Inspection on 15/05/08 for The Mews

This inspection was carried out on 15th May 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Mews 19/06/09

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 28/09/2008.

CARE HOME ADULTS 18-65 The Mews Stone Road Eccleshall Stafford Staffordshire ST21 6JX Lead Inspector Jane Capron Key Unannounced Inspection 15th May 2008 09:00 The Mews DS0000070944.V364226.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 Mews DS0000070944.V364226.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 Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Mews Address Stone Road Eccleshall Stafford Staffordshire ST21 6JX 01785 851 185 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) Select Health Care (2006) Limited Teresa Owen Care Home 8 Category(ies) of Learning disability (8), Physical disability (2) registration, with number of places The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: Physical Disabiltiy (PD) 2 Learning Disabiltiy (LD) 8 The maximum number of service users to be accommodated is 8 2. Date of last inspection First Inspection Brief Description of the Service: The Mews is a private care home registered to provide residential care for up to eight people with a learning disability. The service can take two people that also have a physical disability. The home is located in the extensive and attractive grounds of Hilcote Hall and is approximately one mile from the village and facilities of Eccleshall. The Mews has its own enclosed garden/patio area. The property provides two-storey accommodation. Communal facilities are located on the ground floor. All places are provided in single bedrooms, two of which have en-suite disabled access shower and a total of three bedrooms are located on the ground floor. Access to the first floor is by stairs only. The fees charged range from £540 -£1200 per week. This information was contained in the Service User guide and applied at the time of the inspection. People may wish to obtain more up to date information from the care home. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes This inspection took place over a seven hour period. The service did not know we were visiting. The inspection included talking to people that live there, staff and the regional manager as the Care Manager was not available. Before we visited the service we sent surveys to relatives, people that live there, staff and health and social care staff to gain their views about the service. The service sent us a document called an annual quality assurance assessment (AQAA). This documents gives the service the opportunity to tell us what they are doing well and where they feel they can make the service better. During the inspection we looked at the care people are getting and whether people are provided with choice about their lives and are supported to be as independent as possible. We looked at whether the service is listening to people and keeping them safe through how they recruit and train staff, by looking at the number of staff available to support people and whether staff are aware of the care people need. We have not received any complaints about the service. What the service does well: People that live at the service and other significant people speak positively about the service. Comments include ‘home is wow’ from someone living there and from a professional ‘provides a warm and inviting home where all people enjoy a range of independent living tasks, activities and help with day to day running of the home’. The service has good support plans in place that show the care people need and show how they like tasks to be done. Each person has a person centred plan that is put together by staff with the person. These contain lots of pictures showing what people like to do. People have lots of chances to do the social activities they want to do and take part in running the service. Comments from people include: ‘I go shopping’, ‘I wash up and polish’, ‘I look after the fish’ and ‘help with the rabbit’. We also saw that people go bowling, to discos, go on day trips and have the chance to The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 6 go on holiday. Some people go to college and 2 of the older people go to an Age Concern centre. The service also makes sure that people can have their spiritual needs met. 2 people go to church and the service celebrates Christian festivals. The service listens to the people that live there. There is an easy read procedure in place and staff know who people with specialist communication needs express their views. We received positive comments about the staff. These include from people living there ‘ I like the staff because they treat me’, ‘ staff are brilliant’ and ‘they look after me’, and from professionals, ‘staff friendly’, ‘Nice friendly staff’, ‘staff very professional and welcoming’ and ‘staff put the preferences of service users first and treat them in a respectful manner as individuals’. The staff are trained to meet the needs of people that live there. They have good induction training when they start work and have further training in working with people with specific conditions for example autism and epilepsy. All staff had received training in safeguarding adults and were aware of signs of possible abuse. The home had good procedures for managing and looking after residents’ money. The service protects people through the way if employs its staff and through making sure that staff know how to protect people from abuse. The home has good systems in place to check what the service is providing and this makes sure the views of people living there are heard. What has improved since the last inspection? What they could do better: Although people that live at the service have good outcomes there are some things that can be better. There is one bathroom that does not lock and this must be sorted out so that people can use this in private. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 7 The night staff have not had fire training and this means that they may not be able to give people support if there is a fire. The radiator that was uncovered although not in use must be covered so it cannot be a risk to people. We also feel that if fire doors need to be kept open these should not be a potential fire risk. We also made some recommendations about how the service can improve. These include people having full person centred planning meetings where their goals and hopes can be identified and plans put in place to meet them. There is one area outside that needs to be improved to make it suitable for people to use. The service tells us it intends to make this into a sensory garden and we would fully support this. The service’s laundry is currently not suitable and the service uses the one at the service next door. We would recommend that the service has its own laundry that can meet the needs of people living at the service. 