Inspection on 11/09/07 for Stratton Road (20)

This inspection was carried out on 11th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Stratton Road (20) 13/11/06

Stratton Road (20) 10/11/05

Stratton Road (20) 22/06/05

Stratton Road (20) 26/02/05

Stratton Road (20) 16/11/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Stratton Road (20) 20 Stratton Road Pewsey Wiltshire SN9 5DY Lead Inspector Roy Gregory Unannounced Inspection 11th September 2007 03:00 Stratton Road (20) DS0000028314.V349141.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 Stratton Road (20) DS0000028314.V349141.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. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stratton Road (20) Address 20 Stratton Road Pewsey Wiltshire SN9 5DY 01672 564957 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) Innovations Wiltshire Ltd Miss Beverley Britten Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th November 2006 Brief Description of the Service: 20 Stratton Road accommodates three adults with a learning disability. It is one of four residential care homes owned by Innovations Wiltshire Ltd. Miss Bev Britten is the Registered Manager and Mrs Nan Lance is the responsible individual. Mrs Angie McGrorty, service manager, makes up the management team. The home is in a residential area of Pewsey, within walking distance of shops, doctor’s surgery and other amenities. The home is a semi-detached house, furnished to a good standard. People have single rooms, one on the ground floor and two upstairs, with toilets and bathrooms on each floor. They share a living room, kitchen-diner and garden. The home has one member of staff on duty throughout the waking day and sleeping-in cover is provided at night. Fees for living in the home are based on individual need and range from £800 to £1,000 a week. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place between 3:00 p.m. and 8:30 p.m. on Tuesday 11th September 2007. The inspector met with the senior support worker on duty at the time and more briefly with the registered manager, Miss Bev Britten, and the provider, Mrs Nan Lance. Initially one of the three people living at the home was present. The two others returned from attending a day service later in the afternoon. The inspector was able to spend time and talk with all three service users, singly and together at their evening meal. All areas of the home were seen, including the bedrooms by invitation. Records that were read included care records and support plans, and proof of monitoring health and safety matters, including risk assessments and fire precautions. The inspector looked at how medication was used and how the home links up with health professionals and other community resources. As the home had recently conducted a questionnaire exercise with people in the home, their relatives and external professionals, reference was made to responses that had been received. On a visit to the provider company’s office it was possible to look at staff records, including those about training, supervision and recruitment. Other information was contained in the Annual Quality Assurance Assessment submitted by the manager to the Commission, as required annually of all regulated services. Following the visits, the inspector made telephone contact with the near relatives of two people that live at the home. This was to ask their opinions of the nature of service provided. The judgements contained in this report have been made from evidence gathered during the inspection, which included the visit to the service and taking into account the experiences of people using the service. The inspector would like to thank the people and staff for their welcome and assistance. What the service does well: Each person had a support plan. These used standard sections and were easy to follow. People were aware of their plans, which they said made sure their needs were understood. A standard section of support plans concerned provisions for people’s privacy. People were seen at different times choosing to do things on their own. People got up and went to bed when they chose. One person said they looked forward to their weekend lie-ins. Support plans emphasised a person-centred approach, to include respect for diverse needs. Daily diaries showed that care and support were offered in line with support plans. The community learning Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 6 disabilities nurse and a physiotherapist had written about the staff working well with them to make sure people stayed in good health. People shared use of a car and a minibus with people from two nearby homes. They went on a variety of trips out. They used local shops and pubs, and also had bus passes. One person was playing darts with a local team. Relatives that the inspector spoke to said the home had always communicated well with them. One said, “X has a fulfilling lifestyle; I just want them to continue doing as they do”. Another said, “We’ve been very pleased. Y seems very happy and is helped to be independent”. The three bedrooms reflected the personalities and interests of the people living there. People seemed proud of their rooms. Standards of cleanliness were high, including in toilets and the kitchen. People could get drinks and snacks when they wanted to. They enjoyed having evening meals together, and helping with preparation and serving. They all helped choose in advance what meals they would have. They were about to go on holiday abroad together. They had met together to decide where they wanted to go and to help staff arrange the holiday. They had already been on a caravan holiday together. What has improved since the last inspection? What they could do better: Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 7 No requirements have been set as a result of this inspection. It is recommended that support planning should include setting goals with people. When someone lives in one place for a long time it is easy to settle into a routine without learning many new things. If people were helped to concentrate on particular life skills or interests for a period of time, they could get a sense of achievement and progress. For example, a person was learning to tell the time. It would be good to plan with them who can best help them, and to make sure of checking after a while whether the goal has been reached, or if more ideas to help are needed. A second recommendation is to keep staffing provision under review. The home is often staffed by one person. This is appropriate for a lot of the time. In a small house, where people are independent in many ways, having one member of staff emphasises that it is the people’s home. However, there are times when an additional member of staff would increase the options of individuals to join others on an outing, or to stay at home. Also, relatively independent people will sometimes benefit from one-to-one availability of staff. 