CARE HOME ADULTS 18-65
St Patrick`s House Porton Road Amesbury Wiltshire SP4 7LL Lead Inspector
Elaine Barber Key Unannounced Inspection 16th November 2006 10:30 St Patrick`s House DS0000060340.V319897.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 Patrick`s House DS0000060340.V319897.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 Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service St Patrick`s House Address Porton Road Amesbury Wiltshire SP4 7LL 01980 626434 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) Cornerstones (UK) Ltd John Edwin Maloret Care Home 8 Category(ies) of Learning disability (8), Physical disability (1) registration, with number of places St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Only the one, named, male service user currently in residence in the age range 18 - 64 years with a physical disability may be accommodated in the home. Any placement for short-term care must be agreed with the Commission before placement commences. For the purpose of this condition, short term is defined as a placement that will not last longer than three months. Any placement that will last longer than three months must be reviewed to assess the short-term status of the service user. Any placement of an emergency admission must be notified to Commission in advance where possible, or within the next working day, or two days if over a weekend. An emergency admission is defined as an admission where a service user is likely to be placed at short notice without an up to date assessment of needs having been carried out and the person has not had the opportunity to visit the home prior to placement. 18th November 2005 3. Date of last inspection Brief Description of the Service: St Patrick’s House is an 8 bedded home for adults with learning disabilities aged 18 - 65 years. Both male and female service users may be admitted. The home provides a service to people who may require high level support with behavioural problems, communication difficulties and psychological problems. The home does not provide care for people requiring high levels of support for personal care needs. The home is one of 6 homes owned by Cornerstones UK Ltd, a company run by Mr and Mrs Sinclair. One of the other homes is adjacent to St Patrick’s. St Patricks is a large chalet bungalow with a large garden to the rear of the property and space at the front for several vehicles. It is within walking distance of Amesbury town centre and local amenities. The home was first registered on 31st January 2003. At least four staff are on duty during the day time and two staff sleep in at night. The fees range between £1500 and £2000 a week. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit to the home on 16th November 2006 and a planned visit on 21st November 2006. During the visits information was gathered using: • • • • • Observation Discussion with four people who lived in the home Discussion with three staff Discussion with the manager Reading records including care records. Other information and feedback about the home has been received and taken into account as part of this inspection: • • • The manager provided information prior to the inspection about the running of the home. Four comment cards were received from staff members. A random inspection was conducted in April 2006. The judgements contained in this report have been made from all this evidence gathered during the inspection, including the three inspection visits. What the service does well:
People’s individual needs were assessed so that their needs could be met. People had the opportunity to visit the home so that they were familiar with the home and the people who lived there before moving in. Arrangements for moving into the home were suited to individual needs. Each person had a detailed individual support plan to address personal and health care needs and any assistance they needed to manage their behaviour. People had their abilities, needs and goals reflected in their individual plans to ensure that their needs would be met. People were offered choices and people made decisions about their lives with assistance as needed. There were a range of individual risk assessments and people were supported to take risks and given opportunities for independence. People were provided with a range of activities and opportunities, offering access to their local community. These included holidays, shopping trips, going to the cinema, pub and out for meals. People were able to maintain and develop appropriate relationships with family and friends. People’s rights were respected and their responsibilities were recognised in their daily lives. There was a varied menu, which reflected people’s choices. People were offered a healthy diet and enjoyed their meals. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 6 People had detailed support plans so that they received support in ways they preferred and required. They had access to a range of health care professionals and their physical and emotional health needs were met. Medication was appropriately stored and people had their medication reviewed regularly. People were generally protected by the home’s policies and practices about medication. There was a complaints procedure and people were supported to make complaints. Complaints were investigated, records were made and people were informed of the outcome. People who were spoken to knew how to complain. People’s views were listened to and acted upon. There was information about the local vulnerable adults procedures and staff had received training about protection of vulnerable adults. This ensured that people were protected from harm. The accommodation was spacious with a large lounge and kitchen dining area. Each person had a large bedroom, which was individually decorated and had an ensuite bathroom or shower. People said that they liked their rooms. There were two laundry areas with facilities to meet the laundry demands. The home was clean and tidy and areas seen appeared to be well decorated. People lived in a comfortable, clean and safe environment, suitable to their needs. There was a minimum of three staff on duty at any time during the day. The numbers of staff increased to support people with their activities and appointments. There was a training programme and new staff had learning disability award framework induction and foundation training. Three people had National Vocational Qualifications (NVQ) at Level three, two people were working towards level two and four more staff were due to register for NVQ. There was a range of training for staff. People were supported by an effective staff team, who were appropriately trained and competent to meet their needs. People were protected by the home’s recruitment practices. New staff had an interview, two written references were obtained and Criminal Records Bureau and Protection of Vulnerable Adults checks were obtained before new staff started work. Arrangements for supervision and appraisal had been made so that people would benefit from well supported and supervised staff. The registered manager was suitably qualified, competent and experienced, so that people benefited from a well run home. A quality assurance survey had been conducted and views of people who lived in the home and relevant professionals had been collected. People’s views underpinned all selfmonitoring, review and development by the home although the report about these views needs to be published. There was a range of health and safety measures and staff had received appropriate training. People’s health and safety were protected by the majority of the systems in place. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection?