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 Mews DS0000070944.V364226.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 The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People that use the service are included in the admission process having an assessment to make sure the service can meet their needs and having the chance to visit and try the service before moving to live there. EVIDENCE: The AQAA completed by the service states that its admission process always makes sure people are given information about the service and have a planned programme of visits to enable a prospective user to meet the staff and people living there. The AQQA states that this includes the opportunity for day, overnight and weekend visits before a decision is made for someone to move to the service. Comments in a survey from a user and from speaking to the person that most recently moved to the service confirm that they had been included in the admission process. A survey received from a person living at the service said that they were asked if they wanted to move to the service and were given information about the service. They also say they visited the service. The person we spoke to during the inspection said ‘I came and looked round and chose the colour of my bedroom’. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 10 The AQAA states that prior to any admission an assessment of people’s needs takes place. This admissions process is shown in the service’s Statement of Purpose and service user guide. Our sampling of records of people living at the service show assessments are completed by the service and by the placing agencies before a decision that the service could meet their needs is made. These assessments show people’s health and personal care needs, their social and spiritual needs and any cultural needs. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. People living at the service have individualised support and person centred plans that provide the information needed to provide them with the support they need. The staff, support people to make decisions about their life and consult them about what it like to live at the service. EVIDENCE: The service’s AQAA states that it includes people in their own care planning and that there are 1:1 meetings to discuss issues. They also say that everyone has a person centred plan. As part of this inspection two plans of care were looked at in detail. These show that there is full information about people’s individual needs covering such areas as health, personal care, activities, development of independent living skills, communication, spiritual needs and The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 12 social care needs. They also contain people’s likes and dislikes. For example one person prefers to use gel when shaving rather than foam and this we saw that this had been provided. Another person likes to be woken up by a female staff member and this person told us that this happened. When we spoke to staff about people’s needs it was clear that the support plans are working documents and they are aware of how to provide the care that people want. In addition to support plans each person has a person centred plan. This contains information in an easy read and pictorial format about people’s needs. The ones we looked at had photographs showing for example; people undertaking independent living activities, out on day trips and on holiday. There is evidence that support plans are reviewed with the person however we did not see that any full person centred planning meetings had taken place and that people’s individual goals and targets are identified. We would recommend that a system for these meetings is put in place. The support plans contain risk management plans covering such areas as community access, bathing, health care issues and specific behavioural issues. These provide the guidance for staff to support people without placing them at unnecessary risk. For example; one person requires supervision when having a bath but staff do this discreetly. Where behavioural management plans are in place these are based on positive behaviours and on diversion strategies. The AQAA tells us that the service seeks people’s views and acts upon them. We saw minutes of house meetings and saw surveys of people to gain their views. Actions identified at house meetings have been addressed including requests for more holidays, the have been three already this year, and the development of a sensory garden. People at the service are supported to make decisions about their life. For example one person told us ‘ I get up anytime’ and ‘go to bed when I want’. They also told us that they chose the colour of their bedroom. There are some people living at the service that have specialist communication needs and we looked at whether they are also supported to make decisions. We observed staff providing people with opportunities to make choices. For example; at lunchtime people were offered a range of food. We also observed one staff member asking one person who was tired whether they wanted to rest on the settee or in their bedroom. They chose to stay on the settee. We also observed one person asking if they could go to the shops and saw that this wish was accommodated. We also spoke to staff about their ability to support people to make choices when they have no verbal skills or have specialist communication needs. Staff were able to describe methods of doing this. For example; one person due to their condition uses words out of context but staff are able to interpret what their words meant. One commented ‘it’s about knowing him. He does make inappropriate responses but if you know him you know what they refer to.’ The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 13 We also saw that in this person’s plan that there is a good communication plan that will support staff that do not know the person well. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 14 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): 11,12,13,14,15,16,17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The service is supporting people to have a full and varied lifestyle based on their choices. EVIDENCE: The service supports people to develop and maintain independent living skills. We saw pictures of people undertaking household tasks such as meal preparation, washing up, doing laundry and cleaning. We observed that one person was hanging the washing out and this person told us that they do their own ironing and clean their bedroom. One staff member in our survey stated that they believe that they ‘provided a warm and inviting home where all service users enjoy a range of independent living skills, activities and help with day to day running of the home’. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 15 The service is working to improve communication skills. People have a communication plan and one person has a communication passport. Staff can describe the support people need to communicate and are aware of how people communicate non-verbally to express their views. We observed staff communicating effectively with people with specialist communication needs. The service is supporting people to take part in a range of activities both social and educational. The service takes account of people’s different needs including relating to their spiritual needs and their ages. People undertake activities of their choice including two people attending an Age Concern group and two people going to church. The examination of daily records shows that these activities take place. Three people attend college and one person that chooses not to go to college does some computer work and literacy work at the service. Examples of these activities are in their person centred plan. The service is supporting people to do craft and artwork and examples of some of this is displayed in on the walls of the garden. Several people are interested in gardening and one person said she had planted some strawberries. Another person had bought bedding plants and these are to be put in the garden. There is evidence of other activities taking place from pictures on the walls including going to discos, going bowling, having days out and holidays. In fact several of the people living at the service were on holiday in Wales when we visited. The service had already been on holiday to Blackpool and another trip is planned. Although the service is located rurally people have regular opportunities to access the community using local resources such as leisure centres, shops, and cafes and health care services. The staff support people to maintain contact with family and friends. Some people visit family regularly and the service is assisting one person to try and regain contact with their family. This inspection looked at the meals people received. Menus are provided in a pictorial format and a board in the dining room identifies the day’s menu. These show that a choice is always provided. However we did see that the menu was not strictly adhered to as people were asked what they wanted to eat. The service provides breakfast when people get up and this comprises of toast, a choice of cereals and something hot if wanted. Lunch is light meal something like soup or sandwiches followed by cakes or a yoghurt or fruit. However due to community access people there are times when some people are out of the service. The main meal is taken in the early evening and this consists of a main meal for example Spaghetti Bolognese followed by a pudding. The AQAA states that ‘the menus are produced with the help of service users and they are involved in the preparation and cooking of meals’. This was confirmed through pictures seen on the walls and one person said ‘I The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 16 make my own lunch- ham sandwich’. We also saw that people were supported to do the food shopping and to lay and clear the table and to do washing up. One person needed assistance to have their meal and we observed a staff member doing this sensitively. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 17 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. People are having their health and personal care needs met in a manner that takes account of their wishes. The service’s medication practices are making sure people have the correct medication and reduces the possibility of errors occurring. EVIDENCE: We looked in detail at two people that live at the service and saw that support plans and person centred plans identify the individual health and personal needs of the people that live at the service. These plans show that people are involved in issues about their personal care needs including how they want this care to be provided. For example; one persons wish for shaving gel rather than foam was respected and another person’s wish to look after their own personal care was documented. We observed that people’s oral and hair care needs are met and in cases where people refuse to attend for appointments this is clearly documented. One person told us that they are The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 18 supported to choose their own clothes and go out with staff to buy new clothes. There is evidence of people going to the dentist and we saw that people have toothbrushes and toothpaste in their bedroom. One person informed us that they have a dental appointment next week. We observed that people are well dressed and have age appropriate clothing. We spoke to staff about how they respect people’s privacy and dignity. Staff are aware of the need to address people by their chosen name and in support plans these wishes are documented. In respect of undertaking personal care they could describe how they respect people’s privacy. We saw that locks are fitted to bedroom doors if people wanted them. We did notice that one bathroom did not have a lock. Although this is used by one person and is away from the other communal areas we feel that a lock should be fitted to ensure that person’s right to privacy. We also observed people being spoken to in a respectful manner and by their chosen name. The health care needs of people are recorded in their support plans and we saw records to confirm people receive primary and specialist health care services. For example; one person has regular appointments with a neurology consultant and a psychologist visits another person. Records in another file show that a Community Nurse regular visits the service to visit individuals and to provide advice to staff. Staff are also aware of people’s health care needs and could state how they supported people with conditions such as epilepsy. They were clear that each person’s needs were different but support includes providing extra checks at night, supervision when bathing and monitoring and recording seizures for later analysis by health professionals. A health care professional told us they had observed a member of staff dealing well with a person when they had a seizure. They felt they treated the person ‘respect and dignity’. We looked at the way the service was managing people’s medication. Training records and discussions with staff confirm that staff are trained in medication administration. Medication is appropriately stored in a locked cabinet. We saw that medication is checked when it arrives and records are kept of any medication returned to the pharmacy. Our case tracking shows that records are properly kept and there are no gaps in the records. An audit of a sample of medication confirms that medication is being administered as prescribed. Where medication is prescribed ‘as required’ a protocol is in place to provide the information needed. We also saw that where a person is allergic to medication this was clearly recorded both in their care records and on the Medication Administration Records. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 19 The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 20 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. People who use the service are listened to and actions taken to address any concerns. People are protected from abuse through the service’s procedures and by the staff’s knowledge. EVIDENCE: The service’s AQAA states that it has a complaints procedure that is provided and explained to all people living at the service. We confirmed that a procedure is in place and that this is in a symbolic format. One person told us in a survey that a copy of the procedure was on the back of the door and we saw that this was the case in the bedrooms were looked at. This person also told us they know how to complain and said ‘ I find it easy to talk to staff’. One person we spoke during our visit said ‘I tell staff if I have a problem’. As some people living at the service cannot express their views we spoke to staff about their knowledge about how these people would express dissatisfaction. Staff were able to describe the different methods people would use for example; one person becomes agitated, another cries and one uses a certain phrase to say if something is wrong. Staff report that if they feel someone is distressed they have a one to one talk to try and find out what was wrong and in some cases would use symbols or pictures to help with communication. Staff report that advocates have been used in the past. They also say that they use house meetings and surveys to gain people’s views of the service. We were also told by a health care professional that they feel that the service is The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 21 responsive to complaints. Also a survey of an outside agency states ‘any negative feedback is taken on board and dealt with by team leader and management’. The service maintains records of any complaints and we saw that none had been received. We also saw that any complaints are considered as part of the service’s quality assurance process. The service has safeguarding procedures in place and no safeguarding incidents have occurred since the service was reregistered last year. Staff we spoke to are aware of safeguarding issues and how to respond to any concerns. One told us she ‘ would go to the manager and inform her of the situation. If the complaint needed to be taken further I would go to an outside agency such as the Commission ’. They could describe areas of abuse and who to report them to. Training records confirm staff have received training in protection issues. The service has robust procedures in place to safeguard people’s finances. We checked two people’s records and saw that records are kept of money spent and receipts are kept to support any expenditure. Sampling of these records show that the money tallied with the records. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 22 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): 24,26,28,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service provides people with a good standard of private and communal accommodation that is kept clean and hygienic. EVIDENCE: The service is situated in a rural location in the grounds of another registered service. These services are completely separate. The AQAA provided by the service states ‘we provide a homely atmosphere’ and people we spoke to agreed with this view. A staff member reported in our survey that the service offers a welcoming and homely environment’, a health professional that visits stated the ‘home is welcoming and feels homely’ and comments from the service’s surveys of outside agencies include ‘a fabulous environment to visit’ and ‘welcoming’. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 23 The service provides suitable accommodation. The downstairs rooms are wheelchair accessible. The communal areas including a large lounge are decorated in a modern and attractive way. This contains a range of seating to accommodate the differing needs of the people that use it. There is a separate dining room that contains lots of pictures of the people that live at the service. There is a domestic style kitchen. The service has adequate bathrooms and toilet facilities although as identified earlier in this report one bathroom did not lock. Bedrooms are all single, two with en-suite facilities, and the ones we saw are well decorated in colours chosen by their occupants. Bedrooms are personalised with pictures, posters, photos and ornaments. Externally there is a front garden laid to lawn, and surrounded by trees and shrubbery. At the rear is a courtyard where there are plans for tubs of bedding plants to be put. This area is also home to the rabbit belonging to one of the people that live at the service. Off this courtyard is a large paved area that currently needs to be landscaped. One area contains a gazebo and tables and chairs for sitting outside. The service informs us that this area is starting to be developed as a sensory garden. The service is kept clean and tidy. Staff have had training in infection control. Cleaning schedules are in place. One person responded in our survey saying that the home is always fresh and clean. One of the surveys completed by the service of an outside agency said ‘the home appears clean and tidy’. The service’s laundry is very small and not adequate for the service. However, they have access to the laundry at the other service on the same site that has a full laundry and the proper facilities to wash soiled laundry. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 24 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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service provides staff who have the necessary knowledge and skills and in sufficient numbers to provide people with the support they need. The service’s recruitment procedures are safeguarding people that use the service. EVIDENCE: The service is providing people with sufficient staff to meet their needs. The rosters we examined show that there are at least three support staff on duty during the morning and three people on duty during the afternoon and evening. On some occasions there are four during the day but the fourth person is the Manager. One waking staff member and one staff member sleeping in provide night support. The roster also showed that when there are specific activities or trips taking place additional staff are provided. For example; on one day in March 2008 more people were on duty during the evening to support people to go to a disco. Staff we spoke to tell us they feel that there are enough staff on duty. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 25 People using the service and people that visit the service have confidence in the staff. Comments from people living there include: ‘ I like the staff because they treat me’, and ‘the staff are brilliant’. Comments from other people include: ‘Staff very accommodating. They communicate well with service users and they are aware of the issues’, ‘staff friendly’, ‘nice friendly staff’, ‘staff very professional and welcoming’ and ‘staff put the preferences of service users first and treat them in a respectful manner as individuals’. These views confirmed with what we found. Staff are aware of people’s individual needs and how to meet them. They show people respect and treat them with dignity. Staff receive induction training when they start work and our surveys show staff are positive about this. Comments include: ‘ my induction covered a lot of the knowledge about the job that I was going to be carrying out’ and ‘after my induction I felt confident to perform the job role’. Staff tell us and the records confirm that they also receive a range of further training including medication, safeguarding and training about specific conditions such as autism and epilepsy. The service has a high number of people qualified to at least NVQ level 2. The service’s recruitment procedure was looked at during this inspection. An examination of a sample of staff files show that the service’s recruitment procedures are safeguarding people. People have both Criminal Records Bureau and Protection of Vulnerable Adults checks and two references are provided, one of which is the previous employee. The service also makes sure that people are fit to do the work and checks the identity of prospective staff. The service undertakes formal interviews and includes people that use the service in this process. On one file we saw a copy of pictorial questions used by one person living at the home during a staff interview. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 26 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 service is generally being well led in the interests of the people that live there. Whilst people are generally protected by the service’s health and safety practices the service needs to ensure that when issues that could pose a risk to people are identified they are promptly dealt with. EVIDENCE: The manager was not present during this inspection but we are aware that she has the necessary knowledge, experience and qualifications to manage the service. She has successfully completed registration with Commission. There is good relationship between staff and the manager and one staff commented The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 27 ‘she is a good manager and I can talk to her about anything’. The service had provided us with an AQAA, a self-assessment document that told us about the service. We gave a Senior Manager that was present advice over how this document could be improved to better evidence what the service does well. We felt that the service is being generally well lead and has policies and procedures in place to safeguard people and to make sure staff are trained to meet people’s needs. We feel that the service involves the people that live there in the running of the service. The service is undertaking checks on the service to monitor and review the quality of the service. This is a good system and includes surveys of people that live at the service, relatives and outside agencies. The service also analyses complaints, accidents and falls to identify any lessons to be learnt. Additional audits include checks on support plans, meals and the environment. The service has a business plan in place to continually improve the service. The service Health and Safety procedures are generally safeguarding people. Fire records show that regular testing is taking place. A fire risk assessment and evacuation plan is in place. Records of accidents were kept and analysed. Hazardous substances are safely stored. Information about serious incidents is being sent to the Commission. We saw records showing that where incidents occur plans are put in place to prevent them happening again although these issues could be dealt with quicker. For example; one person had a burn on 28.4.08 thought to be from a radiator. The accident record shows that the service has turned this radiator off until it is covered. A request had been put in to the company for it to be covered but to date this had not occurred although the service manager seen during inspection confirmed that this would be addressed. The service’s records confirm that Health and Safety training is provided in areas such as infection control, moving and handling, fire safety, food safety and first aid. We did however notice that the night staff have not completed recent fire safety training. When we discussed this with the Team Leader she was able to explain the reasons for this and what action the manager had taken to resolve this issue. We were also advised that the night sleep in staff is trained in fire safety. We also saw one bedroom door is being propped open. We were advised that this door only open in day when staff around and always closed at night. A request had been made for a door opener linked to fire alarm to be fitted. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 28 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 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 2 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 4 X X 2 X The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 29 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 YA27 Regulation 12(4)(a) Requirement To provide a lock on the downstairs bathroom to ensure that people have their privacy promoted. Where hot surfaces pose a hazard to people these must be covered. This will protect the people living at the service. Night staff should be trained in fire safety in order that people living at the service can be properly supported in the event of a fire occurring. Timescale for action 23/06/08 2. YA42 13(4)(a) 01/06/08 . YA42 18(1)(a) 23/06/08 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. 3. The Mews Refer to Standard YA6 YA24 YA30 Good Practice Recommendations To put in place full person centred planning meetings to enable people to have their care reviewed and to identify people goals and wishes for the future. To ensure that the outside of the house is landscaped to provide a safe accessible space for people to use. To provide laundry facilities that are suitable to meet the DS0000070944.V364226.R01.S.doc Version 5.2 Page 30 4. YA42 laundry needs of the service. If in the interests of people living at the service doors need to remain open to ensure that these do not pose a fire risk. The Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Mews DS0000070944.V364226.R01.S.doc Version 5.2 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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