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Inspection on 21/08/06 for The Newlands

Also see our care home review for The Newlands for more information

This inspection was carried out on 21st August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Support for the residents is provided on an individual basis. The Home uses a person centred planning approach to care planning and each resident is allocated a key and link worker. Independent advocates have been used. The residents are involved in planning their care and regular residents and families meetings are also held. Health care needs are well monitored and the appropriate medical services accessed. Individual risk assessments are in place and any lifestyle restrictions are justified. The care plans and risk assessments are regularly reviewed. Mandatory training is provided to staff on a rolling programme and all new staff undertake a comprehensive induction. The staff undertake Learning Disability Awards Framework training, which covers a number of specialist areas and 94% of the staff team have already achieved the National Vocational Qualification level 2 or above. The manager and staff are culturally aware and would welcome people of differing cultures. Two of the residents are regularly supported to attend the church of their choice. The residents are able to choose from two Local Authority day centres, however a resident of retirement age is supported to stay at Home. Some of the residents access the community independently. A questionnaire completed by a health and social care professional and received by the Commission for Social Care Inspection prior to the inspection stated, "the clients are actively encouraged into the local community". The residents are free to spend time as they wish in the Home and during this visit, some were in their rooms listening to music or watching TV whilst others gathered with staff in the lounge. Some had already been out shopping that morning and a trip was being arranged for others that evening. Two said that they had been to the local pub on Saturday night. The residents are encouraged to be involved in the day-to-day running of the Home, dependent on their abilities. The residents are enabled to maintain friendships and family relationships. The medication procedures were checked and administration observed. The management team administer medication and they complete the `Safe Handling of Medicines` module based training. There have been no complaints made either to the Home or the Commission for Social Care Inspection and the procedure is available in symbol format. The financial procedures were checked during this inspection and it was established that robust systems are in place. The residents live in a clean and comfortable environment. Staff receive regular supervision, which takes the form of individual sessions with a manager and attendance at staff meetings. The manager has systems in place to ensure that the Home is managed safely. The quality of the service delivered is monitored by the manager and the Department. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 8

What has improved since the last inspection?

Three requirements were made as a result of the last inspection and all have now been met. The Service Users` Guide and contracts now contain more detail as to what is and what is not included in the fees. The staff files held at the Home now contain all of the required information. The staff have all been nominated to attend a full day interagency training on `Recognition and Response to Adult Abuse`. The Home now has a complete management team, following the recruitment of a senior care manager and senior support worker.

What the care home could do better:

Although there is evidence that mandatory training is provided on a rolling programme and that new staff undertake a comprehensive induction, there is little evidence of additional, supplementary training. The manager gave examples where external professionals came to the Home to advise staff on how to support residents with specific needs and it is recommended that these sessions be recorded on the staff training files. Some of the residents are unable to verbally communicate and some of these understand simple makaton symbols. Guidance is available for staff, although the training records do not indicate that they have been provided with any formalised training. A recommendation has been made that the manager examine `equality and diversity` with the staff team and explore further ways of ensuring that residents are supported to make choices, particularly those unable to verbalise their preferences. This may include the provision of specific training applicable to diverse and specialist needs.