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. Stratton Road (20) DS0000028314.V349141.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 Stratton Road (20) DS0000028314.V349141.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): 2 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear assessment and admission process to ensure any admission would be appropriate to the individual concerned. Current users of the service have recently renegotiated contracts. EVIDENCE: The people living at the home have done so for several years. They expect to continue living there, as they are settled and the home can continue to meet their needs. Therefore no admissions have occurred for a long time, and none are in prospect. However, the provider company has developed an admissions policy and procedure within the last year, which has led to well-managed assessments and admissions at two other homes. Since the previous inspection, the company has renegotiated contracts with the funding authority for all three people living in the home. This has given the home increased financial viability, leading to greater security for the people living there. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 10 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’s assessed needs are reflected in care and support plans, which are reviewed and changed as necessary. People are supported in making decisions about their everyday lives. Setting of longer-term goals could help give a sense of achievement and progress. Risks are identified, and assessed in such a way as to encourage safe participation in a range of activities. EVIDENCE: The quality of support plans had clearly received a lot of attention since being subject of a requirement to improve at the previous inspection. Plans for all three people in the home were very well written. All used standard headings. They gave concise but clear guidance to people’s own abilities, and to the areas in which some level of support was necessary to promote independence and enjoyment of life. One person joined the inspector to look over their plan. They were clearly familiar with it, and said they took part in reviews. For another person, communication was an area needing support. Their plan gave clear guidance on how to engage with them, based on experience and outside Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 11 professional advice. Care plans emphasised a person-centred approach, to include respect for diverse needs. All plans included provisions for how to promote privacy. They showed how people liked to use their private rooms and how they wanted staff to make contact. There was evidence that there had been discussion with people about the possibility of using door locks, if they wished. People in the home said staff always knocked at their doors, and waited to be invited in. Observations of care interactions showed that people were consistently offered choices, and able to make decisions about everyday matters. For example, a person went to have a bath when they decided the time was right for them, and people talked among themselves about plans for the evening. One person had a friend living nearby, and made their own decisions about when to visit their friend. An improvement to support plans would be to set goals with people. When someone lives in one place for a long time it is easy to settle into a routine without learning many new things. With one or two goals agreed with people, they could concentrate on reaching them for six months or a year. This would help people have a sense of achievement and control. There was a recent policy on risk taking and risk management. The statement of purpose described the service as “risk aware but not risk averse”. Risk assessments seen were of good quality, with an emphasis on promoting rather than limiting activities. They were checked as part of monthly management audits. This practice followed a requirement being made at the previous inspection for a more consistent formalised way of assessing risks. The inspector suggested that for someone who goes out locally alone, a risk assessment should be put in place, as the staff had begun to identify areas of potential risk. Once in place, an assessment can be routinely reviewed, to ensure safety measures are maintained at an appropriate level. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 12 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 – 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Varied activities give people access to the community and opportunities to maintain leisure interests. Relationships with families and friends are encouraged. People participate in everyday tasks and their rights are respected. A healthy diet is offered, and mealtimes are conducted as people want. EVIDENCE: Support plans gave good descriptions of people’s leisure interests and needs, and reflected what people said about how they liked to use their time. One person’s plan described their love of helping with meal preparation and baking. They helped with cooking the evening meal during the inspection visit, and another person helped with serving it. There were examples of people doing their own washing and going out to buy a paper, and it was obvious they liked to do little things for each other. One person played darts for a local pub team Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 13 and another liked to place horseracing bets at the weekend. A person said they were “choosing things all the time” and were currently learning to tell the time. The member of staff present described Saturdays as “very domestic”, with all three people liking to spend a lot of time by themselves getting basic chores done, and the two men enjoying a lot of sport on TV. Each person was well equipped with audio-visual equipment in their rooms, and also games and hobby