Inspection on 28/11/07 for Strathmore House

This inspection was carried out on 28th November 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Strathmore House 25/11/08

Strathmore House 12/12/06

Strathmore House 08/05/06

Strathmore House 31/01/06

Strathmore House 30/07/05

Strathmore House 25/01/05

Strathmore House 21/07/04

Strathmore House 11/02/04

Strathmore House 02/12/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Strathmore House 27 Queen’s Park Avenue Dresden Stoke-on-Trent Staffordshire ST3 4AU Lead Inspector Wendy Jones Key Unannounced Inspection 28th November 2007 10:30 Strathmore House DS0000008255.V342610.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 Strathmore House DS0000008255.V342610.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. Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Strathmore House Address 27 Queen’s Park Avenue Dresden Stoke-on-Trent Staffordshire ST3 4AU 01782 596849 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) strathmore.house@craegmoor.co.uk Strathmore Care Services vacant post Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2006 Brief Description of the Service: Strathmore House provides residential care for up to 16 adults aged 18 to 65 of both genders with learning disabilities. Strathmore House aims to provide a homely environment that will afford residents greater security, choice, independence and a good quality of life. This is achieved by maintaining a relaxed, friendly atmosphere where staff’s primary objective is to meet individual residents holistic needs, while maximising the services that the home can offer to residents. Strathmore House aim to offer the residents a range of opportunities, both in house and through their activity in the community. All residents are encouraged to take an active role in life and whilst at Strathmore House, all residents are encouraged and supported by staff to develop their independent living skills. Strathmore House is owned by the Craegmoor group, which has many other services nationally. It is located in a suburban area close to local amenities and with easy access to the city. The house faces a large park and there is space for car parking. The service user guide does not contain information about the range of fees and charges for the service. The provider should be contacted for this information. Strathmore House DS0000008255.V342610.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 the service experience adequate quality outcomes. This was a key inspection site visit of this service undertaken on 28 November 2007 and included formal feedback. In total the visit took approximately 08:00 hours. The purpose of this visit was to assess the services performance against National Minimum Standards (NMS) for care homes and to establish if it provides positive outcomes for the people who live there. This service provides care and accommodation for younger adults who have learning disabilities. The visit included checking that any requirements and recommendations of the previous inspection visit of 12/12/06 have been acted upon; looking at information the service provides for prospective residents, their carers and any professionals; looking at information that the service provides to people who use the service to ensure that they understand the terms and conditions under which they have agreed to live at the home and the fees they should pay. Other information checked included assessments and care records, health and medication records; activity and records relating to the menu’s, finances, staff training and recruitment, complaints and compliments, fire safety and health and safety checks. The manager, staff and residents were spoken to during the site visit and a brief tour of the building was undertaken. Before the visit began, the service provided it’s own assessment of its performance, in the form of an Annual Quality Assurance Assessment (AQAA). Surveys were sent out to residents, relatives, and staff and any professional that has involvement in the service. Twelve service user survey’s, six relatives’ surveys, eight staff surveys and one health professional survey was returned. All service users were supported and assisted by the care staff to complete their surveys. The main points are included in this report. Sine the inspection the manager has provided us with some of the information we requested and has written to us to clarify some areas of the report. Where necessary amendments have been made, following discussion with her, to ensure this reports accuracy. What the service does well: Prospective service users have their needs assessed and have the opportunity to visit the home prior to agreeing to move in. The standard of care planning is good and service user can be confident that their personal and health care needs are met. Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 6 Service users and their families are happy with the service the home provides and said that they felt able to discuss any areas of concern that have. The service provides the people who live there with an opportunity to live a relatively independent lifestyle, and encourages them to be involved with a range of occupational and recreational opportunities both in and out of the home. Close links with families are maintained and close working relationships have been established with health professionals and specialist health workers. The staff team is reasonably well established and the numbers of staff who have achieved a National Vocational Qualification (NVQ) is good. There is evidence that staff receive regular one to one supervision sessions and staff meetings. What has improved since the last inspection? What they could do better: Service users state that they are happy at the home and feel that their care needs are being met. But there are some areas identified during this site visit that require further work, to ensure that the service meets the minimum standards we require. Information intended to inform service users about the home should be up to date and include the costs and fees of the service. Each service user must also have a copy of their contracts with the provider. Care plans should give an accurate reflection of the needs of the individual and in all instances subject to regular review. Service users rights must be taken into consideration when risk assessments are carried out to ensure that their independence is promoted at all times. Medication records should be accurately maintained and the storage of medication must comply with the relevant guidance. The environment must be maintained to a good standard throughout the home for the benefit of service users and all shower and toilet facilities must be fully functioning. The heating and lighting to the conservatory must be sufficient and safe. Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 7 Staff should receive all mandatory training. The manager should apply to us to be registered as a fit person to manage the service and should also enrol on the registered care managers course or equivalent. 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. Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 8 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 Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 9 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): 1, 2 and 5. Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. People who may use the service can be sure that they will receive information about the type of service offered, but it is not up to date. People who use the service do not know what their contract includes. This means they are not sure about the terms and conditions of residency. They can be sure that their care needs will be assessed prior to agreeing to move into the home, this gives them confidence that their care needs can be met by the service. EVIDENCE: The Service has a Statement of purpose and Service user Guide, at the time of this visit they were being up dated. The manager provided a copy of the Statement of Purpose following this visit. An up to date copy of the service user guide should also be provided and should contain the fees service users are charged and other costs of the service. None of the service users have a copy of their contract with the organisation. The manager stated that these were kept at the Head office. She also stated when asked, that the organisation invoice’s service users on a monthly basis. This ensures that they have up to date information about the cost of the service. A review must be considered to ensure that service users have an up to date copy of their contract which includes the terms and conditions of Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 10 residency. One service user confirmed that she had a copy of the service user guide. Two service users have been admitted to the service since the last key inspection, one was moved in to the home on a temporary basis due to an emergency. This was discussed with the manager who said, the individual service user was known to the current service user group and the staff team, who were confident that they could meet his needs. The manager is asked to be clear in the Statement of Purpose about the circumstances under which a service user can be admitted to the service on an emergency basis. And in these circumstances be able to provide evidence that other service users have been consulted about the admission, to ensure that they are happy with it. The other service user has moved from another of the local homes also operated by this organisation. In survey’s service users said, “I came and visited before moving in.” “ I came to visit and the social worker gave me information. I visited several times before I moved in.” “I am happy here at Strathmore and would like to stay as long as possible.” Strathmore House DS0000008255.V342610.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 a visit to this service. People who use the service are involved in decisions about their lives, and are encouraged to play an active role in planning the care and support they receive. But the service should make more efforts to promote service user independence in all aspects of life. EVIDENCE: The Statement of Purpose says, “Every service user is encouraged to play a part in the running of the home and we hold regular meetings in order to gain a collective opinion as well as individual perceptions of the home. The aim of these meetings is to provide residents with a forum to express the views and involve them in decision making relating to the running of their home and to give the Home Manager ideas on how they may further improve the service provided. There are regular reviews which the service user, and where appropriate, relatives and friends/advocates are encouraged to participate. Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 12 The frequency of reviews is dependant on service user need but we do ensure that they are completed at least every 6 months” A sample of care records show that service users and their families are involved in care planning and in some examples that the individual has signed their plans. The records also show that each individual has received a service user guide or knows what one is. A relative said, “My son is well supported, the staff understand his needs.” “They give an excellent standard of care, and give residents a normal way of living and activities as possible.” Two service users said,” I know about my care plans, my key worker talks to me about them.” New Person Centred plans are being introduced and the service is in the process of transferring information from the old care planning system. The service should ensure that all care plans and risk assessments are regularly reviewed, as some had not been since June 2006. The service should also ensure that care plans accurately reflect the needs of the individual, in one example they did not. In addition to regular meetings, service users meet on a one to one basis with their key worker to discuss their care, any problems, and plans for the following weeks. Service users said that they felt that these meetings are helpful and each resident knew who their key worker was. A service user reported that although she has a bedroom door key she doesn’t have a house door key, this was discussed with the manager who stated it was custom and practice for service users to have their own bedroom door key, if they want one. Service users have not been routinely provided with a front door key. This should be reviewed and the availability of keys made subject to assessment of ability and choice. The service must demonstrate that it recognises service user rights of independence and support them within a framework of responsible risk taking. Strathmore House DS0000008255.V342610.