Inspection on 11/12/08 for The Hermitage

This inspection was carried out on 11th December 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Hermitage 14/02/07

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Hermitage The Hermitage Ravine Terrace Roker Sunderland SR6 9LZ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrea Goodall     Date: 1 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: The Hermitage Ravine Terrace The Hermitage Roker Sunderland SR6 9LZ 01915677958 F/P Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Debra Rodenby Type of registration: Number of places registered: Education and Services for People with Autism Limited care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD, maximum number of places: 7 Sensory Impairment - Code SI, maximum number of places: 3 Date of last inspection Brief description of the care home The Hermitage is a large, detached house close to the seafront at Roker beach and next to Roker Park. It is set on a short private road and has secure parking on a gated driveway. The house has a large, sheltered back garden. It is close to many local amenities including shops, supermarket, restaurants, parks, and local transport. The Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 7 3 Brief description of the care home Hermitage provides 7 spacious bedrooms for the people who live here. All the bedrooms have en-suite bathrooms with bath, shower and toilet. The accommodation is over 3 floors. Bedrooms are on the first floor and second floors. On the ground floor the house provides 2 spacious lounge/dining rooms, a large lobby lounge and a sunroom at the rear. There is large, family kitchen with annex dining room and separate utility room. The home is not intended to accommodate people with mobility needs and this is outlined in the Statement of Purpose. There is good access into and around the ground floor and there is a WC that is suitable for any visitors who use a wheelchair. Most of the residents previously lived in another care home operated by ESPA, which had become too small for their needs. ESPA purchased The Hermitage to provide more spacious and improved accommodation for the people who live here. The manager and staff team also transferred to the new service and this supported the smooth transition of residents to their new home. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at information we have received since the last visit on 14th February 2007 and the last annual review of this service on 17th April 2008. We looked at how the service dealt with any complaints and concerns since the last visit. We looked at any changes to how the home is run. We asked the Provider for their view of how well they care for people in an annual quality assurance assessment (called an AQAA). We made an unannounced visit on 11th December 2008. During the visit we talked with people who use the service, a visitor, staff, and the manager. We joined residents for a meal and looked at how staff support the people Care Homes for Adults (18-65 years) Page 6 of 30 who live here. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept by a care service. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable. We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? Information about the home is being updated to show people the changes at the home. One staff is going to be signalong person so that all information can be provided for those people who use sign language. The Living Plans (records about peoples goals) are now in pictures so that people can understand their own records. Most people now keep their own Living Plans in their own bedrooms so they can see them at anytime. The home now has more communication tools to help people make their own decisions and choices, such as talking mats. ESPA has its own speech and language therapists to help people at The Hermitage to Care Homes for Adults (18-65 years) Page 8 of 30 have better ways of communicating. Staff have had good training in how to help people when they are upset or angry so that they do not harm themselves or others. There are more staff working here because there are more people living here and some people need more support. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has comprehensive assessments and admission processes to make sure that it can meet the needs of the people before they come to live here. Evidence: The Hermitage has clear written information about its service in a Statement of Purpose and Service Users Guide (information pack). It is good that these also include lots of details in easy-read and pictures to make it easier for the people who live here to understand. At the time of this visit the Statement of Purpose and Service Users Guide were being updated because there are now 7 people living at the home and there are more staff working here. For one person living here British Sign Language is their first language, and some other people use sign-supported English to support their limited verbal skills. There is currently no information about the service on DVD to support peoples sign language, but this is something the manager would like to develop in the future. In the meantime the home has better access to sign training, and one experienced staff is to Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: be a signalong support to help communicate information for the people who live here. ESPA has comprehensive assessment and admissions processes that involve the prospective resident, their relatives, the manager of The Hermitage and all appropriate education, health and social care professionals. This makes sure that peoples needs can be met if they are going to come to live here. The home also recognises if it is no longer able to meet someone needs. Since the last inspection one person has moved to new accommodation as The Hermitage was no longer suitable for them. In the past year two new people have moved here. Their care records showed that a full assessment of their needs was carried out. Prospective new residents have as many opportunities as they need to visit the home, and even have overnight stays if that is appropriate for them, before a decision is made about them moving here. