Inspection on 28/08/07 for Swan House

This inspection was carried out on 28th August 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Swan House 30/06/08

Swan House 19/01/07

Swan House 09/05/06

Swan House 21/02/06

Swan House 11/07/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Swan House 6 Newholmes Monyhull Hall Road Kings Norton Birmingham B30 3QF Lead Inspector Sarah Bennett Unannounced Inspection 28th August 2007 09:35 Swan House DS0000062628.V350882.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 Swan House DS0000062628.V350882.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. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swan House Address 6 Newholmes Monyhull Hall Road Kings Norton Birmingham B30 3QF 0121 444 2710 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) South Birmingham Primary Care Trust Family Housing Association Limited Anirood Nobab Care Home 6 Category(ies) of Learning disability (6), Physical disability (6), registration, with number Sensory impairment (6) of places Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home can accommodate six people with a learning disability under 65 years. The home can accommodate three named people over the age of 65 years 19th January 2007 Date of last inspection Brief Description of the Service: Swan House was purpose built as a care home, on the site of what was previously Monyhull Hospital. South Birmingham Primary Care (NHS) Trust manages the staff and the home, and Family Housing Association owns the premises, which is a bungalow. At present the home accommodates six men. The men all have a Learning Disability; some have impaired mobility, and some display behaviour’s that challenge. The accommodation comprises of six single bedrooms, a communal lounge, dining room, a W.C, adapted bathing facility in the bathroom, shower room, kitchen and laundry room. The home has a garden at the rear and side of the home, with garden furniture and shade. The fees charged as stated in the service users guide are £127.35 per week to Family Housing Association. Each person living there also pays a contribution to the home’s vehicle and this is dependent on how much Disability Living Allowance the individual receives. A copy of the CSCI inspection report is available in the home for those who wish to read it. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit was carried out over one day; the home did not know the inspector was going to visit. This was the homes key inspection for the inspection year 2007 to 2008. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and a questionnaire about the home – Annual Quality Assurance Assessment (AQAA). Two people who live in the home were case tracked this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. The people who live at the home were spoken to. Due to their learning disability and communication needs it was not always possible to get their views on the home. The manager and the staff on duty were spoken to. What the service does well: Each person has a care plan that shows the staff how to support them to meet their needs. They had pictures making them easier to understand. Staff help the people living there to keep in touch with their family and friends. Staff know that it is important for people to remember their past and the people that are important to them. Staff look after the money of the people who live there well. They keep records that show that staff check the money often, they write down what each person buys and always get a receipt. Each person living there has their own bedroom. These include their personal things and people said they liked spending time in their bedroom. Staff know the people who live there well and spent time talking to them. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 6 Staff make sure they often do the fire and health and safety checks to make sure that the people who live there, staff and visitors are safe. What has improved since the last inspection? What they could do better: Money should be available so that the people living there can go on the holiday they choose at the time of year that they choose. Staff should support each person during mealtimes to make sure it is a relaxed and enjoyable time for all the people living there. When something like the washing machine breaks down it should be repaired quickly so that people do not waste their time and the home’s money going to the launderette. The bath needs to be repaired so that people have a choice of having a bath or a shower. More rooms must be redecorated so that the home is more comfortable and homely for the people who live there. Chairs should be bought that are comfortable and the people who live there can get in and out of easily. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 7 The table in the dining room should be in good condition so that it is clean for people to eat their meals on. Records should state that the right checks had been done before staff started working there to make sure that ‘suitable’ people are employed to work with the people living there. Staff should have the training they need so they know how to meet all the needs of the people living there. 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. Swan House DS0000062628.V350882.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 Swan House DS0000062628.V350882.