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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations for the majority of service users in the home. EVIDENCE: Information in the service statement of purpose says, “many social activities are organised at the home and we do try to accommodate, each service users interests and hobbies. If we are unable to do this we will explain this prior to admission. Our social activities include badminton, college, pub, theatre, work experience, swimming, dram, athletics, karate, social club, days out, meals out, horse riding, rambling, holidays abroad and in England.” A relative said “I am kept informed and staff let me know if there are any problems,” “staff are supportive and friendly.” The service supports close links Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 14 with service users and their relatives. Relatives said things like, “My relative has been exposed to new experiences which I think is excellent.” “They try to provide opportunities for service users, this ensures that times of boredom are minimised.” Each service user has a weekly timetable that they agree with their key worker a sample of these show that most residents have a very active lifestyle during the working the day and an equally active evening programme. Further work should be done to improve the opportunities for one resident whose needs are greater than others in the home. Staff said in their surveys, “we should try to promote independence more for the individual instead of holding them back.” Staff, during the visit gave accounts of how they supported individuals to participate in appropriate activities both in and out of the home. Self-advocacy information is displayed in the home and some service users are involved in a local self advocacy group called “reach.” Menus are agreed with service user each week, but no alternative to the main course is recorded on them. One individual buy’s, prepares and cooks his own food in the smaller training kitchen. Service users said, “ some staff are really good cooks we have good choice of food and try to eat a healthy diet.” According to one service user and confirmed in their care records, the home has a no alcohol policy during the week. It is understood following discussion with the manager that this is not a policy of the home, but is linked to individuals health needs. Any reference to alcohol in care files is due to there being an individual need to have clear guidance around appropriate alcohol use. Strathmore House DS0000008255.V342610.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): Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Medication management arrangements require further work to ensure that service users well-being is assured. EVIDENCE: The Statement of Purpose says, “All residents are treated as individuals with individual needs and needing individual care. Our goal is to promote independence and to ensure privacy and dignity is maintained. We try to promote a holistic approach to care where physical, social and psychological needs are given equal importance and appropriate care plans and interventions are put into place.” The records show that service users are supported to attend health appointments and to have regular checks up’s. Specific health issues are monitored regularly and where appropriate specialist health professional Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 16 support is asked for. This is particularly necessary to support the more complex needs of service users, for example Autism. The organisation is introducing a Health Action Plan for all service users. The user-friendly format makes it fairly easy to understand, staff have yet to receive training. It will be properly implemented when they have. Observations throughout the day show a staff team who are sensitive to the needs of service users and respect their wishes and feelings. Service users confirmed this. In one relative survey it said, “My relative could do with a bit more help with personal hygiene.” This was discussed with the manager of the service. The service has a medication policy and procedure, and has an additional procedure for the administration of as required medication; this was last reviewed on 17/01/05. One service user self medicates, and the service has a policy on this. The individual had been assessed prior to being able to proceed. Three service users are prescribed as required medication but one did not have a protocol in place for the administration of Chlorpromazine, this must be addressed. A protocol provides staff with clear guidance for the circumstances under which the medication can be administered. An audit trail of medication from the point of delivery to the time returned to the pharmacy shows that there are occasional gaps in the medication administration records; this was discussed with the manager The medication trolley is stored in a locked room, but is not secured to a fixed surface. This must be addressed. The manager stated that most staff have received training in the use of the current medication system and have also completed either Craegmoors own medication training or a distance learning package with a local college. Staff have also been assessed as competent to administer medication. Strathmore House DS0000008255.V342610.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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. This provides them with confidence in the services ability to keep them safe and to listen to them and their supporters if there are problems. EVIDENCE: A complaints procedure is available in a user-friendly format and is on display in the home. Service users said in their surveys and during the site visit that they know how to make a complaint. The service maintains a record of any complaints it receives, the record shows one complaint had been managed by the home and is satisfactorily resolved. There has also been a complaint that has been passed to the organisation to deal with. We have not received a complaint about this service since the last key inspection. Relatives said that they are aware of the complaints procedure. Staff confirmed that they have received training and guidance on recognising and reporting abuse and are aware of the procedures that have been agreed in Staffordshire and Stoke-on-Trent for the protection of vulnerable adults. Since the last key inspection we have received two notifications from the service, when incidents have taken place and police involvement has been necessary. One incident was as the result of the behaviour of a service user and the other was because of a theft of service users monies. All matters have now been Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 18 resolved and service user monies reimbursed. The service has also made changes to security to reduce the risk of theft in the future. It has previously made changes to policies and procedures and guidance relating to the management of service user monies. Our records show that the service keeps us informed of events at the home and has demonstrated a commitment to the protection and welfare of service users. Strathmore House DS0000008255.V342610.