Inspection on 10/10/07 for Sussex Road, 113

This inspection was carried out on 10th October 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sussex Road, 113 11/12/06

Sussex Road, 113 08/03/06

Sussex Road, 113 02/11/05

Sussex Road, 113 05/07/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Sussex Road, 113 113 Sussex Road Southport Merseyside PR8 6AF Lead Inspector Elaine Stoddart Key Unannounced Inspection 10th October 2007 04:00 Sussex Road, 113 DS0000005295.V347338.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 Sussex Road, 113 DS0000005295.V347338.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. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sussex Road, 113 Address 113 Sussex Road Southport Merseyside PR8 6AF 01704 531025 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) Speciality Care (REIT) Homes Ltd Mrs Greta Morphet Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 3 LD The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 11th December 2006 Date of last inspection Brief Description of the Service: 113, Sussex Road is a large semi-detached, converted property, which is registered to provide care and support, for 38 weeks, for up to three young adults with a learning disability. The home is located in a residential area close to the town of Southport. The amenities close by include shops, pubs, cinema and leisure facilities, which are accessible via the local transport services or within walking distance. One member of staff in on duty per shift. The students access Arden College for their educational needs. The home is registered with Speciality Care (Rest Homes) LTD. The home manager is Colin Munro and the registered manager is yet to be appointed. Mr Peter Cavanagh is the Responsible Individual. The home provides a homely environment for the students’ resident. There are no disabled facilities required. All students have their own rooms. Communal areas include a lounge, dining/kitchen and enclosed rear garden. The charges for the service range from £42303.00 to £68829.00 per thirtyeight week placement. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A site visit took place as part of the unannounced inspection. It was conducted over a one-day period, during the early evening as the students returned from college. Three students were accommodated at this time. A tour of the premises took place and a number of care, staff and health records were viewed. Discussion took place with two students and the home manager. A new registered manager has recently been appointed and will take up position in the near future. During the inspection the two new students who have recently moved in were case tracked (their care files were examined and their views of the service were obtained). This process was not carried out to the detriment of the other student who also took part in the inspection process. All the key standards were inspected and also previous requirements and recommendations from the last inspection in December 2006 were discussed. Satisfaction survey forms “Have Your Say About …” were distributed to all the students prior to the site visit. Comments are included in the report are taken from the students survey forms and also from interviews. An AQAA (annual quality assurance assessment) was completed by the previous manager prior to the site visit. The AQAA comprises of two selfquestionnaires that focus on the outcomes for people. The self-assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service, including staff numbers and training. What the service does well: Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 6 All students are assessed prior to admission and are provided with a detailed care plan. The students have an opportunity to visit the home, meet the staff and the other students accommodated prior to moving in. The local advocacy service has been used to aid the students to voice their feelings about proposed moves. The students’ activity and educational programmes involve the students in day-to-day activities both in the home, at college and within the local community. The students have the opportunity to contribute to the running of the home and their educational programme as they take part in tutorials, student meetings and regular reviews of their care. One of the students is a member of the student council and takes the views of other students to the meetings. The students are involved with planning menus and activities of their choice and have regular contact with their families. The service uses pictorial formats to assist communication in daily living tasks, dealing with safety issues, how to make a complaint and personal care needs. The students confirmed their understanding of the pictures and the complaints procedure during the site visit. The service adresses equality and diversity issues as they have the following policies available: equal opportunity and discrimination. They can demonstrate that they listen to residents needs. A pleasant relaxed atmosphere was present and the staff and students were observed to interact positively together. What has improved since the last inspection? What they could do better: Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 7 A full tour of the premises was conducted with the help of one of the students. A number of areas of improvement were noted, many were still outstanding from the last inspection in December 2006. These include: Redecoration of the home throughout. Paint exterior of the home in keeping with the community. Refurbish the kitchen. Repair broken hall light fitting to provide lighting in the entrance. Repair/or replace broken radiator covers and block staff bathroom pipes in. These would raise the standard of the accommodation and improve the homely environment provided to the students living there. Those areas in need of attention are contained within the environment section of this report and strong recommendations made. The service must fit radiator covers/or risk assessments must be provided in care files. Discussion with the home manager confirmed that repairs and improvements needed are recorded and requested from head office. As only one maintenance person is employed to cover all the establishments within the Arden College network, repairs have to be prioritised. A recent ‘survey of property’ report conducted in July 2007 identified the work required and the estimated costs. However the company has set no dates for completion of this work. The service must complete all outstanding works identified on the electrical certificate dated 9th September 2006. A copy of the new electrical certificate must be forwarded to the commission on completion of the work. The home manager confirmed that new developments include: The information and welcome pack using symbols and written word is to be created. Care plans are to be put into a more accessible formats for the students enabling them to have more input into its creation. The implementation of pictorial healthcare books and policies and procedures are to be available in more acessible formats. The new manager should apply the commission to become registered. 