Inspection on 17/10/08 for St Raphaels

This inspection was carried out on 17th October 2008.

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

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

Other inspections for this house

St Raphaels 24/10/06

St Raphaels 02/06/06

St Raphaels 24/10/05

St Raphaels 05/04/05

St Raphaels 15/12/04

St Raphaels 14/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Raphaels The Butts Brentford Middlesex TW8 8BQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Collisson     Date: 2 1 1 0 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: St Raphaels The Butts Brentford Middlesex TW8 8BQ 02085603745 Telephone number: Fax number: Email address: Provider web address: clare.casey@psmgs.org Name of registered provider(s): Name of registered manager (if applicable) Sister Clare Casey Type of registration: Number of places registered: The Francis Taylor Foundation care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The Registered Person may provide the following categories of service only: Care home only - Code PC To service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 21 Date of last inspection Brief description of the care home St Raphaels is situated in a quiet residential area in Brentford. It is close to the Brentford High Street and within easy reach of Hounslow and Chiswick town centres. There are good public transport links close by. The home is one of two on the site, managed by the Frances Taylor Foundation. The other home, Maryville, is for older people and is inspected separately. There is also, on the site, a convent and six flats for Sisters of the Order and staff. The large, well maintained gardens are available to all people within the complex. There is a Roman Catholic church incorporated in Maryville. The establishment is for twenty one people with learning disabilities and is Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 21 Brief description of the care home arranged in three units. Two units are located in Fatima House, for thirteen people. The St. Raphaels building has eight bedrooms. A courtyard garden separates the two establishments, and each has its own communal living areas, bathrooms, kitcens and laundry facilities. A new facility, the Taylor Centre, is located off the courtyard and provides a centre for activities, as well as offices for the Frances Taylor Foundation. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was carried out on the 17th October 2008 from 10am to 2.45pm. The Registered Manager and the Deputy Manager were on a Mental Capacity Act training course so another visit was made on the 21st October to complete the inspection and meet with the Managers. The inspection took a total of seven hours. We were accompanied on the first day of this inspection by an Expert by Experience and her personal assistant. The Commission for Social Care is trying to improve the way it engages with people who use services so as to gain a real understanding of their views and experiences of social care services. It now uses Experts by Experience who are an important part of the inspection team and help Inspectors get a picture of what it is like to use a social care service. The term Expert by Experience used in this report Care Homes for Adults (18-65 years) Page 6 of 29 describes a person whose knowledge about social care services comes directly from their experience of them. She spoke to four residents and two staff. We looked at a variety of records during the inspection, including care planning files, staff records, training records, complaints, finances, maintenance and medication. We met with most of the residents during the course of the inspection. We had also sent surveys to the residents and staff. We received thirteen from the residents and three from the staff. The majority of the comments were very positive and have been used in this report where appropriate. We met seven staff during the first visit. There were also two students nurses undertaking a placement, and two former students who now work part-time in the home. All of the staff were very positive about working in the home and we found that there was a good rapport between the staff and the people receiving their support. We looked at all of the communal areas in Fatima House and St. Raphaels and also at the new Taylor Centre facilities. We were shown a number of bedrooms which were pleasantly decorated and personalised. Decorating was taking place in the St. Raphaels building during both visits. A new lift was being installed in the Fatima House building. During the first day, several people were attending a day centre in Feltham. Others were in their rooms, or in the communal lounges carrying out activities, such as jigsaws. Most of the residents are mobile and move between the various buildings as they wish. The new Taylor Centre has rooms for craft work, dancing and a wellequipped kitchen. There is also a sensory room for relaxation. The activities include cookery, yoga, keep fit and art. People said how much they enjoyed the dancing and parties. The residents are free to use the well maintained gardens, shared with the Maryville older peoples home, but also have their own large patio. The Manager provided us with the Commission for Social Care Inspections Annual Quality Assurance Assessment, which gave us detailed information about the service, its plans for the future and statistical information about the service. The Expert by Experience said, The residents are satisfied with the support they get. One said, The staff are nice and treat us well. I would not like to live anywhere else. She found that people have choices about their daily activities, what they eat and when they go to bed. She would that staff were happy in the home and said that they receive training as necessary to support the residents as they get older and their needs change. The residents are all from Irish and British backgrounds and most have lived for many years in the previous home on the site which closed in 2001. Those that wish to attend the church in Maryville can do so, but it was seen that some choose not to. There were no specific cultural needs to be met in regard to food or personal care. There is attendance at a variety of clubs, both for people with learning disabilities and in the community. We looked at the Key National Minimum Standards and found that the home is providing an excellent service to its residents. 