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have excellent support to meet their needs so that they lead a lifestyle that suits them. Evidence: There are individual support plans in place for each of the people who live here. These plans provide very detailed information for staff about how to support people with their needs. Each person also has a Living Plan, that is a list of their own goals and aspirations. The Living Plans include goals such as looking for paid employment, choosing their own holiday, learning how to use a mobile phone, and setting up a computer networking page of their own. The plans and goals are reviewed annually with each resident and their relatives when the progress of needs and goals can be checked and new goals added for the next year. At this time one newer persons support plan still refers to their previous home, although their Living Plan refers to The Hermitage. It is anticipated that their support Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: plan is due to be reviewed, and so will then reflect their needs at The Hermitage. It is very good practice that since the last inspection each persons goals and aspirations have been put into easy-read and pictures to help them understand them. It is also good that most people now keep their own copy of their goals in their bedroom so that they can look at them at any time.The monthly progress of each goal is recorded by staff to see whether it is on-going, has been achieved or the person no longer wants to pursue it. People who have Autism Spectrum Disorder can find it very difficult to make choices. However they do make their own decisions on a daily basis such as what to wear, what to eat, and what activities they want to do. It is very good that the home has improved the ways it helps people to make their own decisions by providing lots more information in ways that people understand. For example there is more information in pictorial and easy read form. The home now has talking mats which helps people to give their yes or no answer to choices that they are offered, for example menus, activities, and which staff member they want to support them. It is very good that ESPA employs Speech and Language Therapists who are able to advise the home and provide different communication tools to help the people who live here with their communication needs, and this helps them make their choices. The people who live here are supported to take acceptable risks as part of an independent lifestyle, wherever this is appropriate and manageable. For example, preparing food in the kitchen, having a front door key, and activities in the community such as horse-riding. There are clear risk assessment records in place about all of these areas that show whether the risk is acceptable and, if so, how to support the person to minimise the potential risk. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have excellent opportunities to lead a fulfilling lifestyle and make their own choices so they can develop life skills. Evidence: The people who live here have good opportunities to engage in fulfilling daytime activities of their choice. Five people go to different sessions at The Croft, which is an activity centre run by ESPA in the city centre. At The Croft they have chosen to go to different activities such as drama and dance, IT, pottery, and art. Two people chose not to go to the centre, one preferring to go out on day trips to places that interest them. One person chooses to stay in the house much of the time. However staff recognise that this is not fulfilling his potential lifestyle and are looking Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: at ways to broaden his experiences so that he might find an activity that he enjoys. One person used to have paid employment at a farm and this was both fulfilling and valuing for that person. Unfortunately the farm has closed so staff are helping him to find new paid employment, perhaps in The Croft cafe. People have the chance to try paid employment at The Hermitage, if they want, by taking part in bigger tasks such as gardening, window cleaning and decorating. They receive a small pay packet for this so that they can understand the concept of earning money for their work. As well as structured activities, people are also supported with community-based activities such as swimming, leisure centres, pubs, cafes, cinema, and shopping. Each person has good support to go shopping for clothes and personal items, and more recently, Christmas shopping. The Hermitage is by the coast and many people also enjoy walks along the beach, and it is also close to a number of cafes, shops and other facilities that people living here enjoy. In this way people living here take a full part in their local community. There is good contact between the home and relatives, so that the people who live here can contact their families, and relatives are kept fully up to date about a residents well being. A relative of a former resident (who has moved to another ESPA home) was visiting at the time of this inspection. They were very complimentary about the support that they and the resident had received during his time living at The Hermitage. The relative said that they could not praise the staff enough for their brilliant support. The relative has formally written to the CSCI with a commendation about the dedication and support shown by the manager and staff of this service. As with any shared house residents have agreed some rules so that they respect each others space and accommodation. Staff have supported them to put their rules into easy-read and pictorial form, and they discuss these at their weekly House Meetings supported by staff. In this way people are very clear about their rights and their responsibilities within the house. Everyone is involved in keeping their own rooms tidy and clean. The people who live here do have the physical skills to carry out most household tasks, but would need lots of support and supervision to achieve these. Staff indicated that over the past year the changes in the resident and staff groups had unsettled some residents, and so staff had undertaken most household tasks. However the manager acknowledged that the home is much calmer now and that people should now be supported again to carry out their own housekeeping, such as making their own beds. This is to support people towards their optimum independent living skills. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: Since the last inspection the home now employs a cook. The manager stated that this is beneficial as it releases support staff from all their time previously spent on shopping, ordering, preparation and cooking. However residents still make their own breakfasts and suppers so that their independent living skills in this area are supported. Although the bulk of groceries are ordered by the cook and delivered to the home, residents still have lots of chances to go shopping at the local supermarkets to buy specific groceries that they want, which supports their decision-making skills, and their independent living skills. The cook designs the menus for main meals on the known preferences of residents, and people then choose from the menu what they would prefer. For example, on the day of the of this visit the lunchtime options were either burgers or omelettes followed by a choice of yoghurt-type desserts. The cook also has occasional cooking sessions with residents to support them in their cookery skills. At week-ends residents make their own meals with support staff. Residents are still involved in setting tables and clearing away, and this continues to support their independent living skills. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides people with very good support with their personal care and good access to health care services so that all their care needs are very well met. Evidence: The seven people who live here are all physically fit and can manage most of their own personal care needs, such as washing, although most people do need staff supervision and prompting to complete these tasks. One person is currently less skilled in this area so needs some hand-over-hand physical support to achieve brushing teeth and washing their face. It is very good that 8 of the 23 support staff are male, which means that the six men who live here can receive gender-appropriate support with their personal care needs. (There are always female staff on duty to ensure that the one female resident also receives gender-appropriate support.) Since the last inspection more pictures-prompts have been placed in peoples bathrooms and the toilets, for example to help people remember to wash their hands. This is to support peoples independent living skills. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: The home ensures that people have good access to health care services whenever they require this. All the residents are registered with a GP, and all receive an annual health check. ESPA also employs some health care professionals, including psychology, psychiatry, speech and language therapists and dietician services. It is good practice that if a resident cannot tolerate attending a public clinic, e.g. chiropodist, the home arranges for services to visit them in The Hermitage wherever possible. It is also very good practice that ESPA and the home considers the implications of each persons mental capacity to make decisions, as well as their best interests, when considering how to ensure that they receive the health care that they need. For example, seeking general anaesthetics for people who could not tolerate essential health care treatment in any other way. At this time none of the people who live here have been assessed as capable of managing their own medication, although some prescribed creams are kept in a persons own bathrooms for easy access and prompting by staff. All other medication is managed by trained, designated staff. Medication is delivered to the home in suitable containers. It is securely stored in a locked, alarmed medication cupboard away from residents accommodation. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes complaints procedures and training for staff makes sure that the people who live here are protected from potential abuse. Evidence: The people who live here have information about how to make a complaint. This is in pictorial form to support their communication skills. Their relatives also have this information so they also know how to raise any comments or concerns. There is good contact between the home and the relatives, so that relatives would feel able to discuss any concerns they had. The people who live here also have daily opportunities to show if they are dissatisfied with situations, and there are also weekly House Meetings where people are encouraged to show if they are not happy with something. Staff get to know the individual ways of each person so they would recognise if someones demeanour indicated that they were unhappy. Throughout this visit residents came to sit with the manager and it is anticipated that this would also support them to talk to her about anything they were unhappy or anxious about. The home has clear complaints records and these are checked every month during visits by a representative of the provider. There have been no complaints about this Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: service since the last inspection. All staff have had good training in safeguarding adults, and new staff receive training in this as part of their initial induction. ESPA has a Safeguarding Manager and the home has good contact with the local authority Safeguarding Co-ordindators. In this way there are clear protocols for staff to report any suspected abuse, and staff are very clear about their responsibilities in this area. Due to the nature of their autism, some people need occasional staff intervention during episodes of behavioural needs to prevent them from harming themselves or others. It is very good practice that since the last inspection staff have now received suitable training in how to redirect people from harm using the least physical way. These methods are only used if there is a specific programme in place and if the staff have had the training. There are clear guidelines in place about this which have been shared and agreed with relatives. There are clear, detailed records about occasions when staff have to support people with any behaviour. Over the past year there had been an increase in these occasions, probably due to a number of changes in the house such as new residents, that caused some anxiety for the people who live here. ESPA has ensured that additional staff are now employed at the home to provide more support for people. The occasions of intervention have significantly reduced over the past couple of months as people have greater support and are more settled. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in very good quality, safe, comfortable spacious accommodation so their needs and lifestyle are met. Evidence: The Hermitage is a very spacious, three-storey detached house which is decorated and furnished to a very high standard. It is on a quiet, private road that is very close the beach. The house has a large, private garden that people use in better weather. The house has seven good sized bedrooms for the people who live here. All the bedrooms have their own en-suite bathrooms. There is also a staff sleep-in room, staff shower room and a small office. At this time part of the the office is in an annex area off the spacious, well equipped kitchen. In this way it is not fully private. Although it allows easy access for residents to spend time with the manager, it does not fully allow for privacy and confidentiality. The manager is considering how this area can be provided with door entrance which could be used at times when carrying out confidential meetings. The seven bedrooms have all been highly individualised by each resident to reflect Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: their own tastes and interests, and residents can spend time in their rooms for privacy or hobbies whenever they wish. It is very good practice that ESPA considered the potential needs of resident