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need to make a decision as to whether or not they want to live at the home. EVIDENCE: The Manager said that the statement of purpose of the home and the service users guide to the home SUG had not been updated since the last inspection. At that time they included the relevant and required information so that prospective service users would be able to make a decision about whether or not they wanted to live there. A copy of the service users guide was seen in one person’s bedroom so they have the information they need about the home. The admission procedure included all the relevant information including an assessment of individual’s needs being completed before they moved into the home. The people living there have lived there a number of years and there were no vacancies. Therefore the standard relating to assessment could not be fully assessed at this inspection. Swan House DS0000062628.V350882.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, 8, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the information they need in individual’s care plans and risk assessments so they can support them to meet their needs and take risks ensuring they are as safe as possible. The people living there are enabled to make choices and decisions about their lives with support where needed. EVIDENCE: Two records of the people who live there were sampled. These included an individual care plan. This was detailed, included pictures making it easier to understand and was written in a way that centred on the individual. It included information ‘About Me’, ‘More things to know about me’, ‘People in my life’ ‘Before I lived here’, ‘How I communicate,’ ‘Foods and places I like and don’t like,’ ‘Things I like and don’t like at home,’ ‘My in house activities’ and ‘my outside activities.’ Each section stated the support that the person needed from staff to help them meet their needs and achieve their goals. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 11 One person needs have changed and they require more support from staff. Their records showed and the manager said that the social worker visited the week before to assess the person as to whether extra funding for staff was needed to support them. Care plans were reviewed regularly to ensure that the person was being supported to achieve the objectives that had been set. Where the persons needs or aspirations had changed the care plan was updated to reflect this. Records showed that individual meetings had been held with the people who live there where they talked with their key worker about holidays, the things they like about others who live at the home and the things they don’t like, whether or not they are happy living there, the things they like about their home and what decisions they had been involved in. Due to the communication needs and learning disability of the people living there some of their choices and decisions are limited. For one person the decision they had been involved in that month was going out to choose their birthday presents. Records showed that people were enabled to make the choices and decisions that they were able to. For some people close relatives were also involved in making decisions as to what they spent their money on to ensure as much as possible that decisions were made in the best interests of the individual. Records sampled included individual risk assessments, some of these included pictures making them easier to understand. Risk assessments stated what support from staff the person needed to minimise the risks if there was a fire, of them getting a pressure sore, mobility, using bedsides, during the night, falling, suffering poor health, weight loss, physically abusing others or being abused by others and staff, self-injury, their behaviour, not going out enough, going on holiday and travelling in the minibus. These were reviewed monthly and updated where necessary where the person’s needs had changed. Swan House DS0000062628.V350882.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, 13, 14, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Arrangements are not sufficient to ensure that the people living there always experience a meaningful lifestyle. People are offered a healthy diet but their mealtimes are not always relaxed and enjoyable. EVIDENCE: One person usually goes to a day centre from Monday to Friday but was at home as the centre was shut for a holiday. During the day people were observed taking part in activities inside the home that they enjoyed. This included playing games, doing puzzles, watching TV and listening to music. The washing machine was not working so washing had to be taken to the launderette. Three people went with staff to take the washing and then went clothes shopping. The washing machine had not been working for weeks; this is discussed further under the ‘Environment’ standards in this report. However, staff said this had impacted on the activities that people could do because each day they had to go to the launderette. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 13 The home has a vehicle that the people living there contribute to financially. However, there are only two staff that can drive it, one of which is the manager so people do not always get value for their money from it. The manager said that a new member of staff has been recruited who can drive it and another member of staff is soon returning who is a driver. This will help ensure that people have more opportunities to go out in the vehicle. Staff said they also encourage people to use public transport. Records sampled showed that people go out for drives to the countryside, go to the city centre, go to parks, visit their friends, go to church, go to the bank to get their money and go out for meals and drinks. Inside the home people play games, do puzzles, watch TV and DVD’s, listen to music, relax in the garden and do arts and crafts. Staff said and records showed that the people living there are consulted about where they want to go on