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 29 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 29 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 have the information they require to make a judgement about moving to the home. Visual information is used to support people to understand the documentation. A thorough assessment and admission procedure is in place to ensure that the home can meet a persons needs. The use of advocates to support people is encouraged. Prospective residents are given the opportunity to spend time in the home before making a decision. Evidence: We looked at the files of the people receiving the service and found each file had a copy of a visual Service Users Guide. The Service Users Guide is produced in a visual format for the residents, to support their understanding of the document. We were provided with the Statement of Purpose which was revised in August 2008. This contains comprehensive information on the home which would assist anyone looking for a placement. We looked at the assessments for the people who has been admitted since the last Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: inspection. We found that these contained all of the information, including the local authority and Frances Taylor Foundation assessments, to support the admissions. People had been able to visit the home prior to admission, on as many occasions as necessary, in order to help them to make a decision. We found that the residents had settled well into their new home. The majority of residents have lived there for several years and also in the home which was formerly on the site. Most of the residents are mobile and those that live in the St Raphaels building need to be able to access the stairs as its bedrooms are all on the first floor. At this time, a lift was being installed in the Fatima House building, so that the bedrooms and communal rooms on the first floor can be more easily accessed. Two of the residents are now requiring their transfers by hoist and the home is able to accommodate this. In the files we examined, copies of the terms and conditions of the home were seen. There is a visual version for the residents. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have care plans produced, after consultation, in a style to suit their needs. Plans are individualised for each person. They are based on a full and up-to-date review. Staff are fully committed to support individuals to lead fulfilling and independent lives. People are safeguarded by the care plans containing comprehensive risk assessments, which are regularly reviewed. People have access to advocacy services and are encouraged to promote their rights. Residents are consulted about how the service is run and participate in all aspects of the home, including staff selection, the day-to-day life of the home and its future development. Evidence: We saw samples of five care plans which are written to reflect the support needs of each person. There was information in the care plan to show whether the person was able to participate in preparing it and how they would be supported to do so. There is also a section with a visual person-centred plan. We found that the care plans give clear descriptions of the needs of the person. Each care plan is reviewed regularly, Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: with an update written on the back of each plan so that the changes can be easily identified. On the second visit, we were shown a newly completed care plan containing many pictures and photographs which provides a more person-centred plan. The home reported in its Annual Quality Assurance Assessment that they have developed a new format Person Centred Plan, which incorporate Me and My Life, This is Me and My Hopes for the Future. It is intended that all of the residents will have these in due course. Residents are encouraged to choose the pictures and photographs that they recognise in order to help them to understand better their own care plans. People are encouraged to complete scrapbooks of their activities and interests. We saw evidence that people using the service have been involved in regular meetings to ensure that they have a chance to voice their opinions and help to plan activities and outings. The meeting are also used to give information to the residents, perhaps by using a video or a speaker, to discuss various topics. These included an item on being safe and the fire instructions are also discussed regularly. We saw throughout the inspection that those people who are able to do so, choose to spend their time as they wish. The Speak Out advocacy support group has provided support for the residents for many years and continues to do so. People attend their Chit Chat clubs, go on outings and there are also meetings within the home. The Manager said that they ensure the residents have the opportunity to attend the meetings without staff present to encourage independent participation. The