We looked at training records and this confirmed that staff have undertaken a wide range of training to help them in their Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: roles. Training included health and safety, medication management, working with autism, and working with challenging behaviour. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is managed effectively to provide an excellent quality of life for people who live there. Evidence: The previous registered manager has moved to a different position in the company. There is a new manager for the home and an application to become the registered manager has been received by the CSCI. The registered providers are very involved in the care of people living in the home. They support management well in ensuring that people who live there are very well supported in every aspect of their lives. There are quality assurance and monitoring systems in place, and we saw the last audit undertaken by the providers. We were informed that they have reviewed the style of the questionnaires and hope to have them in a user-friendlier format the next time they are used. The AQAA informed us of the policies and procedures the service works to, to ensure Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: good health and safety practice in the home. We were satisfied on reading this, and in observing practice during our visit, that staff have safe working practices. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 24 The provider should continue to work with the landlord in improving the external parts of the building. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!