holiday. ‘My Holiday’ forms showed that people were supported to choose where they wanted to go and when, who do I want to take me there, do I want another person who lives here to come with me, how much will it cost and how will I get there. These included pictures and staff had used travel brochures and pictures to help the person choose. It was disappointing that one person had been supported to choose their holiday and it had been booked. However, it then had to be rebooked, as South Birmingham Primary Care Trust (PCT) did not have the cheque ready in time to pay for it. Staff said that holidays for the other people who live there are also being booked and one person is planning to go to Ireland to see their family. Records sampled showed and staff said that the people living there are supported to keep in contact with their family and friends. This is through their family and friends visiting them, visits to their family and friends, telephone calls and buying cards and gifts for special occasions. People are encouraged to be as independent as possible. Records sampled showed that people put their laundry away and helped to tidy and clean their bedrooms. There are pet rabbits in the garden that people living there help to feed and to look after. Menus were varied and included fruit and vegetables for each meal. An alternative was offered for lunch and the evening meal. Food records showed and it was observed that there are a choice of breakfast cereals as well as fruit and a choice of breads. In the menu folder it stated what foods each person likes and dislikes and individual dietary needs so that staff are aware of these when developing the menus. At lunchtime most people were asked what they wanted to eat and their choices were respected. One person who was just returning from shopping had their meal cut up and had sauce put on before they came back. Staff said that they know what the person likes but this did not allow for the person to change their mind or choose how much sauce they Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 14 wanted on their meal. During the meal one person kept touching the person sitting next to them, which seemed to annoy them and did not ensure they relaxed while eating their meal. Staff need to ensure that each person is supported appropriately at mealtimes so that they can all enjoy their meals. Staff were aware of individual’s dietary needs and these were provided for. Food records sampled showed that since the last inspection staff have ensured that the people living there are offered at least the recommended five portions of fruit and vegetables each day to ensure their health and well being. Swan House DS0000062628.V350882.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. Arrangements ensure that the personal and health needs of the people living there are met. The management of the medication ensures people get the medication they are prescribed at the right time so ensuring their well being. EVIDENCE: The people living there were well dressed appropriate to their age, gender and the activities they were doing. It was evident that attention had been paid to individuals personal care helping to maintain their self - esteem. People had individual styles of hair and dress. Throughout the day staff supported people to change their clothes when needed so they were not in dirty or stained clothes. Care plans sampled included how staff are to support each person with their personal care. These were detailed and showed how day and night staff are to support people whilst encouraging the person to be as independent as possible. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 16 Records sampled included an individual Health Action Plan. This is a personal plan about what a person needs to stay healthy and what health services they need to access. The plans included pictures making them easier to understand. Records sampled showed that health professionals are involved in the care of individuals. Records showed that staff had followed the advice of health professionals so ensuring individuals health needs were met. Staff had supported individuals to visit their GP when they were unwell. People had been supported to go to the dentist and optician regularly and have regular ‘Well Man’ checks at the doctor’s surgery. Each person had a communication passport, which had been compiled for the individual by the Speech and Language Therapist. They included information on how the person communicates so that unfamiliar people know how best to communicate with the person. Records sampled included a ‘My hospital book’ which included personal information about the individual that if they were admitted to hospital the staff there would need to know so they could support them appropriately. Records showed that people had been regularly weighed and advice from the dietician had been sought where needed. It was evident that advice had been followed and any special dietary needs such as supplements and full fat or skimmed milk were provided. Where people were at risk of constipation, which could affect their well being they had a bowel record. Records of people’s bowel movements were also kept in their daily records. The two records did not match and the bowel records showed gaps of two to six days when it was not recorded that the person had a bowel movement. No action seemed to be taken but on looking again at the daily record they showed that the person had been to the toilet regularly. If two records are needed then these need to match so that people are not at risk of being given laxatives for constipation if this is not needed. Medication is kept in a locked cabinet and is supplied by Boots in blister