Expert by Experience generally found that the people living in the home were offered choices in a variety of areas, including the time they went to bed, what they had to eat and how they spent their time. She felt, however, that there may not always be enough time for staff to go out with people as staff had cleaning to do and, in one unit, there are people with a higher dependency. However, on the first day of the inspection it was noted that the Managers were on training, so there were less staff around than there would usually be. The Manager and Deputy Manager explained the review process, which includes an annual meeting with Social Services and an interim six monthly review. We found that residents are encouraged to invite the people they would like to attend, which may include friends from the home. An example of a visual person-centred review service was seen. In the care planning files were a number of risk assessments for each person, which included those for being out of the home. Where any of the activities in the care plans have identified risks, the risk assessment is kept with it so that they can be reviewed Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: together. These were seen to be reviewed regularly and monthly updates are included for each care plan. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know that they have options from which to choose, including a range of activities both within and outside the home. The home seeks residents views and provides the activities they enjoy. Routines are flexible and residents can make choices in all aspects of their daily lives. People are supported and encouraged to be independent and develop their daily living skills. People are encouraged to eat healthily. Evidence: Since the last inspection, three rooms and a kitchen have been made available in the adjoining building, now called the Taylor Centre. We saw examples of the excellent craft work which is being carried out, and is displayed around the home. We found that keep fit, yoga, cookery, drama and foot massage also take place, the latter during the inspection. Residents said that they particularly like the dancing that takes place and a Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: dance had been held before the final visit to the home. The residents who are in wheelchairs are also able to attend and enjoy these. The Manager confirmed, on the second visit, that there is a ramp available for access to the Taylor Centre as the Expert by Experience was concerned that there was no disabled access. The Expert by Experience reported favourably on the homes sensory room where people can go for relaxation. She found that people said they can, in the evenings, participate in a variety of activites including painting, puzzles or watching TV. They have the opportunity to go on outings or to places of interest and parks. This included the people who are in wheelchairs. They said that they have the opportunity to socialise with people from other services and from the community at the clubs they attend. A new class, which encourages independent living skills, has recently been introduced. There is a well equipped and modern kitchen where people enjoy cooking, including preparing buffets for their dances and parties. Staff said that residents particularly enjoy helping around the home and their care plans reflected this. People are encouraged to help with the laundry and with cleaning their rooms. On the second day of the inspection, some of the residents had cooked and eaten a cottage pie. As there are no classes at the local college for the residents to attend, as they had done in the past, tutors and volunteers undertake these within the Centre. One person told the Expert by Experience that I like doing housework. I hoover and polish and I can tell them when they are not doing it properly. Another said I like cooking and really enjoy the cooking lessons. Residents are able to attend a day centre in Feltham, many doing so on a regular basis and several were out on the first day of the inspection. However, one person had not wanted to attend the day centre and this choice was respected. The person told the Expert by Experience I just felt like staying at home. Various evening clubs are also attended, including those for people with learning disabilities and those for the wider community. Each person has a plan of their weekly activities within the daily record book. We saw a sample of the records and found them to be well recorded and relevant. The home is located close to Brentford High Street and within easy reach of Hounslow, Chiswick and Ealing. The residents also enjoy shopping regularly. There is a mini bus for the residents use but they are also regular users of public transport. Each care plan has details of the residents families and friends and they are encouraged to stay in touch. One person spoke to us of visits from a long-time friend. Two people were visiting their families at the weekend following our first visit. One Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: resident spoke of her birthday party which had seen many members of her family attending. Many family members were seen to be involved in completing the surveys the home had sent out and which form part of its quality monitoring process. The Expert by Experience was told that familes and friends are free to visit as they want Each care plan looks at the cultural and religious needs of the resident. All of the residents are from a white British or Irish background. Their religious preferences are recorded, where appropriate. There are no specific cultural needs in regard to food, or personal care. We found that the home had