Inspection on 10/12/08 for St Anne`s (Huddersfield)

This inspection was carried out on 10th December 2008.

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

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

St Anne`s (Huddersfield) 22/01/07

St Anne`s (Huddersfield) 24/02/06

St Anne`s (Huddersfield) 20/09/05

St Anne`s (Huddersfield) 04/01/05

St Anne`s (Huddersfield) 07/07/04

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Anne`s (Huddersfield) 3 Heaton Road Huddersfield West Yorkshire HD1 4HX     The quality rating for this care home is:   two star good 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: Eileen Engelmann     Date: 1 0 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. the things that people have said are important to them: They reflect 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. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 32 Information about the care home Name of care home: Address: St Anne`s (Huddersfield) 3 Heaton Road Huddersfield West Yorkshire HD1 4HX 01484435571 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Joanne Lesley Higgins Type of registration: Number of places registered: St Anne`s Community Services care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Can provide accommodation and care for one named service user at 3 Heaton Road category PD There will be no new admissions of service users aged 65 and over. Date of last inspection Brief description of the care home St Annes (Huddersfield) is the collective name for a project of three houses registered to provide residential care to adults with enduring mental health needs. The project is managed from Heaton Road and the manager oversees all three houses. Each house has their own staff team with some flexible working across the three houses. Cambridge Road, the larger of the homes is purpose built and provides single bedroom accommodation for up to ten people over two floors. It is close to the centre of Huddersfield. Heaton Road provides accommodation for up to six people and is some distance from local amenities. Beech Street, which is close to local amenities, provides accommodation for up to four people. Both date from Edwardian times and provide Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 20 20 Brief description of the care home single bedroom accommodation over four floors. Each of the three houses has communal facilities and gardens. Public transport is within walking distance of all three houses which are located in residential areas. The Commission was informed that as at 10 December 2008 fees ranged from 260.80 to 483.60 pounds per month. There are additional charges for hairdressing, chiropody and outings. Information about the home and the services it offers is available in the statement of purpose and service users guide, both of which can be obtained by contacting the home. Care Homes for Adults (18-65 years) Page 5 of 32 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: two star good 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 peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. Information has been gathered from a number of different sources over the past 23 months since the service had its last key visit from the Commission for Social Care Inspection, this has been analysed and used with information from this visit to reach the outcomes of this report. In June 2008 we did an Annual Service Review (ASR) for St. Annes. An ASR is part of our regulatory activity and is an assessment of our current knowledge of a service rather than an inspection. The published review is a result of the assessment and does Care Homes for Adults (18-65 years) Page 6 of 32 not come from our power to enter and inspect a service. The outcome of this ASR was that the service continued to provide people with good outcomes. The service did not have a registered manager at the time of this visit (December 2008) so for the purposes of this report we have referred to the acting manager as the manager throughout the text. This unannounced visit was carried out over one day and it took place with the manager, staff and people using the service. The visit included a tour of the premises, examination of staff and peoples files, and records relating to the service. Informal chats with staff and people living in the home took place during this visit; their comments have been included in this report. Questionnaires were sent out to a selection of people living in the home and staff. Their written response to these was good. We received 10 from staff (100 ) and 10 from people using the service (100 ). The manager completed an Annual Quality Assurance Assessment and returned this to us within the given timescale. There was an additional unannounced visit in October 2008 when our Pharmacy Inspector looked at issues around medication. The outcomes of this visit were good and we were satisfied that medication practises in the home were meeting the appropriate standard. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 32 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 9 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People undergo a full needs assessment and are given sufficient information about the home and its facilities prior to admission, to enable them to be confident that their needs can be met by the service. Evidence: Ten people using the service responded to our survey questionnaires, they all told us that they had agreed to move into the home. Nine people said they recieved enough information about the home before they moved in, so they were able to decide it would be the right place for them. Three people that we spoke to during our visit said they were able to look around the home on a number of occassions before deciding to move in. Three peoples care and records were looked at as part of this visit, they each have been provided with a written license agreement on admission, and these are signed by the person or their representative. Care Homes for Adults (18-65 