CARE HOME ADULTS 18-65 The Newlands Royal Walk Cheadle Stoke on Trent Staffordshire ST10 1EL Lead Inspector Sue Jordan Key Announced 21 August 2006 01:30 The Newlands DS0000033400.V306116.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 Newlands DS0000033400.V306116.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 Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Newlands Address Royal Walk Cheadle Stoke on Trent Staffordshire ST10 1EL 01538 752210 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) Staffordshire County Council, Social Care and Health Directorate Mrs Tracey Shirley Joinson Care Home 12 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (4), Learning disability (12), Learning disability of places over 65 years of age (5), Mental disorder, excluding learning disability or dementia (2), Physical disability (4) The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 12 Learning Disability (LD) - Minimum age 40 years on admission 4 Physical Disability (PD) - Minimum age 40 years on admission 2 Mental Disorder (MD) - Minimum age 40 years on admission 4 Dementia (DE) - Minimum age 40 years on admission. Date of last inspection Brief Description of the Service: The Newlands is a Local Authority Home accommodating up to 10 people with learning disabilities, currently between the ages of 50 and 81 years. There are presently 9 people living in the Home. The Home is registered to provide support for 12 Adults with a Learning Disability, 5 of whom may be over 65 years of age, 4 of whom may be over 65 years of age and have dementia care needs, 2 of whom may have mental health needs and 4 of whom may have a physical disability. The Home must not admit any person under the age of 40 years of age. It is situated in a quiet cul-de-sac close to the local hospital and town centre. The home is set in a private and attractive garden and there is adequate car parking provision. The property consists of two semi-detached houses modified over the years to create four distinct living areas, each with its own lounge/dining and/or kitchen/kitchenette facilities. One area is self contained for the three more independent service users and has its own entrance. The Home is on two floors with access being provided by stairs and a shaft lift. All bedrooms are of single occupancy with all but one being on the first floor. An adequate number of toilets are provided on both floors. Eight of the nine present service users attend some form of Local Authority day service provision within the community. One is now retired and is supported by the Home’s staff. The fees charged are £706 per week. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 5 The future plans for the Home are uncertain, as there are a number of Departmental changes being made to the delivery of support services to Adults with a Learning Disability. The residents, staff and families are involved in the consultation process. The Newlands is managed by Tracey Joinson, who is suitably trained and experienced and registered with the Commission for Social Care Inspection. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector who used the National Minimum Standards for Care Homes for Younger Adults, (18-65), as the basis for the inspection. This visit was a key inspection and therefore covered all of the core standards. Some additional standards were also assessed. The inspection at The Newlands took place over a period of six hours and included an examination of records including service user care plans, staff recruitment files, training records, health and safety documentation and relevant policies and procedures. The manager and one member of the staff support team were interviewed. The inspector sat in on the management and staff handovers and observations of staff and resident interaction were made. Where possible, informal discussions were held with the residents and the inspector sat with two of the residents whilst they had their tea. A tour of the environment was also undertaken. Prior to the inspection visit, survey information was obtained from seven relatives, one health and social care professional and two general practitioners. Scrutiny of pre-inspection information completed by the manager was also undertaken. All of the core national minimum standards were met at this inspection. Three recommendations were made as a result of this visit. What the service does well: Support for the residents is provided on an individual basis. The Home uses a person centred planning approach to care planning and each resident is allocated a key and link worker. Independent advocates have been used. The residents are involved in planning their care and regular residents and families meetings are also held. Health care needs are well monitored and the appropriate medical services accessed. Individual risk assessments are in place and any lifestyle restrictions are justified. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 7 The care plans and risk assessments are regularly reviewed. Mandatory training is provided to staff on a rolling programme and all new staff undertake a comprehensive induction. The staff undertake Learning Disability Awards Framework training, which covers a number of specialist areas and 94 of the staff team have already achieved the National Vocational Qualification level 2 or above. The manager and staff are culturally aware and would welcome people of differing cultures. Two of the residents are regularly supported to attend the church of their choice. The residents are able to choose from two Local Authority day centres, however a resident of retirement age is supported to stay at Home. Some of the residents access the community independently. A questionnaire completed by a health and social care professional and received by the Commission for Social Care Inspection prior to the inspection stated, “the clients are actively encouraged into the local community”. The residents are free to spend time as they wish in the Home and during this visit, some were in their rooms listening to music or watching TV whilst others gathered with staff in the lounge. Some had already been out shopping that morning and a trip was being arranged for others that evening. Two said that they had been to the local pub on