A recommendation was made at the last inspection that all care plans should have the same format. Changes had been made to all the support plans and each person had a new style support plan to ensure a consistent approach. A recommendation was also made that staff should record light snacks on the menu consistently. The records showed that light snacks were being recorded to show the full diet that was being taken. In response to a requirement at the last inspection improvements had been made to the recording of medication. This would ensure that when medication was administered the right medication was given to the right person at the right time. A recommendation was also made that the complaint record should be checked every three months and the manager was checking and auditing three monthly. This would identify whether there were any patterns to complaints and the information could contribute to quality assurance. A requirement was made at the previous inspection that all staff must receive training about prevention from abuse. All staff had received training. The four members of staff who completed comment cards were aware of the adult protection procedures. This would ensure that staff knew how to respond to an allegation of abuse and people would be protected. A recommendation was made at the last inspection that receipts should be attached to the monthly log sheets of personal finances that they were related to. Receipts were attached to the appropriate monthly records. A recommendation was also made that the financial records should be audited and monitored by someone external to the team. The records were being audited by a senior manager as part of the monthly Regulation 26 visits. These measures would ensure that people’s financial interests were safeguarded. A recommendation was made at the previous inspection that advice should be sought from an occupational therapist about modifications to a shower. Advice had been sought and a new walk in shower had been installed for the benefit of one person who had a physical disability. In response to a requirement at the previous inspection a weekly check was being made of the fire alarm system and this was being recorded. This would ensure that people would be alerted promptly in the event of a fire so they could be kept safe. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 8 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 Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 9 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 Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 10 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): 2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s individual needs were assessed so that their needs could be met. People had the opportunity to visit the home so that hey were familiar with the home and the people who lived there before moving in. EVIDENCE: One person had been admitted to the home since the last inspection. Information about this person was sent to the inspector before and after admission. The person had an assessment conducted by an occupational threrapist. They had been admitted from hospital and they had made one visit to the home before moving in. A meeting was held between professionals from the hospital and staff from St Patricks to discuss the assessment, care plan and admission. At the meeting it was decided that it was in the persons interests to move in without further visits because of their particular needs. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including visits to this service. People had their abilities, needs and goals reflected in their individual plans. People made decisions about their lives with assistance as needed. People were supported to take risks and given opportunities for independence. EVIDENCE: The care records of three people were seen. Each person had a very detailed support plan including personal care, health care, support with behaviour and a physical intervention plan. A new care plan format had been introduced for each person. The plans were very detailed and clear and easy to amend as needs changed. The plans were evaluated monthly and were reviewed according to the needs of the person but at least six monthly. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 12 The evaluations were very detailed and provided evidence of how people made choices and decisions about their lives. For example they showed how people chose to go out or take part in activities and when they contacted their families. People had individual rooms and had made decisions about how to furnish and decorate them. One person had a health problem, which needed some dietary control. The staff were arranging a multi-professional planning meeting to help the person to decide how to manage this. There were detailed risk assessments, which included environmental and behavioural risks. These included control measures and action to be taken to reduce risks. The focus of the risk assessments was on promoting independence. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including visits to this service. People were provided with a range of activities and opportunities, offering access to their local community. People were able to maintain and develop appropriate relationships with family and friends. People’s rights were respected and their responsibilities were recognised in their daily lives. People were offered a healthy diet and enjoyed their meals. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 14 EVIDENCE: The records showed that people had a range of opportunities offered and there was also a record of when opportunities were declined. Several people used to attend college but this facility had been withdrawn. People were accessing community facilities with staff support. Activities included trips to Salisbury and Swindon, the pub, supermarkets, personal shopping, the cinema, lunch out, and attending a social club. During the inspection people went out shopping with staff support. One person also went out for a drive and a cup of tea. Three people were on holiday in Fordingbridge at the time of the first visit. On the second visit they had returned and all said that they had enjoyed the holiday. One person said that they went out somewhere everyday if only to the shop. People talked about their contact with their families and the records showed when visits and phone calls had taken place. One person had had a birthday recently and had a visit from a relative. Others said that they had contact with their families and phoned them regularly. Each person had their own room which was individually decorated and furnished. Each person had a key to their room if they wanted one. Staff only entered people’s rooms with their permission. People could choose to spend their time in their rooms or in company in the lounge or dining area. People had access to all parts of the home except other people’s rooms. Some people were able to go out independently while others needed staff support. Any restrictions were agreed and recorded in the support plans. Where restrictions had to be imposed these were agreed in a meeting of professionals who were involved with a person. There was a varied menu and individual choices were reflected in the menu for example there was a choice of lunch. One person who needed a special diet had their meals and snacks recorded in more detail. A recommendation was made at the last inspection that staff should record light snacks on the menu consistently. The records showed that light snacks were being recorded to show the full diet that was being taken. People tended to agree what to have on the day rather than have a pre-set menu. If someone did not like the planned meal an alternative was offered. For example the records showed that on one day some people had chicken while others had fish. Staff members cooked the meals and the people who lived in the home helped according to their abilities. People said that they enjoyed the food. People chose where to eat their meals, either in the dining area, in front of the TV or in their own rooms. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 15 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): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People received support in ways they preferred and required. People’s physical and emotional health needs were met. People were generally protected by the home’s policies and practices about medication although some attention was needed to recording. EVIDENCE: The records showed that each person had support in ways that they preferred. People were supported to access the health care that they needed. Visits to health care professionals were recorded. People saw the GP, community psychiatric nurse, psychiatrist, dentist, optician and chiropodist. One person became unwell during the inspection and was quickly taken to see the GP. Each person had a record in their support plan of the medication they took. They also had a list of homely remedies agreed by the GP. A monitored dosage system was used and medication was appropriately stored. A record
St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 16 was kept of medication received into the home, administered, returned and destroyed. A monthly check was made of each person’s medication and a record was kept to keep track of medication taken into and out of the home. The medication was reviewed regularly by the GP or consultant. Unused medication was returned to the pharmacist. During the inspection a representative from the pharmacist collected some medication and signed a record to confirm receipt. A requirement was made at the previous inspection that staff must sign to say that they have administered medication every time it is given. This had been addressed and the administration records were all signed when medication was given. A further requirement was made that two staff must sign the medication record sheet when entries or changes to medication have to be handwritten. This had been partly addressed. There were two signatures when one handwritten change had been made, one change had been signed once and three changes had not been signed. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 17 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): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to this service. People’s views were listened to and acted upon. People were protected by the home’s policies and practices about complaints and protection. EVIDENCE: There was a complaints procedure. There was a complaint format book, which has duplicate pages so that any complaints received in the home could be dealt with properly. One copy was given to the person who made the complaint and the other was held in the book. Several complaints had been made by people since the last inspection. A record was kept of the outcome and whether the complainant was satisfied. One complaint had been investigated by a senior manager and the outcome was sent to the person and to the Commission. Staff asked people whether they had any complaints in service user meetings. The manager stated that he recognised the limitations of this and a representative of the local advocacy network came in once a month so people could make any complaints to them. People who were spoken to knew how to make a complaint. A recommendation was made at the last inspection that the manager should consider keeping a compliments file. The manager had considered this and
St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 18 decided against it. A recommendation was also made that the complaint record should be checked every three months and the manager was checking and auditing three monthly. There was a policy about protection from abuse and information about the local safeguarding adults procedures. All staff had been given copies of the ‘No Secrets’ booklet. A requirement was made at the previous inspection that all staff must receive training about prevention from abuse. Nine staff had received training as part of their Learning Disability Award Framework (LDAF) training. The manager and deputy reported that they were using a British Institute of Learning Disability training package about prevention of abuse. Two staff had received protection of vulnerable adults (POVA) training in May. The training records showed that all staff had either received the POVA training or LDAF training and some had received both. The four members of staff who completed comment cards were aware of the adult protection procedures. Each person had a behavioural support plan and a physical intervention plan to ensure that their behaviour was managed safely and people and staff were protected from harm. People were supported to collect their own benefits and staff helped people to manage their money. People’s financial records described the amount of benefit received and identified the amount of personal allowance. People signed the records when they withdrew money. A recommendation was made at the last inspection that the receipts should be attached to the monthly log sheets they are related to. Receipts were attached to the appropriate monthly records. All balances were checked daily. A recommendation was also made that the financial records should be audited and monitored by someone external to the team. The records were being audited by a senior manager as part of the monthly Regulation 26 visits. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to this service. People lived in a comfortable, clean and safe environment, suitable to their needs. EVIDENCE: The home was extended during the previous year and this extension included new bedrooms, one with a shower room, toilet and hand wash basin and the other with a bath, toilet and hand wash basin. The rooms were in excess of 12 square metres and were well appointed. A computer and telephone were kept in the front hallway. People were happy with their rooms and three people invited the inspector to see their rooms and the inspector saw an empty room. These rooms were large and had ensuite facilities. They were well decorated and one person said that they had chosen the colour of their room.
