Inspection on 15/04/08 for St Blaise Avenue (2)

This inspection was carried out on 15th April 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Blaise Avenue (2) 06/06/06

St Blaise Avenue (2) 20/02/06

St Blaise Avenue (2) 24/11/05

St Blaise Avenue (2) 13/01/05

St Blaise Avenue (2) 04/10/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 St Blaise Avenue (2) 2 St Blaise Avenue Bromley Kent BR1 3DA Lead Inspector Ann Wiseman Unannounced Inspection 15th April 2008 09:00 St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Blaise Avenue (2) Address 2 St Blaise Avenue Bromley Kent BR1 3DA 020 8460 1851 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Maxine.shaw@bromley.gov.uk London Borough Bromley vacant post Care Home 5 Category(ies) of Learning disability (5) registration, with number of places St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care Home Only (CRH - PC) to service users of the following gender: EITHER whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 6th June 2006 Date of last inspection Brief Description of the Service: St Blaise is a two story semi-detached house in a residential road within walking distance of Bromley’s main shopping centre and is convenient for all local amenities and public transport. The home is part of the London Borough of Bromley’s care provision in the Learning Disability sector. The home provides support for five people all whom have a learning disability, currently there are four people living in the house. People are supported in all activities in their day-to-day living, friends and families are encouraged to participate in their lives and leisure activities. There is a garden to the front with parking for two cars and a good sized back garden. Policies, procedures and recruitment are organised through the central office of London Borough of Bromley. Senior staff management and staff support are provided through the local authority. The weekly cost of this service is £997, the people living in the home, on average, personally contributes £35 a week towards the cost. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience Adequate quality outcomes. This was an unannounced inspection and took place over six hours. The registered manager was absent due to illness and has been since January 08, an acting manager has been put in place while she is away. The manager has since returned to work at the beginning of May. When we arrived staff members were gathering as there was going to be a team meeting. While we were waiting for the acting manager to arrive we were given a tour of the house by one of the care staff. The acting manager made the files and records available for us to inspect while the staff meeting went ahead. The acting manager has sent us the Annual Quality Assurance Assessment (AQAA) she had completed. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. We talked to the acting manager and took advantage of so many of the staff being around and talked with five of them. We spoke to the manager on her return to work. We had previously sent questionnaires to the people living in the home, their family members and other professionals involved to give them an opportunity to give us their opinions on how the home is run. There are four people living in the home at the moment. One staff member helped them to complete their survey and they indicated that they were happy in the home although one person wanted to get out more. Of the relatives who responded all said the staff were caring but two people felt that communication between staff and families could be improved, as they are not always given information in a timely manner. They also felt that complaints are slow to be dealt with. One relative said they were not always happy with the outcome of the complaints they had made and had lost confidence with the complaints system, believing the service does not take them seriously. Relatives raised another concern they had saying that there is not enough staff on duty to enable their relatives to get out into the community and there are not enough in house activities on offer. The manager has said that she is reviewing the rota and intends bringing staff in to work at times of the day that will better suit the needs of the people living in the home. What the service does well: This home has an established staff team, some of whom have been working with the people living in this home for many years. It was apparent that the St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 6 care staff have a good knowledge of the needs of people with learning disabilities. People living in the home are given opportunities to have their say about the running of the home by attending the regular house meeting that are held. Relatives are invited to attend provider meetings that are held at the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2 and 4 were examined on this occasion. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who live in this home have had their individual aspirations and needs assessed and people hoping to move in are given an opportunity to “test drive” the home. EVIDENCE: There is a statement of purpose and user guide in place and the Annual Quality Assurance Assessment says that the home has polices and procedures in place for when people move in. St Blaise has a vacancy due to a recent bereavement. The acting manager said that they are using the opportunity while filling the vacancy to test and review their procedures and have developed a flow chart to clarify responsibility, smooth out the admission process and to keep a check that the procedures are followed properly. Files and records show that in the past people were able to visit the home and stay over for a few days before moving into the home. We saw records of these visits on people’s files as well as evidence that their placements were reviewed after six weeks and again at six months. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 8, 9 and 10 were examined on this occasion. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who live in this home know that their assessed and changing needs and personal goals are reflected in their individual plans. They are able to make decisions for themselves. People are consulted on and participate in all aspects of life in the home. Risk assessments are in place and personal information is handled appropriately. EVIDENCE: We examined two files during the visit to the home. Care Plans are detailed and are reviewed regularly. Person Centred Planning meetings are held annually and People are supported to set new goals and review the progress of previous ones. Both of the files contained some notes and reports that were not dated or signed by the person who wrote them. It is important that all documents are dated so that reviews can be tracked. If there is no evidence of date or ownership the contents of the report will be devalued, as it cannot be placed in a time line or put into context. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 10 Skills, Teaching and Assessment of Risk Assessments (STAR Assessments) are completed for every person living in the house. One assessment mentioned that the Kent Association for the Blind have been asked to advise on how the home can better support on of the people living there. People are free to choose to spend time on their own in their own room if they want. Staff respect this choice and protect privacy by only entering a room once they have been invited to by the person whose room it is. The way the care plans were written clearly reflected that this would be expected usual practice. Relatives have said that they have witnessed staff knock on doors and wait for a response before entering. As we toured the home the staff member talked about how certain people liked to spend time in their rooms and preferred not to be disturbed. People help to plan the menu and some go with the staff when they go food shopping. House meetings are held regularly when people can discuss how the house is run and have their say if they are unhappy about anything. We examined the records that are kept and noted that an agenda is set and people present were recorded as well as the outcomes of discussions that take place. All personal information is stored in the office in a locked filing cabinet. We saw notes on the personal files that told people that they can have access to the information they contain if they wish and explained that there are some people who need to see the files and why. Where able the people have signed the note to give their consent to others seeing them. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11, 12, 13, 14, 15, 16 and 17 were judged during this inspection. People who use the service receive Adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People living in this home are offered some limited opportunities for personal development, have contact with family and friends, hold responsibilities within the house and are offered a varied diet. EVIDENCE: Some opportunities are offered to the people to further their development, of the four people who live in the house only one person travels independently, of the others, two people are reluctant to leave the house and do not always attend their day centres. While it is good that staff respect peoples right to decline to take part in activities inside and out of the home it is not always beneficial to their personal development to be left without meaningful activities to occupy their time. The manager and staff members told us that they have been working with those people who prefer to stay in and some headway has been made. People St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 12 are beginning to get out occasionally, this is a good outcome and work needs to continue. However other people living in the home have told us that they feel that they are not given enough opportunities to go out and nor are there enough activities arranged in the home. There is no way of getting an overview of what activities are offered, how many people refused to go and who actually goes out and where they go because the home has no way of recording activities. This has been an ongoing omission and has been subject to requirements in previous reports. An activity sheet was set up but was completed only once in a while and was abandoned soon after. One person’s family member said that they believed that their relative lost out on opportunities to go out because only two staff are normally on duty, sometimes there is only one staff member in the home, this severely restricts people getting out if some of the people decline to take part in an activity. One person said that they would like to go to the pub, play some snooker, pitch and putt or to go swimming in their leisure time but they don’t often get the chance and they also said that more in-house activities should offered. It is presently usual practice for one of the morning staff to go off duty at 9am on weekdays. With some of the people choosing not to attend their day centre, this further limits opportunities for people to get out and about and has a detrimental effect on people’s day off from centre when staff aim to work on a 1-1 basis with them. During their training day people are encouraged to tidy their bedroom and to take part in other domestic tasks. The manager has said that she is going to reassess the rota and make more staff available at times when more people are at home so their needs can be properly addressed. One person has been allocated more care hours and someone comes in at the weekend to work with them on a 1-1 basis, this has given staff more opportunities to them to work with others in the house. The home does not have it’s own transport, which restricts where people can go as some have difficulties that make it almost imposable for them to use public transport. People keep in contact with their families and friends and records show that relatives visit often and some people go to stay with their families. We looked in the food cupboards, fridge and freezers and they were well stocked with ingredients for healthy meals and the menus were varied. People living in the home help to chose the menus during house meetings. While inspecting the kitchen in the afternoon we noticed a pan on the cooker covered with tinfoil. It was a chicken stew that had been prepared for dinner. Staff said that it had been cooked that morning but the large pan was completely cold, indicating it had been cooked and left without refrigeration for several hours. Cooking food in advance and reheating it goes against good food hygiene guidelines. One of the staff members acknowledged that food should not be cooked in advanced and kept in a warm kitchen for several hours making it a possible a health hazard. It is of concern that the other staff member did not agree that it was poor practice despite confirming that she had undertaken food hygiene training. