Inspection on 16/08/07 for The Firs

This inspection was carried out on 16th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Firs 13/01/09

The Firs 06/09/06

The Firs 07/02/06

The Firs 05/10/05

The Firs 25/01/05

The Firs 11/05/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 The Firs Thorpe Road Kirby Cross Frinton On Sea Essex CO13 0NJ Lead Inspector Ray Finney Key Unannounced Inspection 16th August 2007 09:30 The Firs DS0000017963.V349564.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 The Firs DS0000017963.V349564.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. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Firs Address Thorpe Road Kirby Cross Frinton On Sea Essex CO13 0NJ 01255 862617 01255 860259 colindenny10@aol.com 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) Mr Ahmad Fareed Kadar Mr Sheik Kemal Kadar Mr Colin Roy Denny Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (1), Physical disability (1) of places The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 8 persons) One person, under the age of 65 years, who requires care by reason of a learning disability and who also has a physical disability, whose name was provided to the Commission in July 2003 One service user, aged 65 years and over, who requires care by reason of a learning disability, whose name was made known to the Commission in July 2004 The total number of service users accommodated must not exceed 8 persons 6th September 2006 3. 4. Date of last inspection Brief Description of the Service: The Firs is an established care home for eight younger adults with learning disabilities. The home is located in a rural setting in a large country house between the villages of Kirby Cross and Thorpe-le-Soken. Local shops, post offices and schools are found in these villages. The Firs is set in extensive grounds with established gardens to the front, side and rear of the building and off-road parking to the front. Bedroom accommodation is on the first floor with stairs and a passenger lift for access. Toilets, bathrooms and showers are on the ground and first floors. Communal areas on the ground floor comprise of a lounge, dining room and kitchen/dining area. There is wheelchair access to all communal areas and there are ramps to the front, side and rear of the building. There is a day centre attached to the home providing facilities for people in the community. The centre offers a range of experiences such as a spa pool, ball pool and a sensory room. In addition there is a petting farm with sheep, goats, chickens and rabbits. People living in the home can use these facilities. Access to the centre is separate from the home. The home charges between £554.00 and £1,400.00 a week for the service they provide. There are additional charges for personal items such as toiletries, hairdressing, holidays and chiropody. This information was given to the Commission in August 2007. Information about the home can be obtained by contacting the manager; inspection reports are available from the home and from the CSCI website www.csci.org.uk The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as menus, staff rotas, care plans and staff files. The manager completed an Annual Quality Assurance Assessment with information about the home. Throughout the report this document will be referred to as the ‘AQAA’. Visits to the home took place on 16th August 2007 and 5th September 2007. The first visit included a tour of the premises, discussions with the manager and members of staff. At the second visit the inspector met with the manager and the proprietor. Completed surveys were received from people living in the home and their relatives. Observations of how members of staff interact and communicate with people living there have also been taken into account. On the days of the inspector’s visits the atmosphere in the home was relaxed and welcoming and the inspector was given every assistance from the management team and staff. What the service does well: What has improved since the last inspection? The employment of a full time maintenance person has made a noticeable improvement to the environment throughout the home. As well as general maintenance, the programme of redecoration is making the home a pleasant place for people to live. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 6 Other improvements to the environment since the last inspection include the installation of a new kitchen and new furniture in the lounge. The upstairs shower room has been replaced, which has improved the bathing experience for people living in the home. What they could do better: 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. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 7 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 The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 8 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People choosing to live at The Firs can be confident their needs will be assessed before admission. EVIDENCE: One person has been admitted to the home since the last inspection. This person was already attending the day centre attached to the home and has settled in well. The manager confirmed that the family are happy with their relative’s placement in the home. Records examined confirm that the home carries out a full assessment before anyone is admitted. A discussion took place with the manager around assessments and he is able to demonstrate a good awareness of the process for assessing needs. Information provided in the AQAA states that the home plans to review the admissions policy and procedure in the next year to make it clearer for people with communication difficulties. Two relatives who responded to surveys both indicated that they had received enough information about the home. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 9 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Firs benefit from a care-planning system that ensures their needs are met. They are supported to make decisions about their lives and to take risks within their capacity to understand. EVIDENCE: In the past year the home has updated care plans with more details about people’s daily needs; this includes a more comprehensive individual profile and daily needs assessment. The AQAA states that the home has comprehensive care plans that give as much information as staff need to care for people. People who live in the home have input where possible, if not relatives or advocacy services are asked to contribute. A sample of three care plans examined confirms that the home has active, workable care plans that are reviewed and updated. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 10 The home recognises that care plans could be more user friendly for people with communication difficulties and complex needs and there are plans to improve this in the coming months. The manager hopes that the Inclusive Communication Environment project (ICE) that they are piloting in conjunction with Speech and Language Therapy services will give people greater input into making choices and planning their care. As part of the ICE project all staff are to receive training in some kind of communication skills. All will do basic training and produce practical methods for supporting specific individuals with their communication needs. Some staff will be identified as ‘trainers’ so that the programme can be rolled out to new staff. As at last inspection, records examined confirm that the home has a range of risk assessments in place. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 11 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, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home have opportunities to participate in activities that are appropriate to their needs and to access facilities in the local community. The home ensures that people living there build and maintain relationships with their families. The people living in The Firs benefit from a well balanced, nutritional and varied diet. EVIDENCE: The AQAA states that the home encourages people that are able to attend college to take part in courses to improve their skills and have new experiences. At the time of the inspection people were on a holiday break from college, but the manager confirmed that they will be booked onto courses when college starts again shortly. A sample of records examined show that two people attend pottery courses at college. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 12 People who do not wish to use colleges are given the opportunity to access recreational activities on site and in the community. One person enjoys spending time in the garden with tactile activities using sand. Other people use the spa pool for relaxation and others enjoy foot massage. Records examined show that a variety of activities take place according to the individual’s abilities and these are recorded in the care plans. Records examined confirm that people living in the home continue to access activities in the community. These activities include using public facilities such as the swimming pool and bowling facilities in Walton-on-the-Naze. People also attend clubs for people with learning disabilities, including Gateway, the Busby Club and the Endeavour Club in Clacton-on-Sea. One person who completed a survey said “I like going out with carers to pubs and clubs”. As at the last inspection, the home continues to support people to maintain links with family and friends. Records examined confirm that information provided by service users’ families is taken into account when planning care. Completed surveys received by relatives show that they are satisfied with the service the home provides and they are kept informed. Staff spoken with confirm that family links and personal relationships are encouraged. Discussions with the manager and staff indicate that people are supported to make choices about their daily lives, such as times for getting up and going to bed. However, many of the people living in the home have complex learning disabilities and physical needs and are unable to take an active part in daily household routines. One person enjoys taking responsibility for feeding the small animals on site. The AQAA acknowledges that the home could encourage more participation in the running of the home. The manager hopes that the Inclusive Communication Project that is about to begin will help staff develop a greater understanding of people’s wishes. This should enable staff to support people to have a greater involvement in the running of the home. The home continues to provide a high standard of meals. As at the last inspection, food is home cooked and prepared using a good variety of fresh foods, fruit and vegetables. Food is freshly made on a daily basis and dishes range from ‘traditional’ home made dinners to pasta and rice meals. The housekeeper takes pride in the good standard of meals provided. The home continues to make good use of seasonal and homegrown produce and the housekeeper changes the menus to reflect the best foods available. On the day of the inspection, people living in the home were observed to enjoy the food. As at the last inspection, there is a good variety of cereals, stored tinned foods, salad, cold meats, yogurts and soft drinks. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service receive good personal and healthcare support that meets their needs. The home has systems in place to ensure the safe administration of medication to protect people living there. EVIDENCE: It was observed on the day of the inspection that the home continues to provide a balance of male and female staff on duty so that people can receive personal care from staff of the same gender; rotas examined confirm this. Care plans examined contain sufficient information to ensure people receive appropriate personal support. The AQAA states that care plans and diaries record appointments relating to health and the outcomes. Records examined confirm that the home makes sure people receive input from relevant health professionals when necessary. Health Action Plans that were being introduced at the time of the last inspection are still not fully completed for everyone living in the home. Getting these documents up and running for everyone in the home would The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 14 ensure that there is better recording of people’s healthcare needs. This would ensure closer monitoring of changes in people’s health and also help keep track of when routine health checks such as eye tests and dental checks are due. The AQAA states that they plan to have all of the Health Action Plans complete and functioning in the next 12 months. The manager feels that staff awareness of people’s personal and healthcare needs has improved and they are more proactive in identifying people’s needs. The AQAA identifies that people could have more involvement in taking preventative measures to improve their general health, such as taking more exercise and encouraging healthy eating choices and this is an area that they are continuing to develop. The home continues to have appropriate processes in place around the administration and storage of medication. The home operates a monitored dose system for medication. The complex needs and cognitive ability of people living in the Firs means that no one in the home has the capacity to selfmedicate. Medicines Administration Record (MAR) sheets are completed appropriately and staff records examined contain evidence that training around the administration and storage of medicines is carried out by the monitored dose provider. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service have access to an effective and understandable complaints procedure that ensures that they are listened to. The home’s practices and procedures around the protection of vulnerable adults need to be more robust if the people who live there are to be safe from harm. EVIDENCE: As at the last inspection, there is an appropriate complaints policy in place and there are forms available for the recording of complaints and concerns. The policy meets the required standard and contains clear information so that prospective service users and their representatives have a clear route to follow if making a complaint. Relatives who completed surveys responded that they would know who to speak to if they are not happy and would know how to make a complaint. The AQAA acknowledges that the complaints policy could be more user friendly and the manager hopes when they become an ‘Inclusive Communication Environment’ they will be better equipped to make changes to the policy to make it more usable for people with communication difficulties. The home recently raised a Protection of Vulnerable Adults (POVA) alert when an issue relating to the safeguarding of an individual living in the home was discovered. As a result of the local authority’s investigation into the POVA and The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 16 the home’s disciplinary process, the employment of one member of staff was terminated and the issue is in the hands of the police. The investigation process raised a number of issues that must be dealt with if people living in The Firs are to be safeguarded against harm. The manager sent a regulation 37 notification of the incident to us at the Commission and referred the matter to the local authority by raising a POVA but some questions have been raised about dealing with issues immediately and staff recognising their responsibilities to report abusive practices. One of the areas of concern is that there were a number of delays in reporting, both by staff witnessing the incident and the management team. Staff records examined show that staff have received training around Protection of Vulnerable Adults so they should be aware of signs of abuse and their responsibilities in reporting their suspicions. Despite this training, staff did not respond promptly. The management team must address the issue by working closely with staff to ensure they understand what constitutes abuse, they recognise signs of possible abuse, they understand their responsibilities and act promptly and appropriately. Some issues raised by members of staff have been proved to be unfounded including an allegation of psychological abuse. The member of staff raising the issue said they were unaware of the care plan in place to support the individual. The fact that the member of staff appears to have been unaware of the care plan highlights inconsistencies in how staff are working throughout the home. As part of the strategy to improve processes to safeguard people living in the home, the management team must ensure staff are well informed about care plans and risk management strategies. Staff must also recognise their professional responsibilities to keep their knowledge and practices up to date. The manager stated in the AQAA that the management team recognises that they need to revisit safeguarding issues with staff. They have now started working through further in-house training with staff using the workbooks and training materials from the Essex Vulnerable Adults Protection Committee (EVAPC) training package. Staff spoken with expressed concerns about the effect the recent POVA and subsequent staff sacking has had on the staff team. The management team need to address issues of staff concerns through a more robust process of staff supervisions and team meetings. The staff team need to be aware that the negative atmosphere created by a staff team who are not working well together will have an adverse effect on people living in the home and reduce their quality of life on a daily basis. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Firs benefit from a homely, comfortable environment that is well maintained and clean. People’s bedrooms are individual and promote their independence. EVIDENCE: Since the last inspection the home is in the process of a programme of redecoration and maintenance that has improved the environment for people living there. A tour of the premises confirms that the décor has improved and new furniture is in place. The new leather sofa in the lounge is comfortable and of good quality. A new kitchen has been fitted and the room looks fresh and clean; the kitchen refurbishment has been carried out to a good standard. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 18 The employment of a full time maintenance person has improved the standard of cleanliness and improved the maintenance of the fixtures and fittings throughout the home. As at the last inspection, a tour of premises confirms that people’s individual rooms are furnished and decorated to a good standard. Every bedroom is individual and has evidence of people’s personal tastes, likes and hobbies. There have been improvements in cleanliness throughout the home, particularly in bathrooms and toilets. A new shower room has been fitted upstairs which has addressed the minor shortfall highlighted at the last inspection and is a great improvement on the previous shower room. This offers a much better bathing experience for people living in the home. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall people living in The Firs benefit from a competent staff team who are supported to obtain relevant qualifications and people are protected by the home’s recruitment policy and procedures. Staff receive appropriate training and the support and supervision they need to carry out their jobs, although further training around safeguarding would ensure greater protection for people living in the home. EVIDENCE: The AQAA states that the home has maintained staffing levels much better in the last year. Information was given by the manager on the day of the inspection that, out of a total of nine care staff, four have already attained a National Vocational Qualification (NVQ) level 2 and a further four have started the award. In addition three staff have started NVQ level 3. Although the figures are just below the national minimum standard recommended 50 at present, the home is continuing to support staff to complete awards and increase the percentage of staff with this qualification. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 20 It was recommended at the last inspection that people living in the home would benefit from a more knowledgeable and better-qualified staff team if further staff members were supported to complete an NVQ award. The home has addressed this issue and hope to have a much higher percentage than the recommended minimum 50 by the end of the year. To ensure the home continues to maintain good levels of staff with NVQ qualifications the manager is going to train to become an assessor. As at last inspection the home operates an appropriate recruitment process. A sample of three staff files examined all contain the required information including photographs, proofs of identity, two written references and a completed application form. Criminal Record Bureau (CRB) and Protection of Vulnerable Adults checks are carried out to help protect people living in the home by ensuring that anyone who is prohibited from working with vulnerable people is not employed. The home continues to provide staff with a range of information and training to enable them to carry out their jobs. Records examined confirm that staff have signed to say they have received an Employee Handbook, a Health & Safety Handbook, the GSCC Code of Practice and the Essex Vulnerable Adults Protection Committee (EVAPC) Guidance Booklet. There is evidence in the records examined of training in Fire Safety, Manual Handling, First Aid, Medical Suction machine training and medication training by the monitored Dose System provider. The manager states in the AQAA that they would like to take on more in-house training, which can be geared to their needs more precisely. There is also evidence in records examined that staff have received training around the Protection of Vulnerable Adults (POVA) provided by EVAPC. Staff have received appropriate training to enable them to recognise signs of abuse and ensure they are aware of their responsibilities to report and act on evidence of abuse. However, in practice this did not occur (see evidence for National Minimum Standard 23) and the management team must now look at retraining staff and ensuring that working practices give people living in the home the protection they need. Overall, people living in the home benefit from a well qualified staff team. Although one person living in the home commented that staff are “A bit grumpy so hard to please”, relatives who completed surveys are complimentary about the staff. One said, “The staff are excellent especially the manager and my relative’s key worker. They are the best my relative’s ever had”. Records examined confirmed that the home has a supervision process in place that meets National Minimum Standards and staff have regular supervisions and annual appraisals. The AQAA identifies that that they could have more The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 21 input from staff at staff meetings and supervisions and better motivation within the staff team. A discussion with the proprietor and manager following the inspection highlighted the need to deal with the issues arising out of the recent POVA investigation through the home’s supervision, staff development and disciplinary processes. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 22 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall people living in The Firs benefit from a home that is managed by a competent person. The health and safety of individuals living and working in the home is promoted and protected. EVIDENCE: As previously reported, the manager of the home has completed NVQ level 4 in Care and the Registered Managers’ Award. He has a number of years experience in care and has nearly two years management experience in the home. As at the last inspection, the home has a Quality Assurance system in place. The home continues to liaise with families and advocates to ensure their views are taken into account through the Quality Assurance system. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 23 Information provided in the AQAA and records examined on the day of the inspection visit show that appropriate checks are being carried out on water temperatures. Records examined show that fire alarms are tested regularly and fire equipment was checked in January 2007. The home maintains records of fridge and freezer temperature checks and records relating to the preparation and serving of food. There is evidence that the lift was checked in June 2007. Staff records examined show that staff receive training on Health & Safety, Manual Handling and First Aid. On a tour of the premises evidence was seen that hand-washing facilities are in place. However, the complex behaviours of some of the people living in the home means that is not practical to have liquid soap and paper towels in some toilets, although alcohol gel is available to promote infection control. Evidence provided in the AQAA states that the home has not used the Department of Health guide ‘Essential Steps’ to assess their current infection control management. The sample of staff files examined did not contain evidence of training around infection control, although observations confirm that staff follow good practices in this area. People may be better protected if the home reassesses procedures around infection control to consider if they need to take any further measures to keep people safe. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 24 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 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 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA23 Regulation 13(6) Requirement People living in the home must be safeguarded from abuse or the risk of harm by the home’s procedures. This relates to ensuring all staff are supporting people according to the care plans and risk assessments in place. Staff should be supported to do this and their performance monitored through the home’s supervision process. Staff must receive further training to ensure they recognise what constitutes abuse and are aware of their responsibilities to keep people safe by reporting possible abuse promptly and appropriately. Timescale for action 06/09/07 2. YA35 18(1)(c) 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 26 1. 2. YA16 YA36 3. YA42 People living in the home should be encouraged to have more involvement in the day to day running of the home, taking into account the limitations of their abilities. The home’s procedures for supervising staff and sharing information through team meetings needs to be more robust so that people living in the home benefit from a staff team who work together to meet people’s needs consistently. The home’s training programme should make sure that people living in the home are protected by a staff team who have had training around infection control. The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 The Firs DS0000017963.V349564.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!