years) Page 10 of 32 Evidence: We looked at three care plans during this visit, two were for people funded by the local authority and one was for a privately funded individual. In two care plans there was a copy of the community care assessment and Local Authority care plan and the third had an assessment completed by the home. Input from other professionals and/or family is also recorded and each plan is individualised to the person using the service. Information from the Annual Quality Assurance Assessment (completed by the manager in November 2008) and discussion with the manager and people living in the home indicates that the majority of the people using the service are of White/British nationality. The home does accept people with specific cultural or diverse needs and everyone is assessed on an individual basis. Discussion with the manager indicated that the home looks after a number of people from the local community, although placements are open to individuals from all areas. Staff members on duty were knowledgeable about the needs of each person they looked after and had a good understanding of the care given on a daily basis. Information from the peoples surveys showed that they were satisfied with the care they receive and have a good relationship with the staff. Information from the training files and training matrix indicates that the majority of staff are up to date with their basic mandatory safe working practice training, and have access to a range of more specialised subjects. Staff who responded to our surveys said St. Annes provides us with a good and thorough training programme, which ensures we have the right support, experience and skills to meet the different needs of the people using the service. Care Homes for Adults (18-65 years) Page 11 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to be independent within their daily lives using a risk assessment approach to care. Evidence: We looked at the care for three people, each individual has a person centred plan, which identifies their individual needs and abilities, choice and decisions and likes and dislikes. In addition to this information there are risk assessments to cover daily activities of life, behaviour management plans where a risk to the person or others has been identified, and clear information about health and input from professionals and the outcomes for people. Reviews of care with the families, person living in the home and care co-ordinator from the local authority are taking place and minutes of these meetings are in the plans. We noted that one persons care plan had not been evaluated since September 2008, Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: despite this individual going through a number of changes to their needs and self caring abilities. Another indivdiual self medicates and although there is a risk assessment in place it is basic and requires more detail to become robust and meaningful. These issues were discussed with the manager who assured us that they would be dealt with straight away. The manager told us that she had already identified the need to review the support plans for finances and self medication prior to our visit, and would ensure changes in care needs were also included in the review. Staff enable people to take responsible risks in their every day lives and information within the care plans includes a number of risk assessments covering activities of daily living. Talking to the people living in the home and watching them go about their daily business showed that the majority of individuals find it relatively easy to maintain their independence and are able to make their choices and decisions known without a lot of input from the staff. People we spoke to are able to live fairly independent lifestyles, one person told us I go out everyday and can do what I want to without having to ask staff for assistance. Staff who responded to our surveys said we provide a safe, secure environment for people, which promotes their rights to an independent lifestyle using an individual approach to care. Discussion with the manager indicated that the home has accessed IMCAs for two people in the past year and another has an appointee for financial matters due to a mental health condition. The rest of the people using the service are able to deal with their own finances and evidence in the care plans indicates this is part of their daily routines. Care Homes for Adults (18-65 years) Page 13 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities within the home and community means that people using the service have the opportunity to maintain and develop their social skills, and participate in stimulating and motivating activities that meet their individual needs, wants and aspirations. Evidence: People using the service are actively encouraged and supported to take part in community activities, further education and day centre facilities. The support to recovery service in Huddersfield has helped one person trace their family tree, one person takes part in their walking group each saturday, another individual attends for Information Technology and College classes and others take part in football activities. Pathways in Mirfield have a photography group and a walking Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: group and people can take part in environmental projects, wood work and gardening. Other groups that are accessed by people living in the home include Lifeline for those with alcohol related issues, Dash which is a group for older people and Workline where one person is applying to do voluntary work. The recording of activities, in the care plans, means that there is clear information about who enjoys what hobbies and interests and how these are accessed within the home and community. Two people showed us around their accommodation and said that they enjoyed life within the home, and that staff were helpful and supportive and always available if they needed to talk to anyone. On the day