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. Sussex Road, 113 DS0000005295.V347338.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 Sussex Road, 113 DS0000005295.V347338.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): Standards 2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A full assessment of need is completed prior to admission to ensure the service can meet their needs. Prospective students have the opportunity to visit prior to admission and are provided with contract agreements in suitable formats. EVIDENCE: Two new students have been admitted since the last site visit in December 2006. Both had full assessments of need and care plans in place, which were viewed during the visit. These provided information on a pen picture of the student, dietary needs, allergies, likes, dislikes, activity programmes, curriculum for educational programme and risk assessments. Contracts are agreed with the Learning Skill Council. Student tenant agreements are provided in a suitable picture format. Students spoken with confirmed their understanding of the document during the site visit and had signed their agreements. Both students confirmed they had visited the home prior to admission and expressed that they were settled in their new environment. Comments include: “I visited the unit before I moved in” Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 10 “I spoke to the residents about the home” “My parents helped me to decide to move in” “I made visits to the home before I moved in” “I like it here. The people are very nice. I have made good friends”. “It is quieter here and homely” Specialist services are available for the students to access, such as a speech therapy. Staff are trained to enable them to communicate effectively with the students and picture formats and signing are used to aid communication. The service uses the ‘Board maker’, which displays pictures to enable the students to identify activities, menus, tasks and how to complain. Staff were observed to communicate effectively with the students accommodated. Sussex Road, 113 DS0000005295.V347338.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): Standards 6,7,8,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans of care are in place and are regularly reviewed. Students are consulted and participate in all aspects of life at the home. Staff support the students to lead as independent lifestyles were possible. EVIDENCE: Two individual care and education plans were viewed during the site visit. These documents detail assessments of need, individual care plans, educational programmes, behavioural and medical issues and hobbies, interests. Care plans are reviewed every three months or before if required. Care plans are drawn up with the students, family, staff and other professionals involved in their care. Regular meetings take place with the speech and language therapist and educational psychologists were necessary. A key worker system is in place to enable the students to have individual support from member of staff who is aware of their individual needs. Long and short-term targets are set, which monitored daily and recorded. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 12 Their educational programme includes a range of lessons drama, catering, history, drama, music, catering and activities such as swimming. Varied and balanced timetables for the students are recorded on individual care files. Each student has an educational programme and activity plan in a ‘picture format’ to aid their understanding. Students’ individual activity programmes showed that students take part in discos, bowling, cinema and pub visits. Duties for independence training are recorded and students are encouraged to help prepare meals, do their own laundry and clean their rooms. Students are supported to take risks as part of an independent lifestyle and risk assessments viewed demonstrated this. These are reviewed by the home manager every three months or before should the need arise. The service responds to unexplained absences and has a procedure in place for this. The manager demonstrated the action to be taken and who to notify. Students are encouraged to maintain family contacts and families are made welcome to visit. Students spoken with confirmed student meetings are held and they use these to discuss activities and menus. Weekly tutorials give the students the chance to speak about their college life. One of the students is a representative for the student council and speaks on behalf of the other students. Students are encouraged to manage their own finances were possible. One student has his own account and manages his own money. Staff encourage students to take part in the daily routines of the home and they each have independence training tasks. An advocate service is available for the students to access if they wish. The students spoken with during the site visit provided the following comments on how they make choices and decisions about their daily living. “We have weekly students meetings” “We decide on activities and meals” Sussex Road, 113 DS0000005295.V347338.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): Standards 11,12,13,14,15,16,17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Physical and emotional needs are met in the way they prefer. The students are encouraged to take part in appropriate activities, engage in the community and maintain family contacts. EVIDENCE: The site visit took place over the early evening period when the three students returned from college. The students were observed to be relaxed within their environment. Two students have recently been admitted in September 2007 and said they were settling in to their new home. The students were observed to be comfortable and spent time in the lounge watching TV, playing on the computer and chatting with staff about the events of the day. The students were involved in their daily living tasks and helped to prepare the evening meal and clear away dishes. They were getting ready to attend the evening disco with their friends. