Inspection on 14/05/08 for The Old Vicarage (Notts)

This inspection was carried out on 14th May 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 The Old Vicarage (Notts) The Old Vicarage Bullock Lane Ironville Nottinghamshire NG16 5NP Lead Inspector Helen Macukiewicz Announced Inspection 14th May 2008 09:00 The Old Vicarage (Notts) DS0000071119.V364438.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 Old Vicarage (Notts) DS0000071119.V364438.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 Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage (Notts) Address The Old Vicarage Bullock Lane Ironville Nottinghamshire NG16 5NP 0115 963 1844 0115 963 1844 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) Creative Care (East Midlands) Ltd Rachel Louise Nixon Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following categories 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 fall within the following categories: Learning Disability - Code LD (16-25 years) Only service users between the ages of 16-25 to reside at the home. The maximum number of service users who can be accommodated is: 4 New Service 2. Date of last inspection Brief Description of the Service: The Old Vicarage is a converted former private residence. It is situated in the village of Ironville on the Nottinghamshire/Derbyshire border. There is a village shop, post office, school, churches and pubs. There are public transport links to nearby towns, where amenities such as Leisure Centres and supermarkets are located. The house has two lounge areas, a quiet room, dining kitchen, office for staff, toilets and laundry room on the ground floor. Four bedrooms and a bathroom on the first floor. There are extensive grounds and separate garages to the outside. The gardens are secured by high fencing and the driveway is gated. The service mainly offers care and accommodation for up to 4 younger adults aged between 16 and 25 who may exhibit severe challenging behaviours. The current weekly fees range from £2123.00 to £3931.00 per week. There is an additional top-up of £11.30 per hour if an extra member of staff is required. The weekly fees include all activities. This is a newly registered service and has no previous Inspection report. The Old Vicarage (Notts) DS0000071119.V364438.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 1 star. This means the people who use this service experience adequate quality outcomes. We told the manager we would be visiting the home to undertake an inspection the day before this visit. This was to ensure minimal disruption to the service and the care of people living there. 1 pre-inspection questionnaire was received from a parent. Due to the timing of this visit, the Manager had not yet completed a self-assessment of the home and so the information from this could not be used in the planning of this inspection. Computer held records of all contact between the Home and the Commission for Social Care Inspection since the service was registered were used as part of the planning. During this Inspection we were unable to have a discussion with the people who use the service due to their specific communication needs. Therefore indirect observations of their care took place. We asked parents and visiting professionals involved in the care of people living in the home for their views. We spoke to the Managing Directors, Manager and staff. The care files for both people living in the home were looked at in detail and their care was examined to see how well records reflected care practices within the home. Relevant records belonging to the home were also examined such as complaints and policy documents. A brief tour of the home took place including some bedrooms. During this Inspection we undertook a thematic probe that looked at the area of safeguarding. This was part of a national information gathering exercise to help us find out how well care homes are protecting the people using their services. As part of this we looked at safeguarding policies and procedures, spoke to the manager and staff, visiting professionals involved in the care of people living in the home and parents. A thematic probe is how we gather additional information on a particular theme from a key inspection. The questions for a thematic probe will be used in all key inspections carried out between a defined date and for a defined service type. So all the thematic probes were done in the same way and we also use prompts and questions to help us focus on what to look at, and who to speak to in the home. Throughout this report us/we refers to the Inspector/the Commission for Social Care Inspection. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Procedures need to be followed when dealing with peoples’ personal allowances to ensure they are fully protected. Staff need more training in order to keep people safe and to ensure the wellbeing of people living in the home. Recruitment procedures need to be better to ensure people are fully protected against unsuitable workers. Please contact the provider for advice of actions taken in response to this The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 7 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 Old Vicarage (Notts) DS0000071119.V364438.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 Old Vicarage (Notts) DS0000071119.V364438.