materials. One person particularly enjoyed jigsaw puzzles, and playing dominoes with staff. During the evening people enjoyed some time together around the TV in the sitting room, and sometimes played games. Friendships among the group were important to individuals. The three people had spent a caravan holiday together, with staff support, earlier in the year. They were about to go together to a resort in the Canary Islands, following a successful similar holiday in the past. This was to be with a person living at another of the Innovations homes, and three members of staff. They described their involvement in choosing the holiday, and showed details of what was booked. During the course of the week, people attended some day services. There was evidence of good liaison between the home and a Resource Centre used. In her response to the service’s quality questionnaire, the manager of the resource centre said the people often referred to things they had done with home staff. She described the home as a “client-led service”. Bus passes had been obtained for all people living in the home. The company also has two vehicles available to help get people where they need to be at different times, using staff from any of the homes to drive, as appropriate. The company was actively considering how to meet activity and social needs in the future, if there should be further cutbacks in external services. People could plan to go out for shopping and other trips. Records showed they did so often, but staff availability could be a limiting factor. If there was only one member of staff available to the house, as was sufficient for most of the time, then any activity needed to include all the people in the house at the time. Two staff were needed to enable one of the people to access the rear garden. People liked to attend the Gateway Club. A relative of one of them provided the transport for this. There was also evidence of going to local pubs and individuals going to family events. Two people liked to attend meetings of “Open Minds”, a local self-advocacy group. One person had been to a family party and there was evidence of exchange of information both ways between the home and family to ensure a successful evening. The person had returned at 11:45 p.m. and then stayed up for a while. By contrast, another person was recorded one evening as having been tired and chosen to go to bed really early. People said they always made their own decisions about getting up and going to bed, one saying they looked forward to lie-ins at weekends. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 14 The evening mealtime was very enjoyable. It gave a picture of how much the people living in the house regard it as their home. They described monthly menu planning sessions, where they ensured everyone’s wishes were incorporated. Records showed that people received a varied diet, including some meals out. Meal times could be easily changed to suit individual needs, and a light tea was provided if someone had eaten a substantial lunch as part of a day activity. One person was on a weight control diet and records showed there had been no gain since it began. People spoke of getting their own breakfasts and snacks. Stratton Road (20) DS0000028314.V349141.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. The home provides personal support in line with people’s preferences and needs. There are good links and systems to ensure physical and emotional health needs are met. People are protected by the home’s medication procedures. EVIDENCE: Support plans were specific in describing personal care needs. They emphasised those areas in which people were self-caring or needed little additional support. The plans also gave good guidance about individual longterm health conditions. For a person with skin and ear problems, their plan explained both precautionary measures that must be assisted, and reactive measures for when conditions became more severe. Department of Health “Heatwave” guidance was kept to hand and there was evidence of related precautions having been taken when indicated. A physiotherapist had supplied one person with a standing frame to help with strengthening limbs. There was a protocol for use of the frame, with guidance Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 16 to staff on the was positioned whilst using it. confidence and it. reasons for use of the frame and how to support safe use. It in a way that allowed the person to undertake other activities When it was used, the supporting member of staff displayed the person was in control of when and for how long they used Changes and concerns that staff had noted in relation to another person had led to a request for a specialist assessment that had been carried out. There was evidence overall that the home and provider had good links with health professionals in the community. People were allocated a “key worker”, who was responsible for maintaining routine health appointments and checking on clothing needs. Otherwise, all staff knew the people well and were able to care and support in a consistent way. Daily diaries were kept for each person. These showed that care and support were offered in line with support plans. One person’s “Health Action Plan” was seen. A community learning disabilities nurse responded to the home’s quality assurance questionnaire in May 2007. She recognised “good staff attitudes” and wrote: “Requests for information or to carry out guidelines are met.” Another response was from a physiotherapist: “Staff are receptive to advice and positively working in partnership in promotion of health preventative working.” One person in the home had been subject of an assessment for hydrotherapy, which they were attending regularly. Medications were not used to a great extent in the home. The arrangements for storage and administration of medicines were good. Support plans explained why particular medications were in use, and why related care directions were important, for example monthly weighing. A requirement and recommendations made at the previous inspection, to improve the safety of practice and recording in administering medicines, had been followed. The provider was planning to install medicines cabinets in individual bedrooms. Two people said they would welcome this, as they could then take greater responsibility for their own use of medicines. Stratton Road (20) DS0000028314.V349141.