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 14 The service offers a wide range of home and community based activities based on the individual students assessed educational and social needs. They encourage interaction and involvement with housemates as they take part in student meetings, activities and daily living tasks. Staff support students to attend their Arden College educational programme by assisting with personal care, transport and tutorials. The students twenty four hour curriculum is supported by staff and continues at the home and individual programmes are in place to evidence this. Weekly tutorials take place and involve the students, tutors and staff. College excursions include trips to the cinema, swimming and bowling. Students are encouraged to keep in regular contact with family and this was confirmed in discussion with two students who are in regular contact with their families and commented: “In see my family most weekends” “I visit my Nan a lot” “My family come here to visit” Students are given a choice of what to eat in the home and encouraged to make sensible decisions when choosing where to eat in the community. Students decide on menus within the weekly meetings and set out the daily menus on the picture boards so they are aware of what the meal of the day is. Students have lunch at the college five days a week. Breakfast and their evening meal is provided at the home. The manager confirmed that the weekly budget for food is £53.00 per week and this is for four adults (including staff). The manager confirmed that the budget is limited, however menus viewed were varied and students spoken with were satisfied with the meals. Comments include: “The food is very good” The students are encouraged to plan and budget and one student assists the manager during shopping trips by using the calculator to add up the shopping list. Materials for washing and cleaning are allocated to the home and the manager demonstrated these were in plentiful supply. Cupboards were well stocked. Care plans identify the students likes, dislikes, preferences in regards to activities. One student likes to do gymnastics and attends these sessions regularly with his family. Access is available to regular seasonal parties through the college. Christmas, Summer and Easter are celebrated. The service adresses equality and diversity issues as they have the following policies available: equal opportunity and discrimination. They can demonstrate Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 15 that they listen to residents needs. Students have the option to attend church if they wish and celebrate different cultural events such as Chinese New Year. The symbol resources that have been put in place aid communication with the students who have learning difficulties. A computer system in place for students use. Students should be offered keys to rooms and this was discussed with the manager at the visit who agreed to address the issue. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 16 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): Standards 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Physical and emotional needs are met in the way the students prefer and are recorded within their plan of care. EVIDENCE: Two care plans viewed detailed students healthcare needs and support requirements. All students have access to a local GP. All visits to health care professionals are recorded within their care plans. The students have access to an educational psychologist and language therapist via the college. All staff have received medication training. No students were in receipt of medication at the time of the visit. Medication policies and procedures are in place and available to staff for reference. Staff spoken with are aware of protecting the students dignity when it comes to addressing healthcare whether it be in the home or community. Students are encouraged to complete their own personal care routines and supported when required. Sussex Road, 113 DS0000005295.V347338.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): Standards 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The student’s views are listened to and acted upon and they are protected from abuse. EVIDENCE: Two students spoken with confirmed they are aware of the complaints procedure and how to complain. The procedure is available in the office and is presented in an accessible picture format in the kitchen for the students. Weekly tutorials and student meetings take place and students are able to talk about concerns. A complaints book is available for students to record any concerns. No complaints have been recorded since the last inspection. Students spoken with commented: “I would speak to the home manager or write it in the book” “The complaints procedure is displayed in the home”. All students have regular contact with their families and confirmed that would tell them if they were not happy. Pictorial how to deal with bullying guidelines are displayed in the kitchen. All staff have received Protection of Vulnerable Adults (POVA) training and policies on prevention of harm and abuse are available in the office. This ensures staff have the knowledge of how to alert any concerns. Incidents and accidents are reported to monitor residents care needs. However the manager is to obtain a new accident book for this. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 18 A copy of the safeguarding adults policy and procedure is available. The whistle blowing policy is on display for staff to access should they need to use it. The students are encouraged to manage their own monies were possible, however the manager confirmed that their families usually undertake this. One student has his own bank account. All transactions are recorded and receipts obtained for audit purposes. Sussex Road, 113 DS0000005295.V347338.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): Standards 24,25,26,27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and comfortable. Sufficient shared and private space is provided. Improvements and repairs are needed to raise the standard of accommodation. The lack of radiator covers/or risk assessments put students at risk. EVIDENCE: A full tour of the premises was conducted with the help of one of the students. A number of areas of improvement were noted and some are outstanding from the last visit. These would raise the standard and safety of the accommodation and improve the homely environment provided to the students living there. Those areas in need of attention include: Redecoration of the home throughout. Paint exterior of the home in keeping with the community. Refurbish the kitchen. Repair broken hall light fitting to provide lighting in the entrance. Repair/or replace broken radiator covers and block staff bathroom pipes in. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 20 The service must fit radiator covers/or a risk assessment must be in place to ensure the safety of the students. Areas highlighted at this visit: replace carpet in student back room due to stains and decorate staffroom. Discussion with the home manager confirmed that repairs and replacements are recorded and requested from head office, however as one maintenance person is employed to cover all the establishments within the Arden College network, repairs have to be prioritised. The company completed a summary of property work in July 2007 (Report was seen). Repairs and improvements needed were estimated but no dates for completion identified. Outstanding repairs and decoration have an impact on the standard of the home and should be addressed to improve the student’s accommodation. All students have their own bedroom. Individual rooms were viewed and were found to be comfortable and clean. The students have decorated their rooms with their own personal items i.e. posters. All rooms are lockable. But not all students have keys (manager to address). Space is available for students’ personal possessions and music systems, TV’s and videos. There is large bathroom, shared by the three students, which is lockable. The laundry facilities are located in the utility area. Water temperatures are recorded on outlets to safeguard the students. The lounge is comfortable and the suit has been cleaned. A TV, DVD, free view box and a computer are available for student use. The kitchen is clean but in need of refurbishment. All appliances are in working order. There is a small enclosed garden. The students commented that they are satisfied with their rooms. As part of their educational program and with the help of staff, the students are encouraged to keep their home clean. Visitors are made to feel welcome and this includes family, friends, advocates, social workers and inspectors. Health and safety practises and checks are in place. Certificates for services were checked and were found to be up to date, with the exception of the electrical certificate, which was to be faxed to the commission for evidence. The certificate dated 9th September 2006 showed outstanding works required by the service. These must be completed and a copy of the new electrical certificate must be forwarded to the commission on completion of the work. Sussex Road, 113 DS0000005295.V347338.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): Standards 32,34,35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recruitment and selection process is robust to protect the students. Manual handling training must be updated for the staff to ensure they can carry out their roles safely. EVIDENCE: The service provides one member of staff on duty per shift including a sleep in duty each night. Staff handovers take place at each shift cahnge. A core group of staff are employed and there is one vacancy, which the home manager aims to fill quickly from staff employed within the service. No new staff have been employed since the last inspection. Staff files were viewed at the last visit and contained the required recruitment and selection procedures. All potential new staff are taken on subject to a criminal record bereau test. The training programme viewed showed an ongoing training programme for staff, which is up to date with the exception of Manual Handling. This must be updated for the staff employed to ensure that staff carry out their roles safely. The home manager confirmed, “Training is good. We did managing aggression Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 22 course yesterday”. The manager is involved in many courses to ‘aid communication’ with students. 100 of staff have completed National Vocationl Qualifications (NVQ) level 3. Good team communication exists between staff within handovers, the communication book and regular staff meetings. Staff and students were observed to interact very well during the visit and the students spoken with commented on their satisfaction with the staff employed. Comments include: “I like it here. The people are nice. I have made good friends”. “It is quieter here and homely” “I get on with all the staff” Sussex Road, 113 DS0000005295.V347338.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): Standards 37,38,39,42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of the students. The service must complete all electrical works to provide a safe environment for the students to live. EVIDENCE: Since the last inspection the registered manager has left the service and a new manager has been appointed and is to take up the position in the near future. The manager should apply to the commission to be registered. The daily running and management is undertaken by the home manager Colin Munroe who has worked for the service for a few years. Regular home audits take place and were viewed. These include, a recent financial audit by the parent company on 30/4/07, recent clinical governance Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 24 audit by parent company in October 2007, monthly provider visits, Infection control audit in September 2007 and internal audit and action plan completed on 4/10/07. Students are consulted via weekly meetings and the last resident questionnaire was done 11/11/06. A new one is to be done once the new students have settled in. The last two CSCI inspection reports are available to view including ‘easy read’ report. Policies and procedures made available in the office and are updated annually Certificates for services were checked and found to be up to date, with the exception of the electrical certificate. The home manager was requested to obtain a copy and confirmed one was available dated 9/9/06. The service must complete all outstanding works identified on the electrical certificate to provide a safe environment for the students. A copy of the new electrical certificate must be forwarded to the commission on completion of the work. Fire drills and alarm checks are recorded and a fire risk assessment was completed on 13/4/07. Accidents and injuries are recorded. These ensure the health and safety of the students. A pleasant, comfortable and inclusive atmosphere was present. Students were observed to be relaxed in their environment and interacted well with staff on duty at all times. All records were accessible, organised and easy to understand. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 3 X X 2 3 Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 26 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 23 Requirement The service must complete all outstanding works identified on the electrical certificate to provide a safe environment for the students. A copy of the new electrical certificate must be forwarded to the commission on completion of the work. Provide radiator covers/or ensure risk assessments are in place. (Outstanding from last inspection. Time scale not met). Staff manual handling training must be brought up to date. Timescale for action 31/12/07 2. YA24 23 31/12/07 3. YA35 18(a) 31/12/07 Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA37 YA24 Good Practice Recommendations The new manager when appointed should make an application to the commission for registration. The service is strongly recommended to carry out the following repairs and improvements to raise the standard of accommodation for the students. These include: Redecorate the home throughout due to wear and tear, paint exterior, refurbish kitchen, repair broken radiator covers, repair hall light fitting, block staff bathroom pipes in and replace student carpet in rear upstairs bedroom. Sussex Road, 113 DS0000005295.V347338.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Sussex Road, 113 DS0000005295.V347338.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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