packs using the Monitored Dosage System (MDS). This makes it easier for staff to know what medication to give each person and at what time. Copies of prescriptions are kept so that it is clear what each person is prescribed and these can be checked against their medication packs to ensure the Pharmacist has dispensed their right medication. Medication Administration Records (MARS) had been signed appropriately and these cross-referenced with the person’s blister pack indicating that their medication had been given as prescribed. Some people are prescribed as required (PRN) medication. A protocol stating when and why this medication should be given was in place so that staff know when the person should have it. At the front of each person’s MARS there was a photo of the individual and a Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 17 summary of how they take their medication so that unfamiliar staff would know which person to give the medication to in the way that they prefer. Some people are prescribed Controlled Drugs (CD’s) and these are stored as required in a separate cabinet. Staff check these drugs at the handover of each shift to make sure they are not being used inappropriately and keep a record of this. The records cross-referenced with the amount of drugs kept in the CD cabinet indicating that they had been used appropriately. The manager said that six of the current staff are assessed as competent to administer medication. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 18 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. Arrangements ensure that the people living there know that their views are listened to and acted on. Arrangements have improved and are now sufficient to ensure that the people living there are protected from abuse, neglect and self-harm. EVIDENCE: The South Birmingham PCT complaints procedure was available in the home and in the service users guide that people had in their bedroom. This ensured that if they were unhappy about anything they or their relatives knew how to complain. There had been no complaints about the home received by the home or the Commission in the last twelve months. Some people who live there can at times behave in a way that ‘challenges.’ Care plans included how the person’s behaviours affected them and others living there and how staff need to support the person to manage these behaviours. This included how staff can reduce the person’s anxieties and stop them hurting themselves or others. Individual’s finance records were sampled. These cross-referenced with the amount in the individual’s wallet indicating that people’s money had been spent appropriately and kept secure. Staff check each person’s money at the handover of each shift so ensuring that it has not been lost or misused. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 19 Care plans included details of ‘My money and how it’s looked after’. Records showed that people’s money had been spent on personal items not on items that should be provided as part of the fees that individual’s pay. Receipts are kept of all purchases. Each person had an inventory of their belongings. These had been updated when they had bought new things so that staff would know what belonged to each person and it would be easier to identify if things should go missing. Staff records showed that staff had training in The Mental Capacity Act that had recently come into force and adult protection and the prevention of abuse. This will help staff ensure that they know how to ensure that people who are able to can make decisions about their welfare and how to keep them safe from abuse. Before the last inspection there had been a delay in reporting an allegation of abuse that had been made. However, this had now been investigated and action had been taken to ensure that systems were in place so that staff receive the training needed so they know how to keep the people living there safe from harm. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 20 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, 26, 27, 28, 29, 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Arrangements are not sufficient to ensure that people live in a homely, comfortable, clean and safe environment that meets their needs and promotes their independence. EVIDENCE: The dining room was well decorated and since the last inspection lampshades have been provided making it a more comfortable room. The table was very worn and needed re-varnishing or replacing. There were sturdy dining chairs that were in good condition although some of the chair frames needed cleaning to prevent the risk of cross-infection. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 21 The lounge was well decorated and there were framed photographs of the people living there on the wall making it look homely. There were some stains on the carpet, which should be regularly cleaned. Leather sofas were provided although these were fairly low and difficult to get out of. Consideration should be given to ensuring that the people living there have comfortable chairs that are at the right height so they can get out of them easily. All the redecoration required at the last inspection including redecorating the kitchen had been completed except in the WC. The manager said that the carpets in three of the bedrooms and the hall were to be replaced the next day and the flooring in the shower room was to be replaced soon. This however would not affect the use of this, as there is only the shower available while the bath is not working. The manager said that it is difficult to get work done and provide new furniture as any orders have to be authorised by so many people within the PCT and the people