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 18, 19, 20 and 21 were inspected on this occasion. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The people who live in this home receive personal care as they prefer, have their health needs addressed and medication is stored and administered in a way that promotes safe practice. EVIDENCE: We viewed two care plan’s, they were well written and reviewed regularly, needs were assessed and there was enough detail to enable people to receive the personal care they need in the way that they would prefer. Everyone is registered with the local doctor and personal files examined showed evidence that the support of other health care agencies were sought if the need arose, for example Speech and Language and Psychology. Other expert guidance is accessed thought the Bassett Centre and the Kent Association for the Blind. If people do not have anyone independent of the home to speak up and protect their rights or they are assessed as having a need, they will be referred to the advocacy service. One person already has an advocate appointed. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 14 No one have been assessed as being able to self medicate and all medication is stored in a locked medication cabinet fixed to the wall in the office, on examination of the cabinet all the medication was found to be in order, there were no gaps on the recording sheet and there were photographs of the people in place. This service is using the system managed by Boots the Chemist, who blister the medication, deliver it and will undertake audits of it’s storage and the administration of the medication and offer training. Staff said that they would expect to care for the people living in the home through changes due to age or illness for as long as their abilities and training allow. Recently someone whose health has been deteriorating for some time was taken into hospital and was supported by the staff team. Records show that they worked hard to make sure that the person in hospital was well cared for during the illness staff often worked extra shifts. Sadly the person passed away and we would like to offer our condolences to the other people living in the home and the staff team. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Both Key Standards 22 and 23 were inspected during this inspection. People who use the service receive Adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. This home is run by the local authority and so uses its complaints procedure. It does not always work within the set timescales and some people have lost confidence in the system. People are protected from abuse. EVIDENCE: This home has a robust complaints procedure in place, it uses the boroughs corporate procedure. We have looked at the procedure and it recording, the way that complaints are recorded makes it possible to follow a complaint from the start to its completion. The file contained evidence that someone living in the home was assisted to make a complaint by his or her key worker and we saw that it was investigated and the findings were explained to the person and they were given an apology. Relatives of people who have responded to our survey have said that when they have made a complaint it can take a long time to receive a reply and sometimes they are not satisfied with the answer and are left feeling frustrated and dissatisfied, one relative said “we have made complaints but have felt the issues have never been fully resolved” and “Frankly I have no faith in the system at all.” Another relative commented, “ I have made one or two complaints but it does take forever to receive confirmation or a written reply.” St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 16 People being dissatisfied with the how complaints have been managed has been a reoccurring theme at St Blaise and has been mentioned in previous reports. The recent change in manager has been welcomed by the relatives we spoke to, she has made a good first impression on them, they say she is easy to talk to and they have noticed she has started to make positive changes in the way the home is run. With a new manager in place it would be a good opportunity for her to take proactive steps towards strengthening the homes procedures and rebuilding relationships with the relatives that have felt dissatisfied when they have voiced concerns and complaints in the past. Safeguarding polices and procedures are in place and the acting manager and staff we spoke to demonstrated a good understanding of them. They were able to tell me what they understood by the terms adult protection and whistle blowing. The staff also knew what they would do if they suspected or witnessed people being abused and understood the different forms of abuse. Staff files contained evidence that safeguarding training was given and staff confirmed that they had attended the sessions and that updates where planned. The staff files also confirmed that the required checks had been carried out before staff started working in the home. Recently an adult protection concern was raised. The outcome was that it was not an abuse situation and it was not taken further. A staff member had been concerned by a comment made by a person living in the home. The staff member said they had mentioned it to the manager but the investigation was not instigated until the comment was shared with a visiting health professional who took it further. The manager and staff must act immediately when concerns are raised. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 24 and 30 were inspected on this occasion. People who use the service receive Adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. St Blaise is a comfortable, safe environment that is need of new carpets, some redecoration and repair. The home is clean and hygienic except for the carpets in communal areas and some of the bedrooms that are worn and very dirty. EVIDENCE: There has been some redecoration since the last inspection and consisted of a coat of paint over the existing woodchip wallpaper. There are areas that already need redoing, such as a wall in the kitchen that has been water damaged caused by a leaking shower. The wall in the front garden was still waiting repair and has been in the same condition for the last three years. The garden at the front of the house was untidy, the grass needed cutting and litter that had blown in was left among the plants and bushes. On approaching it, the house does not give the impression of a well kept and maintained home. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 18 The back garden is accessible to all of the people living in the home but is also in need of a tidy up, there was some rubbish that needs to be removed including a shopping trolley. A gardener has been employed through Job Match, an organisation that works towards finding work for people who have a learning disability. The gardener was due to start work at the end of April. The manager has agreed that the home would benefit from having a few more homely touches and has plans to add them; She has already installed new blinds in the kitchen and has bought some wallpaper boarders to make the rooms more individual. People have already been viewing the vacant bedroom while looking for somewhere to live, but no one has shown an interest so far. When we saw the bedroom it did not have a bed or curtains, the walls were marked and dirty and the carpet was also stained. What was left in the room was in need of a good clean and the furniture was mismatched and dusty. It was not an inviting room to people thinking of moving in. The manager assured us that the room would be decorated and properly furnished before anyone does moves in. The carpets throughout the house are in need of replacing. They are worn in places and are very dirty. The condition of the carpets has been an ongoing concern to us and they must now be changed. If new carpets are not going to provided quickly the existing carpets must be professionally cleaned as an interim measure. It is apparent from the number and nature of the stains to the carpets in this home that care is not being taken of the carpets here. It would benefit the homes environment if carpets were cleaned as the spill occurs and the life of the new carpets would be prolonged. It is the staff’s responsibility to maintain cleanliness in the home and the people living in the home are encouraged to assist them. It was mainly clean apart from the carpets and was free from offensive smells. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 and 36 were examined during this visit. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The people living in this home are supported by staff that are competent, qualified and trained. People are protected by the homes recruitment policies and staff are supported and supervised. EVIDENCE: Two staff files were examined and they contained copies of the job description, job specification and evidence that CRB checks are carried out. The files also contained copies of the references obtained and indicates that the required recruitment policies and practices are in place. The home has the required percentage of qualified staff. The manager has attained her NVQ4 and Registered Managers Award, and of the four permanent care staff two have an NVQ qualification in care. It would be good practice if the home were to work towards all of it’s permanent staff gaining a care qualification. It is usual for staff to be working on their own with one or more of the people at home, one of which can be quite challenging. It has previously been established that the lone working risk assessment is generic to all staff. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 20 It is not good practice to have a generic risk assessment as the people who live in the home have different needs in supervision and staff have different skills, capabilities and health needs. It was a previous a requirement that lone working risk assessments are carried out for each staff member individually, this has not been done yet. The assessment must take into account each individuals skills and experience as well as their health needs; for example if a staff member is diabetic, are her sugar levels well controlled and what steps will she take to keep herself in good health? Also the differing needs of the people living in the home and how they interact together should be taken into consideration. The risk assessment must state what safeguards will be needed to defuse challenging situations and what support the other people will get while the carer is otherwise distracted. Health and safety issues particularly relevant to working alone, such as minimising the chance of accidents happening will need to be considered. This is the second time this requirement has been made; failure to comply with the requirement may lead to us taking enforcement action. Training offered is varied and includes First Aid, Adult Protection, Physical Care, Food Hygiene, Visual awareness, Manual Handling, Managing Challenging Behaviour, Person Centred Planning, Medication Awareness, Supporting Communication, Working with Diversity, Fire safety and Dementia Care. There is evidence on file that staff attended the training offered and supervision notes seen indicate that formal supervision is given regularly. All of the staff we spoke to displayed a genuinely caring attitude and were able to answer our questions in a way that showed they had a good knowledge of the needs of people who have a learning disability. They confirmed that they have not started work until all the safeguarding checks had been made. They also said that they had taken part in the training and are given supervision and annual appraisals. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key standards 37, 39, and 42 were judged during this inspection. People who use the service receive Good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who live in this home benefit from a well run home and can be confident their views are listened to. Health and safety is properly addressed. EVIDENCE: The manager is still going through the registration process but has finished the registered manager award and her NVQ4 in care so is suitably qualified for the post and continues to undertake training and development to update her knowledge, skills and competence while maintaining the home. Staff and family members that we have spoken to say that the manager was settling in quickly and has begun to make changes for the better in the house, relatives have made positive comments and say they find her easy to talk to. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 22 People are given the opportunity to comment on the quality care they receive during key worker time and house meetings, we saw notes that are kept of both meetings during our visit. Care files contained copies of letters sent to relatives to invite them to attend provider meetings. Quality assurance questionnaires are given to people living in the house and their relatives annually. We saw those from previous years and were told that this years surveys had just been sent out and the manager is waiting for them to come back. The home keeps us informed of any significant incident that happens. Regulation 26 visits are made regularly and reports of the visits are kept. In the past this service has sent a copy of the report to us, it is no longer necessary, as we can access them during site visits. The staff we spoke to confirmed that they had undertaken moving and handling training and that it was regularly updated. The two staff files we looked at had copies of the training certificates. We examined a sample of the health and safety records and they were found to be in order. The fire equipment was last checked in July 07 and the portable electrical equipment was tested in September 07. The environmental health officer visited the house on 4th April 08 and found three minor areas that needed attention, all have been done since this visit. The London Borough of Bromley Health and Safety Officer carried out a check on 7th April 08 and found some small issues that need to be addressed such as lights in the kitchen without covers, an extractor fan that was not working due to a build up of dust and paving stones in the garden being uneven. The manager assured us that all of the areas raised would be attended to. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 x St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA14 Regulation 24 Requirement Timescale for action 20/09/08 2. YA17 16(2i) 3. YA23 13(6) 4. YA24 23(2d) There must be a continuing review and improvement of the quality of care provided in the home, in particular to monitor that sufficient staff are employed to meet the needs of the people living of the home to enable them to go out, take part in activities in the home and to enable 1-1 training time to go ahead. Food offered to the people living 20/09/08 in the home must only be prepared in a way that minimises the risk of harm to those eating it. There must not be any delay in 20/08/08 dealing with and reporting suspected abuse, delay in reporting abuse will cause people to continue being harmed unnecessary. The majority of the carpets in 20/09/08 the home are worn in places, are stained and are unhygienic. They must be replaced, if there is an unavoidable delay in fitting the new carpets of more than four weeks the existing carpets must be professionally cleaned. DS0000038974.V361705.R01.S.doc Version 5.2 St Blaise Avenue (2) Page 25 5. YA42 12 To keep people living in the home safe when there is only one staff member in the home with them lone working risk assessments are to be carried out for each staff member individually. They must take into account their skills and experience as well as their health needs, also the differing needs of the people at home should be considered. The risk assessment must also consider health and safety issues particularly relevant to working alone. This is a restated requirement, previous timescale 04/10/06 20/09/08 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 YA14 Good Practice Recommendations It is recommended that records are kept of any activity that is planed to take place and the record should include information about whether the intended activity happened and why if not. This would allow the home to monitor what activities that actually take place and to better cater to the wishes of the people living in the home. People living in the home have said they would like it if more in- house activities took place. It is recommended that the home set up a timetable of regular activities. The home does not have it’s own transport, which restricts where people can go as some have difficulties that make it almost imposable for them to use public transport. It is recommended that they should consider either obtaining their own vehicle or obtaining access to one. It is recommended that the new manager should take the opportunity of being a “new broom” to improve the way that this home deals with complaints and therefore build better relationships with relatives that have been DS0000038974.V361705.R01.S.doc Version 5.2 Page 26 2. 3. YA14 YA14 4. YA22 St Blaise Avenue (2) 5. YA25 6. YA24 dissatisfied with the way complaints have been managed in the past. It is recommended that the vacant room is made to look ready and inviting so that people thinking of moving into the home can better appreciate what it would be like to live in this home. All staff should take responsibility to keep the home well maintained and clean. This should include cleaning up spillages as they happen and take steps to prevent damage to carpets etc. This will keep the home looking fresh and welcoming. St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Blaise Avenue (2) DS0000038974.V361705.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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