when designing adaptations to the house. For example, there are light switches on the outside of each bedroom door so that staff can use these to seek the attention of residents without intruding into their room. There are also flashing lights in each bedrooms that are linked to the fire alarm system so that people with a hearing impairment can be alerted to the fire alarm when it is activated. Since the last inspection unobtrusive padding has been provided to some t-fall and eves in bedroom ceilings and to the main staircase to prevent taller residents (and staff) from banging their heads. The padding is covered by leather-effect material that does not detract from the homes character. ESPA provides a maintenance team that attend to repairs and decoration. At the time of this visit the team were carrying some repairs to the roof. The home also employs a part-time housekeeping staff who carries out major domestic tasks, and this ensures that all areas of the home are kept very clean. All the people who live here can take part in some simple domestic tasks with support and prompting from staff, such as bringing their laundry down to the small laundry room on the ground floor. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live here receive very good support from competent, well-trained staff that value and respond to their individual needs. Evidence: The staff team consists of the manager, senior support staff, support staff, a cook and a housekeeping staff. There is a good mix of age, experience and gender within the staff team. It is good practice that since the last inspection ESPA has increased the number of staff at this home to support the increased number and needs of the people who live here. The staff rota allows a minimum of four support staff on duty, but there are often more to meet the activities of the residents. For example there were six staff on duty (not including the manager) on the day of this unannounced visit. Staffing levels are sufficient to meet the individual needs of each of the people who live here, for example one person needs two staff to support him when out on a community activity. ESPA is an equal opportunities employer and continues to use robust recruitment and selection processes to ensure that only suitable staff are employed here. Over the past year three staff have left or transferred to other ESPA homes and five staff have Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: started working here. As part of the recruitment process potential new staff are invited to visit the home, so that residents can meet them and make any comments. The manager is involved in the interviews of potential new staff so that she can make sure they have right personality for this busy home. The staff records show that all the necessary checks and clearances are carried out by ESPA, including references and police check (which is called a CRB Disclosure). New staff receive in-depth induction training which includes all health & safety training as well as training in Autism Spectrum Disorder. Staff then go on to care training called LDQ (this is national vocation qualification in supporting people with a learning disability). At this time about half the staff team have achieved this qualification and the rest are about to start training towards it. Some very experienced, long-standing staff are now overdue for refresher training in some health and safety areas, such as fire safety and emergency first aid (although their practices remain safe). The training is readily available via ESPAs training section but these staff have been covering the many staff absences this year due to vacant posts and sick leave, so have not had time this year to refresh their training. However there are plans for these staff to receive updated training in these areas as a matter of priority. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well run in a way that upholds the best interests and welfare of the people who live here. Evidence: The registered manager has been in post for many years with ESPA. She has attained the Registered Managers Award and is about to complete NVQ 4 in Health and Social Care. These are suitable qualifications for a manager of a care service. She was the manager at the previous home where four of the residents lived before they, and the staff team, moved to The Hermitage when it opened a couple of years ago. In this way she is very familiar with the needs of the people who live here and is able to direct her staff team in a way that maximises the support for each person. Before this inspection the manager completed an annual quality assurance assessment (called an AQAA) for the CSCI to comment on changes or improvements to the service. The AQAA was comprehensively completed and gave excellent details of the Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: many improvements and continued plans for improvements at this service. The manager is supported by two senior support staff, and she is supervised by a line manager on behalf of ESPA. She attends monthly Managers Meetings which provide peer support, and the home is visited on a monthly basis by the deputy chief executive of ESPA who reports on its operations. In this way there are clear lines accountability within the home and within the organisation that support the management and operations of this service. ESPA has comprehensive quality assurance processes to continuously review the quality of the service at The Hermitage. Residents are invited to give their views at House Meetings, and at their annual review meetings. ESPA also occasionally provide people with questionnaires for them to comment on the service they receive. The home has a comprehensive health & safety policy and this has been improved since the last inspection to include a critical response plan and staff are to be trained in this. ESPA now has a Health & Safety Officer who is going to review all risk assessments about the house and practices to ensure that these are in line with the latest legislation. The fire systems at this home include sprinkler systems throughout the building, which have been approved by the Fire Authority. These provide an excellent system of managing the potential risk of fire. All staff receive health & safety training when they start work here. The manager is aware that there are some gaps in health & safety training, such as infection control, but this is planned for the near future, and it was clear from this visit that the welfare of the people who live here continues to be well met. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 35 Plans to provide refresher training for staff in fire safety and emergency first aid should continue to ensure that all staff have up-to-date training in these areas. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!