of our visit a number of individuals were out shopping, attending day centres and visiting the local amenities; others had chosen to stay in watching television or spending time in their rooms. Details of family and personal relationships are recorded in each persons file, these are very individual and staff offer support where required to maintain these contacts. On the whole people using the service are able to independently arrange visits and meetings with their friends and families at times and places to suit themselves. At the moment there are no church services in-house, but people can access the local church. One person attends the catholic church and choir. People living in the home are encouraged to celebrate Christian festivals such as Christmas, Easter and Harvest Festival; birthdays are celebrated in different ways depending on the individuals wishes. The people living in the home relate well to each other and the staff. The conversations between the people using the service and the staff were natural and spontaneous, and it was evident that the people living in the home have a good sense of humour and enjoy a laugh and a joke with others. We were made welcome in the home and it was clear throughout our visit that people were interested in what we were doing and went out of their way to let us into their daily lives. People living in the home are on the whole independent with their own meal planning, shopping and food preparation. Tea-time meals are cooked by people using the service, and each person has an allocated day, whilst staff cook on a Sunday. People that we spoke to said they are offered a choice of meals and can choose where they eat. During this visit people were observed making drinks, eating snacks and preparing the evening meal for others. The support needed by each person to undertake each task is recorded in their care plan, and staff ensure they recieve the help they require to suceed. Care Homes for Adults (18-65 years) Page 15 of 32 Care Homes for Adults (18-65 years) Page 16 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare needs are met through good inter-agency working and by the staff having a sound knowledge of each individuals needs. Evidence: It was apparent from discussions with the staff and observation of the people using the service that people require primarily support and encouragement to do as much as possible for themselves. Whilst a few individuals require some assistance with personal care such as bathing and washing, this is relatively low key and in the main consists of staff supervision and guidance. The staff are fully aware of the need to maintain peoples dignity and efforts are ongoing to achieve this whilst carrying out care tasks. The care plans are very detailed about individual wishes and routines so that peoples independence is supported and individuality is not lost. The home is able to offer people a choice of staff gender for carrying out personal tasks, as the home employs a good mix of male and female care staff. Discussion with the people living in the home indicates that they have no difficulties communicating with the staff and that they can express their preferences of staff gender for Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: individuals giving their personal care or acting as their support worker. In general there was a very flexible approach to the peoples routines although individuals have small housekeeping duties to perform. A plan of the housekeeping tasks for people to do is kept in the handover book and individuals have agreed to these in their care plans. People said that they have good access to their GPs, chiropody, dentist and optician services, with records of their visits being written into their care plans. They all have access to outpatient appointments at the hospital and records show that they have an escort from the home if wished. Comments from the people indicate they are satisfied with the level of medical support given to them and each person has their own healthcare record in their care plan. We carried out a random inspection at the service in October 2008 to look at medication, this was prompted by a number of medication errors being reported to us by the home. Our pharmacy inspector completed the visit and on the whole was pleased with the medication system and records. Two requirements were made at this visit A controlled drugs cabinet that meets legal requirements must be obtained, and There must be a system in place to make sure medicines are stored as instructed by the manufacturer, this includes putting a date of opening on when required. Checks at this visit found that staff have removed eye medication from the fridge in accordance with storage instructions and that dates of opening are now in place. This requirement is now met. Discussion with the manager indicated that the home is to purchase a controlled drug cabinet, even though at present no-one is using this type of medication. This should be in place by the end of January 2009. This requirement will remain on this report. Checks of the staff training programme showed that all staff have recieved medication training from Boots and are undergoing their level 2 certficates in medication with Park Lane College, Leeds. People who self medicate have risk assessments in place, but these need to be more detailed and robust to ensure people are able to maintain their independence whilst remaining safe (see section 2 of this report). One persons medication had been hand written (transcribed) onto the medication sheets, as they had come in after the pharmacist had printed the records. We recommended that where staff are writing in the details, there should be two staff Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: signing the entry to indicate they have both witnessed that the information on the sheet (name of medication, strength and administration methods) is correct. We found an inhalor for a named individual in the medication cabinet, and the inhalor