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 a visit to this service. There are appropriate procedures, including staff training, to protect people from harm, and to receive and act on complaints. EVIDENCE: A person in the home described how they had been able to talk openly with a senior member of staff regarding discomfort in how another member of staff had treated them, earlier in 2007. This had led to a management decision to suspend the member of staff pending enquiry. The staff member had then resigned, but the management continued with a referral to Protection of Vulnerable Adults procedures. More recently, the company has co-operated with local multi-agency safeguarding procedures regarding an issue in another of the company’s homes. In line with a requirement made at the previous inspection, an external trainer for abuse awareness training for all staff had been found and provided training to all staff. There was provision for updating this every two years. Staff had been issued with the latest version of the “No Secrets” brief guidance to local inter-agency safeguarding procedures. The senior management team, including Miss Britten, recently attended refresher safeguarding training with people from the community team for people with a learning disability. There was a new policy on abuse, which included “whistle blowing” provision. There was an effective policy and procedure covering any incident of a person going missing. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 18 There was a good standard of recording of incidents and accidents, including use of body maps to record any injury sustained. Support plans included guidance on individual support to people’s use of personal money. There were systems for safekeeping and for recording any transactions. There was evidence of support and guidance being readily available from the Wiltshire County Council appointee, who in turn monitored safe practice. There was work in progress, including obtaining appointee advice, on ensuring people received full entitlement to mobility allowances. The complaints information provided to people’s representatives was satisfactory. Both relatives who were spoken to said they knew how to complain. They considered the home and provider to be approachable and had experience of satisfactory responses to queries raised. No formal complaints had been received by the service since the previous inspection. Two people living in the home said they would raise any concern first with the senior support worker, Miss Britten, or Mrs Lance. Stratton Road (20) DS0000028314.V349141.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, 25, & 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 20 Stratton Road provides a homely environment, maintained and kept clean to a high standard. Individual bedrooms reflect people’s needs and lifestyles. EVIDENCE: The house had a spacious feel in the shared rooms and individual bedrooms, with a practical and attractive layout. There were some inevitable knocks from frames and wheelchair use, but décor was in good condition. People there were happy with the bland and uniform colour scheme in most of the house. Plans were in place to undertake some redecorating and addition of more modern and colourful curtains. There was work in progress on making the rear garden more accessible, the company having taken on a gardener for the three homes in Pewsey. The three bedrooms reflected the personalities and interests of the people living there. One person talked of having chosen a colour scheme for their Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 20 bedroom as it was due for redecoration. Relatives said they had always regarded the environment as good and well kept. There was a recently developed policy on infection control. This was based on Department of Health “Essential Steps” guidance. All parts of the home were cleaned to a good standard, including bathrooms and the kitchen. Two minor risks to hygiene in one of the bathrooms were corrected immediately when pointed out. There was a utility room with washing machine and drier, and washing was dried outside when the weather allowed. Stratton Road (20) DS0000028314.V349141.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 – 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by competent, trained staff, who experience regular supervision and are supported by an employer committed to staff development. Recruitment practices ensure people are protected from being cared for by unsuitable staff. EVIDENCE: The staff member on duty during the inspection visit was designated as the senior support worker to 20 Stratton Road. As such, she spent most of her duty time there and people living there identified her as their main support. Other staff were rostered to work at any of the company’s houses in Pewsey, so people experienced a variety of support workers. The senior support worker said this had the advantage of allowing people interaction with staff of both genders and different ages. Each person had a key worker from the staff group, responsible for helping maintain people’s routine appointments, clothing needs and so on. Lone working has always been a characteristic of how the home works, and continued to be so. There was a lone working policy. An on-call manager was Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 22 always available. Staff operated a handover of information between shifts. The senior support worker said lone working was generally appropriate to the needs of the home. There were times when there were only one or two people at home, and even with all three the home had a more domestic feel with just one staff member. However, it meant that at times of pressure on staffing, due to sickness and leave for example, there was a risk the home could not be staffed for part of a day. A person from the home had recently spent a number of hours, on two consecutive days, at another of the homes in Pewsey, because of insufficient staff cover for all the houses. The senior support worker felt strongly that people should be able to stay in their own home. There was evidence that the company management had been trying to reduce the incidence of such shortfalls since the previous inspection, when a recommendation had been made to address the problem. Rota planning was a main component of a weekly managers’ meeting. The