living there have to constantly wait for things to be ordered and delivered. Two of the bedrooms were looked at. These were personalised according to individual tastes and interests and contained many personal items. One bedroom had been redecorated since the last inspection but the other bedroom was showing signs of wear and tear and in need of redecoration. At the last inspection the activity room had been redecorated and this was now a space where the people living there could go to watch TV or listen to a CD. The manager said they also plan to put sensory lights in so it could become a relaxation room. Staff said and records showed that the bath had not been working for about three months and they were waiting for a new part. They said that they rang the maintenance team every week to check when the part would be delivered so that the people living there could have a choice of having a bath or a shower. Following the inspection a representative from the maintenance team said that the part for the bath was on order. They also said that the cost to replace the bath was too high. The manager said that they had quotes for a new bath but they did not think this had been provided for in this year’s budget. On 14th September the manager said that the part for the bath had been ordered but not yet delivered and they would be making a bid to change the bath in the next financial year. This bid would need to be considered, as it is unacceptable that the people living there do not have a choice of having a bath or a shower and there is only one shower to be used between six people. This puts pressure on staff and does not ensure that people have an opportunity to have a shower at the time they want to. Staff said that the tumble dryer, which had recently been replaced, was not working. A part had been ordered for it. Following the inspection a representative from the maintenance team said that the part was ordered but they would chase it. Staff said the washing machine had not been working for Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 22 three weeks and they needed a new one. Staff were having to take the washing to the launderette every day and even though they got service washes done they still had to take it there and collect it. Staff said and records showed that this impacted on the activities that people did every day and they were also spending £10–12 each day on the launderette. Following the inspection the maintenance team said that replacing the washing machine was the responsibility of the staff at the home, as it would come out of the home’s budget. The inspector spoke to the manager on 14th September who said that a new washing machine had been bought but they were still waiting for the part for the tumble dryer. The home was generally clean and free from offensive odours. Cleaning materials were stored safely so that the people living there were kept safe from using them inappropriately. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Arrangements for staffing the home their support and development are variable, which could impact on the support they give to the people living there. The arrangements for the recruitment of staff do not always protect the people living there. EVIDENCE: Rotas showed that seven of the thirteen staff that work there have NVQ level 2 or 3 in Care and three staff are working towards NVQ 2. This exceeds the standard that at least 50 of staff has NVQ level 2 or above so ensuring they have the skills and knowledge to meet the needs of the people living there. Rotas showed that there were three members of staff on each shift during the day and two waking night staff each night. There had been two new staff start working there since the last inspection. The manager said he usually works day shifts but this week was covering some shifts due to staff taking their holiday. The manager said there were two full-time and one part – time vacancy of twenty- nine hours. He said that two people been had been recruited for the full-time posts and they were waiting for satisfactory Criminal Record Bureau Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 24 checks before they could start working at the home. Permanent staff work extra shifts to cover the vacancies and regular bank staff are also used so that staff that work there know the people who live there. Agency staff are only used occasionally. Minutes of staff meetings showed that these are held regularly. At the last meeting staff discussed training and development issues, holidays for the people living there, structural changes within the PCT, care plans, risk assessments and meetings with the people living there. There had been one meeting specifically for night staff and the manager said these are to be scheduled monthly. This is important to ensure that night staff are included in the staff team and their role is valued in meeting the needs of the people living there. Three staff records were sampled. For two of the staff there was not a record that a CRB check had been completed. The manager said that these were held at the Head Office of the PCT. A record stating that the check had been completed needs to be available in the home so that it is clear that ‘suitable’ people are employed to work with the people living there. Other records relating to the recruitment of the member of staff including a completed application form and two written references were available. Staff records showed that when staff first started working at the home they completed an induction so they knew how to meet the needs of the people living there and were clear of their role within the home. As part of their induction they also completed the Learning Disability