provided flat screen digital frames on the walls of the bedrooms for the two people whose health has deteriorated and spend some time in their rooms resting. They can enjoy the pictures and sounds to help them to relax. Meals and cooked and served separately in each of the three kitchens, and the menu is based on the food that the residents enjoy. The main meal is taken at lunch time. The residents who attend the day centre have their main meals there. A lighter meal is served in the evening. The people living in the home told the Expert by Experience that they have a choice of what they eat and are asked for their views on the menus at monthly meetings. Care Homes for Adults (18-65 years) Page 17 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive appropriate healthcare support. The home is able to support those people whose health has deteriorated. Individual plans clearly support peoples personal and healthcare needs and detail how they will be delivered. Suitable equipment is provided to ensure people have the support they needs. The home is being adapted to meet the needs of people whose mobility needs may increase. Evidence: The details of all of the personal care preferences of each person are recorded in their care plans. People in St Raphaels have their own en suite shower rooms and toilets. An assisted bath is also available. In Fatima House there are baths, showers and assisted baths so that people can have a choice of the facility they prefer. One bathroom is to be converted to a walk-in shower to provide a wide choice of facility. We saw that peoples physical needs are met by regular visits to the dentist, optician and other health professionals. The outcomes of visits are recorded so that it can be seen that needs are being met. Staff said that the annual flu vaccinations would be given soon and a nurse visits the home to do this. We saw that people are supported Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: to attend regular preventative screening tests. The home is supported by the Community Team for People with Learning Disabilities whenever this is required and we saw information on visits to learning disability professionals. There has been a deterioration in the health needs of two of the long-term residents, both physically and mentally as dementia has developed. The staff were confident about meeting their needs and they have the equipment and training to do so. With the addition of the lift and ramps, the home is being adapted to meet the needs of people whose mobility might deteriorate. The home reported in the AQAA that We were visited by Health Link who discussed with service users how they feel about the national health service - how it affects them and what changes they would like to make - this was a very vocal discussion. Details of the current medication are kept in each care planning file. We checked a sample of the medication and it was in good order. Care Homes for Adults (18-65 years) Page 19 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a complaint procedure that is clearly written and easy to understand for the residents. Safeguarding of the residents is reinforced by training arranged for both staff and the residents. Evidence: We saw that only one complaint had been made since the last inspection which involved a complaint by one resident about another. This was resolved by discussion with the people concerned and this was recorded. There is a visual complaints procedure available. Staff confirmed that they had recent safeguarding adults training, run by the London Borough of Hounslow safeguarding adults department. Through discussion, we found that staff had a good understanding of the procedures. The Manager said that the residents had also been able to have the benefit of a talk from the safeguarding adults officer to support them in their understanding of the subject. There have been no safeguarding issues raised in the home. Care Homes for Adults (18-65 years) Page 20 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to see the home as their own and personalise all of the personal and shared spaces. It is well maintained, attractive home and garden and has very good access to community facilities and services. It has the specialist equipment and adaptations to meet the individual needs of the people who use the service and is working to improve these further. Evidence: Both houses provide good communal accommodation for the residents. There are two comfortable lounges in St Raphaels and two in Fatima House. St. Raphaels has a large kitchen/dining room where residents tend to congregate. Fatima House has a kitchen and dining room on each floor. The addition of the rooms in the adjoining Taylor Centre has provided a wide range of spaces for the residents to enjoy. The layout of the grounds enables the residents to enjoy the freedom to move around in a secure environment, using all of the available facilities. The home is also located near to shops, transport and leisure facilities, which provide opportunities for outings. The home has a very well maintained garden, shared with Maryville care home and the Convent. There is also a large patio with ample seating, between the St Raphaels and Fatima House. Large sunflowers and bedding plants were in the raised flower beds. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: All of the areas we saw were pleasantly furnished in a homely way. There is an emphasis on ensuring the residents know that it is their home by displaying their craft work. We saw many examples around. Completed jigsaw puzzles have been framed and hung around the home. We saw several of the bedrooms, sometimes with the residents showing us their room and their personal belongings. Each of the rooms reflects the interests of the residents and many had photographs of family, friends and the activities they enjoy. The home had sufficient equipment to meet the needs of the residents, including a hoist for two of the residents in Fatima House. The additional of a lift in Fatima House means that people whose mobility deteriorates can continue to be accommodated. The Expert by Experience commented on the lack of accessibility to the toilets in Fatima House. We mentioned this to the Manager who said that she would take this into account when the bathroom refurbishment is planned, which is in the near future. There is a ramp from the garden to the Taylor Centre which makes it easier for wheelchair users and it was reported in the AQAA reports that the home is looking to provide more ramps around the home. We saw that all areas of the home were very clean and tidy. Rooms were being decorated in St Raphaels, where there is a first floor laundry and residents are encouraged to help. There are separate laundry facilities in Fatima House. Care Homes for Adults (18-65 years) Page 22 of 29 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. Staffing levels are satisfactory to meet the needs of the residents. Relevant training is provided for the staff, and on a regular basis. The National Vocational Qualifications level is good. Staff have the opportunity of support through regular supervision and team meetings. Evidence: We found that each of the three units has its own staffing rota. There are two staff in the St. Raphaels, and two on each floor in Fatima House. There is good continuity among the staff, with a low turnover. The staff we spoke to were very aware of the residents needs and preferences. We examined a sample of three staff records and found them to be kept in good order, with all of the required information in place. We were provided with the training records for the staff. We found that staff have undertaken all of the basic training courses in moving and handling, first aid, fire safety, food hygiene, epilepsy care, safeguarding adults, infection control and medication. Some learning disability training was also seen to have taken place and the staff attend training provided by the Community Team for People with Learning Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Disabilities. Distance learning course are also being introduced. The people living in the home are involved in staff recruitment, which includes being involved in interviews. The home has ten care staff with the National Vocation Qualification at Level 2 and one at Level 3. Staff confirmed that they are supported and supervised. We saw samples of the supervision records which showed that the home meets the targets of having at least six sessions a year. As well as staff meetings, for which we saw minutes, there are group supervision sessions to discuss specific topics. We, and the Expert by Experience, were told by the staff that they were happy in the home, have the necessary training and are able to continue to support people with their changing needs as they get older. Care Homes for Adults (18-65 years) Page 24 of 29 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 has the required qualifications, many years of experience and is competent to run the home. Record keeping is of a good standard. Residents are able to contribute to their records and the all of the records are maintained in good order. The views of the people living in the home, their families and staff are sought in a variety of ways. Evidence: We found the home to be well managed. The Registered Manager has the Registered Managers Award and a National Vocational Qualification Level 4 in care. The Deputy Manager has NVQ Level 3 and is undertaking the RMA. He also has the NVQ Assessors Award. The Deputy Manager also manages the supported living service, for nine people living in the local community, which has a separate staff team. The residents of the houses all have links with the former home and visit the home to meet their friends and attend events. We were shown the surveys which has been completed by people living in the home Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: and their families. People were supported independently to complete the surveys. The Deputy Manager was working on a report of the findings of the surveys and sent us a copy of the report after the inspection. The Registered Manager and Deputy Manager also completed the Commission for Social Care Inspections Annual Quality Assurance Assessment. We saw a sample of the servicing and maintenance. These included the small electrical testing in September 2008 and the gas check in May 2008. We saw evidence of weekly fire tests, and there were fire drills in St Raphaels in June and September 2008 where the residents evacuated the building. Although the fire risk assessment was not available initially, the Deputy Manager provided us with a copy shortly after the inspection, which was found to be very comprehensive. This was produced in 2006 and needs to be reviewed. The Manager said that would be done when the lift work in Fatima House is completed. The work which was identified in the risk assessment as being required was confirmed as having been completed by the Managers. This included the special equipment, to be used in the event of the fire alarm being activated, for a person with a hearing impairment. They were advised to ensure that, should requirements be made in the future, it should be noted when they are completed so that there will be evidence of this. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 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!