was out of date. Staff immediately disposed of it and ordered a new one. It was noted that this person was not taking the inhalor daily as prescribed and staff were advised that this must be put into practise. At the time of this visit there were no fridge medications in use and no controlled drugs. Care Homes for Adults (18-65 years) Page 19 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints system with some evidence that peoples views are listened to and acted upon. Evidence: The home has a complaints policy and procedure that is found within the statement of purpose and service user guide. It is discussed at care reviews and given out to people in a leaflet format. Peoples survey responses showed individuals have a clear understanding about how to make their views and opinions heard and those people spoken to said we can always talk to the staff or the manager. One person told us I have made a complaint in the past and the staff supported me through the process. Checks of the homes complaint record shows that there have been some minor issues where people using the service have made complaints about other people in the home, but these have been investigated by the manager and quickly resolved. Staff training records examined during our visit show that all staff recieve safeguarding training every 6 months and the home is purchasing a training DVD to ensure staff have easy access to information. One member of staff is booked to do their Train the Trainer course in February 2009, so they can deliver safeguarding training to existing Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: staff and new employees. One safeguarding allegation has been made in the past twelve months. The allegation was investigated by Huddersfield Social Services and found to be untrue. No further action was necessary. Discussion with the people using the service indicates that they feel safe within the home and are confident that staff would help them if they had any concerns or problems. We observed staff making their daily checks of the peoples finances. Satisfactory records are held and receipts kept were necessary. Indivdiuals are offered support were needed and this is recorded in their care plan. Care Homes for Adults (18-65 years) Page 21 of 32 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. The environment provides people with safe, comfortable and homely surroundings in which to live, that meet their individual needs and lifestyles. Evidence: As part of this visit we looked around each of the three homes that make up this service. The homes are clean and odour free, and there is evidence of ongoing maintenance and redecoration. People showed us around their bedrooms, which are personalised with their own belongings. In each house there are single occupancy rooms, which are not en-suite, but have bathrooms and toilets in close proximity to the living accommodation. There are communal lounges and dining rooms in each home, and all three premises have a friendly and homely atmosphere. At Heaton Road new windows have been fitted throughout the property, there is a new shower to the ground floor and hand rails fitted inside and outside of the property. The dining room, lounge, kitchen and one bedroom have been redecorated and a carpet has been replaced in one bedroom. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: All three homes are decorated to a good standard and there is a record of replacement and refurbishment available for inspection. The manager told us she carries out a health and safety audit each month and any request for repairs is sent to the maintenance department who visit each home monthly. The homes laundry facilities are clean and well organised, discussion with the manager indicated that people are allocated their own wash day and supported to do their own laundry. Care Homes for Adults (18-65 years) Page 23 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff morale is high resulting in an enthusiastic workforce that works positively with people to improve their whole quality of life. Evidence: Information from our staff surveys indicates that the majority of staff feel there is sufficient staff on duty to meet the needs of the people using the service. Information from the staffing rotas and the annual quality assurance assessment (November 2008) show that 576 staffing hours a week are being provided for the service, an additional 55.5 hours are provided by non care staff. At the time of this visit in December 2008 there were 20 people using the service and the staffing levels were at least two care staff on duty during the day time and one staff member on duty at night for each of the three homes. Using information about dependency levels provided by the manager at the this visit, checks against the Residential staffing forum guidelines for a Mental Health home show that staffing hours are being met. 50 of care staff have completed their NVQ 2 in care and new starters complete an Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: induction programme when they start in post. Each staff member has their own training file and knows what training they must attend each year. The staff training files indicate most people are up to date with their mandatory safe working practise training and that they have access to more specialised subjects linked to mental health and the needs of the people using the service. We recommend that the manager produces a staffing matrix to clearly show all the training attended and by who, plus dates of when sessions need to be refreshed or updated. Checks of the staffing rotas and observation of the service showed that the home employs male and female care staff and a number of staff are from different countries and cultures. The service is also an equal opportunities employer and has staff with disabilities on its payrole. The home has a recruitment policy and procedure that the manager understands and uses when taking on new members of staff. Checks of staff files showed