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): Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, and comfortable environment, which encourages independence. But it could be improved by ensuring that the décor and fittings are well maintained and shower facilities fully functioning. EVIDENCE: The Statement of Purpose includes information about the home such as, “The Home has 13 single and 1 double bedrooms. All rooms meet standards in relation to size and décor. We do not envisage room changes once a resident is given a room, however, if a room change is necessary then this is only arranged after consultation and agreement with the resident. Residents are advised of the room they will occupy prior to admission and are encouraged to bring their own personal belongings to the home to personalise their room. However, we ask that the Home Manager be consulted first in order to ensure that the home continues to adhere to Fire and Health & Safety Regulations. The resident should also consult their Terms & Conditions of Residency given Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 20 to them on their admission to the Home.” It was also noted in the information provided that one bedroom is below the recommended 10 sq metres. During the site visit, it was evident that some redecoration is needed. The main lounge was particularly in need of painting or re-decorating, as the appearance of the wallpaper is grubby and looked dirty. The manager said that this is something she is looking to arrange. In the staff surveys it was mentioned that due to the location of the current office; the conservatory is regularly used by staff as an office and meeting place, which precludes service users from using it freely. This was discussed during the site visit although the manager stated that service users freedom to use the conservatory is not restricted. This was evidenced during this visit. The manager confirmed that plans are under way to move the current office from the first floor, to a bedroom on the ground floor. This will provide an office space that is accessible to service users and staff. The service user who will be moving to the newly created bedroom has been asked if this is acceptable and has agreed. Over a period of time he is being introduced to the proposed new bedroom. This has sufficient space, but is located on the first floor with no immediate toilet facilities close by. The manager was asked to look at this. The change of use of this room was also discussed with the fire safety officer who has made some recommendations. As a consequence of these planned changes, the conservatory will be redeveloped to make it an alternative lounge and recreational space for service users. The lighting and heating in this area should be looked at to ensure it is suitable and safe, at the moment the lighting is minimal and the heating is one wall mounted electrical heater. Service users said they wanted their bedrooms decorating, and in one example a service user bedroom was obviously in need of work, with furniture that is in a poor state of maintenance and repair, and décor that needs to be improved. It is apparent that bathrooms and toilets also need to have some work carried out, for example the ground floor shower room at the foot of the stairs leading to the current office is not working and needs to be repaired to be in good working order. The home has a main kitchen that is well equipped and suitable for the purpose, service users routinely become involved with making drinks and food preparation. In addition there is a separate interconnected kitchen area provided where service users on a 1:1 basis or independently develop their cooking skills. The service has a pay phone in the main hallway. Strathmore House DS0000008255.V342610.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, 34, 35 and 36. Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. Staff in the home are generally well trained, skilled and in sufficient numbers to support the people who use the service. But some areas, ie mandatory training is not up to date. This potentially leaves people at risk. EVIDENCE: Staffing levels for the day of the visit were, 3 support staff during the morning and early afternoon shift and 3 during the evening. The managers’ hours are additional to this. There is also 1 waking night staff and 1 sleep in. Weekends are noted to have fewer staff allocated, but the manager reported that this is flexible and additional staff would be deployed if an event were planned. Weekly care staffing hours equate to 360 plus the managers 40. 6 staff have an NVQ level qualification at level 2 or above, this equates to 50 of the work force the manager said 2 other staff have been nominated for this training. Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 22 A training matrix shows that most staff have received mandatory training, but there are some gaps in Health and Safety, basic food hygiene, fire safety, infection control and manual handling. The AQAA confirms that only 40 of the workforce has basic food hygiene training, but since it’s completion the service has confirmed that at the time of the inspection it is 60 and since that time has increased to 80 . Other planned training includes Autism. In one staff survey comments included, “I am on a training programme at the moment. As I am a new member of staff I am well supported by other staff.” Another member of staff said,” I’d like to do my NVQ training, but have not been able to.” This was discussed with the manager. The service has policies on Equality and diversity, and has provided staff with guidance. It also has recruitment procedure in place that ensure that prospective staff do not suffer discrimination. Relatives said, “Overall the staff are excellent.” Staff meetings are held approximately every 2-3 months minutes are up to date for the August meeting, but have not yet been done for the October meeting, this is because the manager is the only member of staff who has access to the computer. This is of concern as a staff questionnaire stated, “ I have asked for minutes of the staff meeting but as yet have not received them.” This was discussed during the site visit. 