company had recruited some relief staff. There was ongoing recruitment, which it was planned would remove the risk of insufficient staff availability and provide more opportunities for double staffing. This in turn would enable more community access for people in the home. One person in the home said they would like to have more staff sometimes, if it meant more choice about going out or staying in. Another said they liked usually having only one member of staff in their home, and considered they went out enough. Both relatives who were contacted saw staffing as sufficient. One said the telephone was always answered whenever they rang. The other commented that “it’s not a big house, and only one person needs a lot of support”. Recruitment records sampled showed that prospective members of staff completed an application form and were interviewed in a consistent way, with records kept. It could be easily seen that new staff did not start working for the company until after the company had received disclosures from the Criminal Records Bureau (CRB) and confirmation that the individuals were not listed on the Protection of Vulnerable Adults (POVA) list. Two references were obtained for each person recruited. There were photographs of all members of staff. Identity cards were being developed, so that in any situation outside the home, staff could prove to others their duty of care. Senior support workers were responsible for supervision of support staff and were themselves supervised by the registered manager Miss Britten. All senior staff had received training in supervision of staff. Records showed staff were receiving supervision every four to six weeks, each session ending with setting a date for the next one. There was recent experience within the company of supervising individuals more frequently for particular reasons. Supervisions were recorded on a standard format, which proved them to be a meaningful exercise. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 23 In the company office there was a training matrix showing what training each member of staff in the company had achieved, and when renewals were due. Copies of certificates were held in individual staff files. The company employed 14 support staff across the three homes in Pewsey. Of these, five had achieved National Vocational Qualification (NVQ) in care, level 2, and three were currently working towards it. An induction programme for new staff, compliant with “Common Induction Standards”, was ready to use with staff currently being recruited. There was evidence of arrangements being made to secure a training provider that can provide support to the staff’s induction, mandatory and NVQ training needs. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 24 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 a visit to this service. The management team provides leadership and direction so people benefit from a well run home. Quality assurance systems include obtaining the views of service users’ and their supporters to monitor and improve the service. There are systems in place to identify and promote the health and safety needs of residents and staff. EVIDENCE: Since the previous inspection, the company has appointed Mrs McGrorty as service manager, and there is also now an administrator. These appointments have enabled more consistent liaison between the company and placing authorities. Better funding for placements had been negotiated. This resulted in improved provision for people using the service: new vehicles, more staff recruitment and environmental improvements. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 25 It was clear that considerable effort has been put to improving systems of working, training and recording. New policies and procedures have been put in place and old ones updated. Managers carry out a number of internal monthly monitoring checks. Following a requirement made at the previous inspection, an annual quality assurance exercise has been put in place, including a feedback tool for key workers to use with people living in the home. Questionnaires were sent to a range of professionals in May 2007 and a number of full responses had been received. There was also a staff questionnaire. The relatives spoken to confirmed they had received and returned questionnaires. One was pleased this was to be an annual exercise. The management team used collated responses to identify areas for development. Health and social care professionals who responded identified management changes as having been effective. One said changes had been “not too fast for service users to understand.” Monthly monitoring visits acted in part as an audit of health and safety measures, including fire precautions and drills. Records were sampled. Action points were indicated where any shortfall or developmental need was found. As required at the previous inspection, risk assessments had been drawn up in relation to radiators and hot water outlets. There were arrangements for the training of staff in moving and handling, fire safety, first aid, food hygiene and infection control. A person living in the home confirmed they were aware of fire precautions in use, and knew how to respond in the event of the fire alarm sounding. One of the senior support workers had delegated responsibility for health and safety issues in all the homes, whilst another was designated fire officer. Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 26 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 X 5 3 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 4 25 4 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 4 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 4 13 3 14 3 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Stratton Road (20) DS0000028314.V349141.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action 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 YA6 YA33 Good Practice Recommendations Aim to set goals as part of the care planning process. Keep staffing provision under review, to ensure people’s wishes in regard to activities can be met, and to avoid any demands on people to spend time at other homes. Stratton Road (20) DS0000028314.V349141.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 Stratton Road (20) DS0000028314.V349141.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. 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