Saturday night. The residents are encouraged to be involved in the day-to-day running of the Home, dependent on their abilities. The residents are enabled to maintain friendships and family relationships. The medication procedures were checked and administration observed. The management team administer medication and they complete the ‘Safe Handling of Medicines’ module based training. There have been no complaints made either to the Home or the Commission for Social Care Inspection and the procedure is available in symbol format. The financial procedures were checked during this inspection and it was established that robust systems are in place. The residents live in a clean and comfortable environment. Staff receive regular supervision, which takes the form of individual sessions with a manager and attendance at staff meetings. The manager has systems in place to ensure that the Home is managed safely. The quality of the service delivered is monitored by the manager and the Department. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? 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 Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 9 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 Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. Every effort is made to meet the needs and aspirations of the service users. EVIDENCE: The Statement of Purpose and Service Users Guide have been reviewed and amended as previously required. Some of the information has been developed into symbol format and made available to the residents. The present residents have lived at The Newlands for a number of years and there have been no permanent admissions recently. However the Home provided emergency shelter for one person, from April 2006 for a period of three months. The manager was able to confirm that an initial care plan and assessment was received from the social worker prior to admission and a temporary file set up in the Home. The manager from The Newlands also liaised with the manager from a previous respite placement. A review meeting was held prior to the person moving into the Home to ensure its suitability. Risk assessments were carried out. A discussion was held at this inspection as to whether the Home respects the equality and diversity of the present residents. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 11 The Newlands provides support to nine adults with a learning disability. Within that there are a range of abilities and needs, communication, behavioural and physical. The Home is able to demonstrate that it supports the individual; each person is involved in person centred planning, which provides a holistic approach to the identification of need. The residents, if able, can use this forum to express their preferences and an action plan is drawn up as to how these are to be met. The Home encourages the use of independent advocates and also provides each resident with a key and link worker from the staff team. The staff undertake Learning Disability Awards Framework training, which covers a number of specialist areas and 94 of the staff team have already achieved the National Vocational Qualification level 2 or above. Mandatory training is provided on a rolling programme and new staff undertake a comprehensive induction. The manager gave examples where external professionals had provided ‘inhouse’ training to the staff relevant to specific residents and their needs. Health needs are closely monitored and access to health professionals provided. This includes ‘Well-woman and man” clinics, six monthly check ups with the general practitioner, chiropody and dental appointments. Specialist help has also been sought for some individuals, including speech therapy, behavioural management, occupational therapy and counselling services. Equality and Diversity training is available and the staff at The Newlands have been nominated to attend. An Equal Opportunities approach is used in staff recruitment and those staff with specific learning or cultural needs would also be supported. Two of the residents are regularly supported to attend the church of their choice. The manager and staff are culturally aware and would welcome people of differing cultures. Some of the residents are unable to verbally communicate and some of these understand simple makaton symbols. Guidance is available for staff, although the training records do not indicate that they have been provided with any formalised training. Some of the Home’s documentation has been developed into symbol format, which can be understood by some. The possible use of photographs was discussed during this visit. The inspector sat with two of the residents whilst they had their tea. All of the residents were offered a choice of two alternatives, however additional sauces The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 12 and salt and pepper were not available on the table and all of the residents had a cup of tea, rather than a choice of drinks. The manager was recommended to examine ‘equality and diversity’ with the staff team and explore further ways of ensuring that residents are supported to make choices, particularly those unable to verbalise their preferences. This may include the development of ‘user friendly’ formats and more evidence of the provision of specific training applicable to diverse and specialist needs. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. Care planning centres around the individual resident and provides staff with the information required to meet their needs and aspirations. EVIDENCE: The care plans for two residents were checked on this occasion. Both have a Person Centred Plan in place, which covers all areas of need, emotional and physical. The Person Centred Plan is developed with the resident and other significant people in their life at a formal meeting and this is then further developed into care plans and risk assessments. The staff have sufficient information as to how they are to meet the residents’ needs. Each area of the care plan is reviewed monthly and Person Centred Plan reviews are held six-monthly. The Person Centred Plan paperwork is in pictorial format. Each resident has an allocated key worker and link worker. The manager holds regular ‘residents’ meetings’ and external advocates have been accessed for some individuals. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 14 Residents and their relatives have had the opportunity to attend the Departmental consultation meetings with regard to the proposed changes. The manager is going to examine further the area of choice, particularly for those unable to communicate verbally. Numerous risk assessments have been developed, which support individual activities. These are also reviewed regularly. Any restrictions or limitations placed on the resident is carefully documented and justified. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents are supported to live varied lives, dependent on their wishes and abilities. EVIDENCE: All but one of the residents attends a Local Authority Day Centre and they are able to choose from two. A local satellite centre has recently opened, which means that the residents can be more closely involved with the local community. As part of their day service programme, some of the residents are supported to attend college courses. One of the residents has reached retirement age and is supported by The Newland’s staff to remain at home. Discussions with some of the residents indicated that they are able to access the community independently. Two residents are supported to attend local churches of their choice. One of the residents said that he loved cleaning the Home’s mini-bus. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 16 Three residents have just returned from a caravan holiday with two members of staff. One said that they had a good time and told the inspector that they had been to different places every day and out to eat every evening. He said that he had had breakfast in bed. On the day of this inspection the Day Centres were closed. The Home has had some recent staff shortages due to annual leave and sickness, however this is due to be resolved with the return of one staff member. The manager said that the management team work alongside the support staff in these situations to ensure that the residents can get out and about. The Home has borrowed the Day Centre’s mini-bus, whilst their own is being repaired so that they can organise day-trips. The residents are free to spend time as they wish in the Home and during this visit, some were in their rooms listening to music or watching TV whilst others gathered with staff in the lounge. Some had already been out shopping that morning and a trip was being arranged for others that evening. Two said that they had been to the local pub on Saturday night. Where possible, the residents are encouraged to keep their own personal space clean and tidy and staff are allocated to assist different residents at the daily handover. Some of the residents live more independently within a selfcontained unit. All of the residents are offered the opportunity to have a key to the front door and their bedroom and the flat has its own access. The residents are enabled to maintain friendships and if necessary staff will physically accompany them on visits. Many of the families are actively involved in their relative’s lives and home visits and stays are facilitated. Seven questionnaires were completed by relatives and sent to the Commission for Social Care Inspection prior to this inspection, all of which were positive about the care provided in the Home. Comments included: “My relative is well looked after by all the carers and is taken out and about. They also go out for meals and day trips”. “The staff are worth their weight in gold and should be valued as such”. A questionnaire completed by a health and social care professional and received by the Commission for Social Care Inspection prior to the inspection stated, “the clients are actively encouraged into the local community”. Families are invited to their relative’s Person Centred Plan review and the manager holds regular relatives’ meetings. The residents usually have their main meal at the Day Centre and a lighter tea is provided in the evening. A choice is made available and the meals served on The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 17 a trolley so that the residents can choose by sight. This is especially important for those unable to verbally communicate. The inspector sat with two of the residents whilst they had their tea. All of the residents were offered a choice of two alternatives, however additional sauces and salt and pepper were not available on the table and all of the residents had a cup of tea, rather than a choice of drinks. Written menus are available although a discussion took place as to whether pictorial or photograph formats could be introduced. This could form part of the project on the meeting of diverse needs and enabling choice. The Home has a central kitchen and employs a full-time cook. Most of the meals are prepared from here. However, each of the two lounge areas has a kitchenette area, where the residents can assist in some meal and drinks preparation. They also help with the washing up. Three of the residents have their own meal preparation and eating areas. One of the residents has a swallowing difficulty and has been attended by a speech therapist. A specific diet has been put into place and detailed records are kept. The residents are regularly weighed. Where required appropriate eating aids are available. The Environmental Health department inspected the kitchen in December 2005 and the staff were praised for its cleanliness. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents are provided with health and personal care support based on their individual needs and preferences. EVIDENCE: Personal care needs and preferences are recorded within the residents’ person centred plans and care plans. Staff monitor the residents’ personal care, where necessary and this is confirmed during the staff handover. Staff also reported that the residents could request a bath or shower at any time. The Home has the facility of an assisted bath, if required. The residents look clean and well cared for and are clothed appropriately. Daily routines are recorded in the care plans. Health needs are closely monitored and access to health professionals provided. This includes ‘Well-Woman and Man” clinics, six monthly check ups with the general practitioner and optician, chiropody and dental appointments. Specialist help has also been sought for some individuals, including speech therapy, behavioural management, occupational therapy and counselling services. One resident has recently been diagnosed as partially sighted and a vision specialist is coming into the Home to advice and guide staff. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 19 All health visits and appointments are recorded, including any action to be taken. Two questionnaires completed by general practitioners and received by the Commission for Social Care Inspection prior to the inspection were positive about the care provided in the Home, the communication from the staff and the action taken to manage the residents’ care needs. The medication procedures were checked and administration observed. The management team administer medication and they complete the ‘Safe Handling of Medicines’ module based training. The manager also assesses their competency. All medication brought into the Home is checked by the shift manager and any medication refused or discontinued is returned to the pharmacist appropriately. Protocols have been developed for each medication, which are signed by the general practitioner. They have also signed consent forms for any homely remedies provided. The pharmacist undertakes quarterly reviews of the medication systems. The Home no longer use sticky labels on the medication records, as per the Commission for Social Care Inspection pharmacist’s recommendation. The Department has recently developed a new, comprehensive medication policy. One of the residents has recently, sadly passed away in hospital. A coroner’s inquest was not required and the Home is able to demonstrate that they monitored the person’s health and contacted the relevant health professionals appropriately. Staff visited the hospital on a daily basis and liaised with the relatives. All but one of the residents attended the funeral and those particularly close to the person are being supported to grieve. The Newlands DS0000033400.V306116.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 at least once during a 12 month period. 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. The home has an open culture, with various avenues provided by which to express their views. The systems and procedures within the Home protect the residents. EVIDENCE: There have been no complaints made either to the Home or the Commission for Social Care Inspection. The complaints procedure is available in symbol format. An internal quality audit established that some residents did not know how to make complaints and this is being addressed. Each resident has a link and key worker and advocacy services are accessed, in required. Regular residents’ meetings are held. The staff have access to relevant Adult Protection procedures and are given guidance regarding adult abuse issues during their National Vocational Qualification training. They have also all been nominated to attend a full day interagency training on ‘Recognition and Response to Adult Abuse’. The manager has made an appropriate referral to the Adult Protection team on behalf of one resident, which as yet is unresolved. This relates to a letter received by the resident, believed to be a scam and not to the Home itself. The Home temporarily supported a person for three months, following a vulnerable adults referral. The financial procedures were checked during this inspection and it was established that robust systems are in place. The Department also carry out a thorough audit of these procedures quarterly and the last one was in July 2006. Where possible residents are supported to manage their own monies and lockable facilities are available. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 21 Where required, behavioural management plans are in place and guidance has been sought from external professionals. All staff have been trained in the management of violence and aggression, with the emphasis being on diversion and distraction techniques. Protection of Vulnerable Adults and Criminal Records Bureau checks are carried out on all prospective staff. The Newlands DS0000033400.V306116.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents live in a clean and comfortable environment. EVIDENCE: New fire systems have been fitted throughout the Home and as a result new evacuation procedures developed. The newly employed handyman has improved the outside area. The environmental health department visit was extremely positive. A questionnaire completed by a health and social care professional and received by the Commission for Social Care Inspection prior to the inspection stated there is a “very warm, homely environment”. The future plans for the Home are uncertain, as there are a number of Departmental changes being made to the delivery of support services to Adults with a Learning Disability. Therefore the current plan is to keep the Home clean and safe for the residents. This was confirmed during a tour of the Home. However the manager reported that one bedroom is soon to be decorated. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 23 The Newlands DS0000033400.V306116.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is “good”. This judgement has been made using available evidence, including a visit to this service. The residents are protected by a well-recruited, trained and supervised staff team, although more evidence could be provided that staff are trained to support more diverse needs. EVIDENCE: 94 of the staff team have achieved the National Vocational Qualification level 2 award or above and new staff undertake the Learning Disability Awards Framework award, which is pertinent and more specific to the residents. Although there is evidence that mandatory training is provided on a rolling programme and that new staff undertake a comprehensive induction, there is little evidence of additional, supplementary training. The manager gave examples where external professionals came to the Home to advise staff on how to support residents with specific needs and it is recommended that these sessions be recorded on the staff training files. Some of the residents are unable to verbally communicate and some of these understand simple makaton