4 staff recruitment files show that all relevant pre employment checks have been carried out including CRB checks. 2 written references and application forms that show the individuals work history. In one example it states that the individual had an NVQ qualification, but there was no evidence that proof of this had been obtained, this was discussed with the manager. Service users don’t currently get involved with staff interviews but do comment on staff when they visit the home as part of the interview process. Staff commented on the 1:1 supervision sessions by stating, “It’s always good to have face to face chats. It builds up good working relationships.” “Staff and manager have a good communication between each other as a team.” Strathmore House DS0000008255.V342610.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): Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that the management and administration of the home is based on openness and respect and has effective quality assurance systems in place. But the manager is not yet approved by us and has not undertaken the training recommended and there are some gaps in mandatory training which potentially place the people who use the service at risk. EVIDENCE: The manager is a registered nurse RNLD, but she has not started the Registered Managers Award (RMA) and has yet to apply to be registered and approved by us. This was discussed with her as we have expected an application to be submitted for some time, a commitment has now been given to do this. Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 24 A staff survey said, “Since there has been a new manager the home is a lot more settled and is run a lot more smoothly.” Relatives said, “I hope the freedom for local management to manage successfully will not be impeded now that Strathmore have become part of a large group company.” “I would like to know more about the organisation.” A service user said, “The new manager is good and listens to us.” Each service user has an individual financial agreement signed by them and has inventories of their property. Records show that 2 staff sign each transaction to confirm that it is correct and the manager undertakes weekly audits. In addition new finance guidance and procedures have been introduced as a consequence of an investigation into missing monies. A sample of service users finances was checked and found to be satisfactorily maintained. Individuals are supported to take responsibility for their own monies. Information in the AQAA indicates that all necessary checks of equipments, servicing and maintenance are carried out regularly. Staff and service users are involved with fire drills and fire safety risk assessments have been carried out. Fire training remains an issue as identified in the staffing section of this report as does some mandatory training. The organisation has a system for monitoring the quality of the service and monthly visits to the home are arranged to check the conduct of the home. Reports of these visits are available in the home and have been made available to us on request. A check of the certificate of registration shows that manager’s post is vacant. This is because the current manager has not yet been approved by us. This matter will be dealt with separately. Strathmore House DS0000008255.V342610.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 CONCERNS AND COMPLAINTS CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score Standard No 22 23 Score 3 3 3 3 X 2 X ENVIRONMENT Standard No Score 24 1 25 x 26 x 27 2 28 2 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000008255.V342610.R01.S.doc LIFESTYLES Standard No Score 11 X 12 3 13 2 14 3 15 3 16 2 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Strathmore House Score 3 3 2 x 2 x 3 3 x 3 x Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 YA5 Regulation 5 Requirement The service must ensure that service users have copies of their contracts and the fees and costs they are expected to pay for the service. The service must ensure that medication is securely stored. All staff must receive fire safety training. The service must ensure that the environment is well maintained throughout. The manager should apply to us to be registered as a fit person to manage the service. Timescale for action 10/04/08 2 3 4 5 YA20 YA42 YA24 YA37 13(2) 23(4)(d) 23 9 04/02/08 10/04/08 28/02/08 28/02/08 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 2 Refer to Standard YA1 YA1 Good Practice Recommendations The service should clearly indicate in the Statement of Purpose its criteria for admission to the home. Service User Guide should be up to date to include the fees and cost of the service. DS0000008255.V342610.R01.S.doc Version 5.2 Page 27 Strathmore House 3 4 5 6 6 7 8 9 11 12 13 14 YA6 YA9 YA20 YA20 YA24 YA32 YA36 YA34 YA37 YA24 YA27 YA24 Care plans should be up to date and regularly reviewed to ensure that they present an accurate reflection of service user needs. Service users should have their own front door key, subject to risk assessment and agreement. The service should ensure that medication is signed for on each occasion it is administered and medication should be properly and securely stored. Medication prescribed as required should have clear instructions or a protocol, that identifies the circumstances under which is to be administered. The service should ensure that a programme of redecoration is carried out. All staff should receive mandatory training, this included, health and safety, basic food hygiene, infection control and manual handling. The service needs to improve the methods currently used for producing minutes of staff meetings. To ensure that they are circulated in a timely fashion. The service should ensure that they check for evidence of qualification of new staff. The manager should apply to undertake the Registered Care managers Award or management equivalent. The service should provide copies of any plans to change the use of the office to us and confirm approval by fire safety officers. The service must ensure that current toilet and shower facilities are fully functioning. The conservatory must be fitted with adequate lighting and heating. Strathmore House DS0000008255.V342610.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands Regional Office 3rd Floor 77 Paradise Circus Queensway Birmingham B1 2DT 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 Strathmore House DS0000008255.V342610.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. 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