St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 20 There was a new utility room in the extension and another utility room close to the dining area in the kitchen. These had large domestic style washing machines and tumble driers to accommodate the laundry demands. The home was clean and tidy on the days of inspection. There was a large communal sitting room, with sofas and pictures, which had a homely feel. There was a large dining table in the kitchen and people sat at the table after returning from their activities. One of the ensuites had been altered to make a walk in shower room suitable for someone with a physical disability. In response to a recommendation at the previous inspection the manager had obtained guidance on appropriate equipment from an occupational therapist. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were supported by an effective staff team, who were appropriately trained and competent to meet their needs. People were protected by the home’s recruitment practices. Arrangements for supervision and appraisal had been made so that people would benefit from well supported and supervised staff. EVIDENCE: There was a recruitment procedure. At the random inspection the recruitment records of three staff were checked and these showed that the procedure was being followed. One new member of staff had been recruited since the random inspection. Their recruitment records were in order. They had completed an application form, two written references and a Criminal Records Bureau (CRB) and protection of vulnerable adults (POVA) checks had been made before they started work.
St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 22 The rota showed that here was a minimum of three staff on duty but usually more. The rota was flexible around the needs of the people and they could have staff support with activities and appointments. There were usually two members of staff sleeping in at night. However, the owner reported that this had reduced to one member of staff while there was a vacancy. She also reported that this was a satisfactory arrangement at present. There was a training plan. This showed the requirements for training, the training that each staff member already had and the action required so that each staff member had the required training. New staff had learning disability award framework induction and foundation training. A range of training was provided including first aid, food hygiene, health and safety, infection control, medication, fire safety, physical intervention, communication and makaton. Physical intervention training was provided by the manager and training manager and there was ongoing refresher training. The manager reported that the training followed the model of training recommended by the British Institute of Learning Disability but was not accredited. Three staff had a National Vocational Qualification (NVQ) at level three and two staff were working towards NVQ. The deputy was working towards the Registered Managers Award. This did not yet meet the standard of 50 of staff having an NVQ at level 2 or above. This was being addressed and the training plan identified that four more staff required NVQ training to ensure that 50 of staff had an NVQ. Four staff who completed comment cards said that they had formal one to one supervision which was recorded, they had regular team meetings and they had enough support to do their jobs well. The deputy manager reported that they were making further improvements to the system for staff supervision. She stated that the system of booked supervision had not always suited the staff’s needs. When issues arose staff needed to discuss them with a supervisor rather than wait for a planned session. Supervision was to be provided by the three team leaders and the deputy manager. The registered manager was to supervise these four staff members. There would be a system of planned supervision and the team leader on duty would provide day to day supervision. There were annual appraisals. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to this service. The registered manager was suitably qualified, competent and experienced, so that people benefited from a well run home. People’s views underpinned all self-monitoring, review and development by the home although the report about these views needs to be published. People’s health and safety were protected by the systems in place. Although some attention was needed to recording. EVIDENCE: The manager had worked in the home since the home was opened. He had a range of skills in managing people with challenging behaviour. He was
St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 24 appropriately qualified. He had overall responsibility, although some tasks were delegated to the deputy manager and other staff in the home. Quality assurance was being developed. Questionnaires had been sent to care managers, doctors, community nurses and other professionals. The views of the people who lived in the home had been sought. The information had been collated at head office but a report of the findings and an improvement plan had not yet been produced. There was a health and safety policy. There was information about health and safety, Control of Substances Hazardous to Health (COSHH), food safety and manual handling. Staff received training about health and safety, first aid, food hygiene, and manual handling. Radiators were covered and the hot water temperature was regulated to reduce the risk of burns and scalding. The temperature of the water was also checked daily. Portable appliances were tested annually. There was a fire risk assessment and fire safety checks took place. There was a requirement at the previous inspection that the fire alarm system must be checked on a weekly basis and a record made. This had been addressed and checks were taking place weekly and being recorded. There was another requirement that when staff have attended fire safety training a record of the date must be made above the person’s initials. A record of fire instruction to staff was kept but the date when it took place was not being recorded. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 2 X X 3 x St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 26 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement Two staff must sign the medication record sheet when entries or changes to medication have had to be handwritten. The registered person must produce a report of the findings from the quality assurance survey, supply to the Commission a copy of the report and make a copy of the report available to service users. Timescale for action 16/11/06 2. YA39 24 31/01/07 3. YA42 23(4) (d) When staff have attended fire 16/11/06 safety training, the actual date of training session must be recorded above the persons initials. (This was a requirement at the last inspection and the one before.) St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 27 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 YA2 Good Practice Recommendations It should be clear to service users what the consequences may be when they break the contract of the house rules that they have agreed to sign and follow. This recommendation was not checked on this occasion. 2. YA35 The training about physical intervention should be accredited to ensure that it is up-to-date and remains best practice. St Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Patrick`s House DS0000060340.V319897.R01.S.doc Version 5.2 Page 29 - 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!