symbols. Guidance is available for staff, although the training records do not indicate that they have been provided with any formalised training. A recommendation has been made under National Minimum Standard 3 that the manager examine ‘equality and diversity’ with the staff team and explore The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 25 further ways of ensuring that residents are supported to make choices, particularly those unable to verbalise their preferences. This may include the provision of specific training applicable to diverse and specialist needs. Equality and Diversity training is available and the staff at The Newlands have been nominated to attend. An Equal Opportunities approach is used in staff recruitment and those staff with specific learning or cultural needs would also be supported. The management team receive training applicable to their role, including medication and the control of substances hazardous to health. Two members of the management team have been nominated to train as manual handling trainers, which will give a total of three in the Home. The Department have developed a new infection-control training booklet. The residents also watch the fire safety and food hygiene training videos and the manager hopes that some of the residents will be assisted to understand the principles of infection control. A recently recruited senior support worker confirmed that she had an initial two-week induction and that she has been nominated to undertake the National Vocational Qualification Assessors award. Two new staff recruitment files were examined and the procedures comply with Schedule 2 of The Care Homes Regulations 2002. There is written confirmation that both have successfully completed their probationary period. Staff receive regular supervision, which takes the form of individual sessions with a manager and attendance at staff meetings. The Department has held consultation meetings with the staff regarding the proposed changes to the service. A staff member interviewed confirmed that she feels supported by the manager. The staff have a handover period at the beginning of every shift. The Newlands DS0000033400.V306116.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 at least once during a 12 month period. 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 residents receive a well-managed and safe service. EVIDENCE: The manager, Tracey Joinson is registered with the Commission for Social Care Inspection and has achieved the Registered Managers Award. She has many years experience of working with adults with a learning disability and her role in the Home is clear and defined within a job description. The insurance policy and Commission for Social Care Inspection registration document are both displayed in the office. The Home now has a complete management team, following the recruitment of a senior care manager and senior support worker. They are supported by a support services administrator, who directly manages the auxiliary staff. The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 27 The Department are presently preparing to change their delivery of services to adults with a learning disability. All residents, staff and relatives have attended consultation meetings, although it is not yet absolutely clear what the full implications will be for the people living at The Newlands. However the residents have been assured that full assessments will be undertaken, which will also involve the staff, advocates and social workers. An update regarding the changes is sent to the Home on a monthly basis and the manager sends copies to the relevant people. The manager and the support services administrator carry out health and safety audits on a monthly basis and copies are sent to the head office. Following each audit an action plan is developed. The last one was completed in June 2006. They provide evidence that all areas of Health and Safety are carefully examined. The Department also audits the Home annually. New fire evacuation procedures have been developed to coincide with the new systems fitted and staff interviewed confirmed that they are regularly involved in mock fire evacuations. These also include the residents and it was reported that they are very familiar with the procedures to follow. The environmental health department visit in December 2005 was extremely positive. Generic and individual risk assessments are completed and reviewed regularly. Mandatory training is provided to staff as part of a rolling programme. A senior manager carries out a quality assurance audit in the Home, on a sixmonthly basis. The areas examined are finance and marketing, the kitchen, care, property, health and safety and quality assurance. Much of the criteria are based on the National Minimum Standards. An additional audit is carried out annually, in which the views of residents are gathered. Both audits result in an action plan and possible requirements. The registered manager organises staff supervision, staff, residents and relatives meetings. There is a comments book available in the hallway. The Newlands DS0000033400.V306116.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 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 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 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 3 4 X 3 X X 3 X The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 29 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA3 Good Practice Recommendations The manager was recommended to examine ‘equality and diversity’ with the staff team and explore further ways of ensuring that residents are supported to make choices, particularly those unable to verbalise their preferences. This may include the development of ‘user friendly’ formats and the provision of specific training applicable to diverse and specialist needs. It is recommended that ‘in-house’ training provided by external professionals be recorded on the staff training files. 2 YA35 The Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 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 Newlands DS0000033400.V306116.R01.S.doc Version 5.2 Page 31 - 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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