Award Framework (LDAF) training. Training records showed that all staff had received training in moving and handling and food hygiene. Some staff also had training in first aid, adult protection and the prevention of abuse, Person Centred Planning (PCP), autism, epilepsy, record keeping, advocacy, challenging behaviour, medication, the Mental Capacity Act, fire safety and the ASSET Health and Safety distance learning course. The manager said that all staff are booked to do training in minimising confrontation, healthy eating and also dysphagia (swallowing difficulties). The manager said he would ask the dietician to do some training for staff on celiac disease so that staff know how to meet the needs of all the people living there. Staff records sampled showed that staff had regular supervision with their line manager. This is to ensure that they receive the support to do their job and their training and development needs are identified to ensure they have the skills to meet the needs of the people living there. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 25 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 arrangements ensure that the people living there benefit from a well run home. The views of the people living there underpin the selfmonitoring and improvement of the home. Sufficient arrangements are in place to ensure that the health and welfare of the people living there is always promoted and protected. EVIDENCE: The manager is registered with the CSCI and has several years experience of managing care services for people who have a learning disability. He is a Registered Learning Disability Nurse (RNLD). The manager said he is planning to retire possibly in October this year. Findings of this inspection show that Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 26 there have been further improvements made to running the home in a way that ensures that the people living there benefit. A representative of the Provider, Family Housing visits the home monthly as required under Regulation 26. These include seeking the views of the people living there and staff and a report of their visit is made. At the end of last year the PCT completed an audit of the home following the much-publicised ‘Cornwall report.’ The manager said that the recommendations from this audit had been met or were being met. A manager from the PCT also visits monthly and completes an audit of the home. Fire records showed that an engineer regularly services the fire alarm and extinguishers. Staff test the fire equipment regularly to make sure it is working. Staff have regular training in fire safety and regular fire drills are held so that staff know what to do if there is a fire. An updated fire risk assessment was in place that stated what action is taken to ensure that the risks of there being a fire are minimised as much as possible. Staff use hoists to move some of the people who live there from one position to another. Records showed that these are regularly serviced to make sure they are safe to use. Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 27 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 3 2 X 3 X 4 X 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 X 26 2 27 1 28 2 29 2 30 2 STAFFING Standard No Score 31 X 32 4 33 3 34 2 35 2 36 3 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 X 12 2 13 3 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 28 No 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 YA34 Regulatio n 13 (6), 19 Requirement Evidence that a satisfactory CRB check had been completed on all staff employed there must be available in the home to ensure that ‘suitable’ people are employed to work with the people living there. Timescale for action 07/10/07 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 YA12 YA14 Good Practice Recommendations The washing machine should be repaired soon after it breaks down to ensure that this does not impact on the activities that the people living there do each day. Individual’s money should be available so that the people living there can go on the holiday they choose at the time of year that they choose. Staff should support each person appropriately during mealtimes to ensure it is a relaxed and enjoyable time for all the people living there. Bowel records should be clear so that if people are at risk DS0000062628.V350882.R01.S.doc Version 5.2 Page 29 3. 4. YA17 YA19 Swan House of constipation they can receive the treatment they need to ensure their health and well being. 5. YA24 The table in the dining room should be in good condition so it is clean and suitable for people to eat at. The chair frames should be cleaned regularly to reduce the risk of cross-infection. The tumble dryer should be repaired so that people’s clothes can be dried efficiently and that their activities are not reduced from staff spending more time getting the washing dry. Bedrooms should be decorated regularly so they are comfortable for the person to spend time in. The bath should be repaired so that the people living there have a choice of having a bath or shower. The WC should be redecorated to ensure it is clean and to reduce the risk of cross infection. Suitable comfortable chairs that people can get in and out of should be provided to ensure that individuals are comfortable and their independence is promoted. Staff should receive the training they need so they have the knowledge and skills to meet all the needs of the people living there. 6. YA24 7. 8. 9. 10. 11. YA26 YA27 YA27 YA29 YA35 Swan House DS0000062628.V350882.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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. 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