that police (CRB) checks, written references, health checks and past work history are all obtained and satisfactory before the person starts work. The employment records show that the manager is using a selective approach to recruitment; ensuring new staff have the right skills and attitude to meet the needs of people in the home. Care Homes for Adults (18-65 years) Page 25 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. Evidence: There is no registered manager for the service at present, although the acting manager has been in post since December 2007 and has submitted her application to register as manager with us. We have referred to the acting manager as the manager throughout this report. There is a deputy manager at one of the other homes and together with senior care staff they assist the manager in the effective running of the service. Throughout this visit the manager demonstrated a good understanding of what constitutes good care and provided numerous examples on how that could be achieved. From discussions with the people using the service and the staff, it was apparent that the manager possessed good leadership skills. Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: The manager has a democratic style that involves the people living in the home and the staff in the decision making processes. The home does not have a formal quality assurance process in place, but does have a range of quality monitoring systems in use. We spent some time discussing these with the manager and we recommended that she develop more robust audits covering all aspects of the service. Policies and procedures within the home have been reviewed and updated to meet current legislation and good practice advice from the Department of Health, local/health authorities and specialist/professional organisations. Feedback is sought from the people living in the home through regular satisfaction questionnaires, and the manager is including other stakeholders in this process to gain more viewpoints on the quality of the service. The manager is also aware that she must produce a development report as part of this process to highlight where the service is going and/or indicate how the management team is addressing any shortfalls in the service. We looked at the responses to the surveys sent out in August 2008, the manager has collated the information and made changes to the service accordingly. House meetings have moved from weekly to monthly in response to peoples input, activities have improved with the introduction of the homes own walking club and beauty therapy group. One person told us that they meet other people at the local bus station, get on a bus to a certain point and from there go for a group walk which ends at a cafe for drinks and snacks. This is being organised by a care worker from one of the homes and is proving to be very popular with people. Meetings for people using the service are held on a regular basis and minutes are available for those expressing an interest. Staff have meetings with the manager and everyone is encouraged to join in with discussions and voice their opinions. People and staff agreed that they are able to express ideas; criticisms and concerns without prejudice and the management team will take action where necessary to bring about positive change. Maintenance certificates are in place and up to date for all the utilities and equipment within the building. Accident books are filled in appropriately and regulation 37 reports completed and sent on to the Commission where appropriate. Staff have received training in safe working practices and the manager has completed Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: generic risk assessments for a safe environment within the home. Risk assessments were seen regarding fire and daily activities of living. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R 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 29 of 32 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 Requirement 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 Requirement Timescale for action 1 20 13 A controlled drugs cabinet that meets legal requirements must be obtained. This will make sure that the home is complying with the new legislation for storing controlled drugs to make sure they are secure. 02/02/2009 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 7 The manager should ensure that where a persons needs are changing, these are reviewed and updated on a more regular basis. So care being given is appropriate to their needs. The manager should make sure that risk assessments around self medication are detailed and informative, so they promote a persons independance whilst keeping them safe. The manager should check the medication records to ensure that where staff are hand writing medication onto the sheets (transcribing), there are two staff signing the entry to indicate they have both witnessed that the 2 9 3 20 Care Homes for Adults (18-65 years) Page 30 of 32 information on the sheet (name of medication, strength and administration methods) is correct. 4 35 The manager should produce a staff training matrix to show what training has been attended, what is yet to be achieved and by whom. It should also show what refresher training and updates are needed, when and by whom. The registered provider should ensure there is a registered manager in place by the end of April 2009. The manager should widen the range of audits completed as part of the quality assurance process to ensure all aspects of the service are monitored. The manager should also produce a development report as part of the quality assurance process to highlight where the service is going and/or indicate how the management team is addressing any shortfalls in the service. 5 6 37 39 7 39 Care Homes for Adults (18-65 years) Page 31 of 32 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 © (2009) Commission for Social Care Inspection (CSCI). 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