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): Standards 1, 2, 3, 4 and supplementary standards 1.5 and 2.9 for care homes accommodating young people aged 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre-admission planning and assessment ensures that people are able to move into a home that is suited to their needs. EVIDENCE: Information about the home (Service Users Guide/Statement of Purpose) was available in both normal type and Makaton. This gave information about the purpose of the home, key policies and how to make a complaint so people had the information they needed, in an appropriate format. An admission policy was seen. Admission procedures stated that wherever possible, people had a full assessment and visited the home before moving in. There were Social Services assessments of need from the placing authorities in the care files. These provided information for staff about the needs of people, before they were admitted to the home and included relevant information from the transitions co-ordinator about their educational needs. The manager and managing director said that pre-admission visits took place and that they completed an in-depth assessment themselves to ensure that The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 10 the person was suitable for the home, and they would ‘fit in’ with the people already living there. Both parents who were contacted said they were more than happy with the admission procedures. One said ‘staff are very supportive, (x) seems to have settled well’. Completed in-house pre-admission assessment forms had not been completed. This would have supported the depth of pre-admission assessment. An example of an in-house assessment form was seen. This was very personcentred. However, it did not include a section to record pre-admission visits, the potential impact of the admission on other people already living in the home and the outcome of the assessment (ie: whether or not the admission was appropriate and their needs could be met). All of which would support the verbal testimonies of staff regarding the pre-admission process that had been used. The Old Vicarage (Notts) DS0000071119.V364438.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): Standards 6,7,9 and supplementary standards 6.11, 6.12, 6.13, 9.5 for care homes accommodating young people aged 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements in place for ensuring that individuals’ needs and choices are met and that people can participate in their chosen activities safely. EVIDENCE: Both people had an individual plan of care. Their parents had provided in depth written information for staff about care needs, daily routine and likes and dislikes. It was clear that the plan of care drawn up by staff had taken account of this information. Care plans were detailed and relevant. They provided a good level of information about the persons’ needs, were clearly written and person-centred. Pictures and symbols were included where appropriate. Individual targets and behaviour plans were included. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 12 Staff were receptive to the changing needs of people. Staff at the home had reviewed the care plans as needs changed. There were also reviews of the placement by the placing authority recorded in the files. Most of the basic information required by schedules 3 and 5 of the care homes regulations 2001 was seen in peoples’ care files. Although some of this was in a confidential file that was not used daily. This meant that the information was not readily available in an emergency situation or for staff to quick reference. Keeping this information accessible would offer better safeguards for people. People were unable to manage their own weekly allowances without the full support of staff. Financial records showed that people were able to make transactions to cover day to day expenses and that they had access to their money. The records of transactions were not always checked and signed for in line with the homes’ policy. Because all staff had access to peoples’ money, this meant that people were not fully protected in this area. People were enabled, as far as possible to make decisions about their daily life. One person had a plan of their day in symbol format. This enabled them to make some non-verbal choices about activities they wanted to participate in. There were also choices built into daily routines such as choice of meals, rising and bedtimes. Where allowing the person to make a choice involved risk to their safety, staff made choices on their behalf and documented this within the risk assessment section of the care plan. People were allowed to take responsible risks where this was deemed safe. Risk assessments and management strategies were recorded in the care plans. A policy was in place should a person go missing. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 13 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): Standards 12 -17 and supplementary standards 11.5, 12.7-12.11, 14.7-14.10 and 17.10 for care homes accommodating young people aged 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Current resources are managed well in order to provide some meaningful and therapeutic activities for people and meals offered are healthy and varied. Daily routines within the home ensure that the rights of people are respected. EVIDENCE: Wherever possible people were encouraged to develop their life skills as part of an educational programme, or linked to behavioural rewards. Life skills such as cleaning, laundering of clothes and food shopping with the support of staff were all part of the expected daily routines. One care file contained an educational plan based on the Open College Network curriculum. Staff in the home delivered this programme with support of education staff. Life skills formed the basis of most educational work The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 14 undertaken at the home and this was appropriate to the needs of the people living there. People attended weekly swimming sessions and a weekly outdoor activity centre where they used a climbing wall and went caving. A visiting professional involved in the care of one person, and a parent told us that since being in the home, the person had been able to participate in more activities appropriate to their needs. One parent said that staff encouraged people to reach their potential. People were assisted to access the local community; staff accompanied them for walks in the surrounding area and food shopping at local supermarkets. A local leisure centre was used for swimming sessions and people attended a weekly Disco. A week long activity based holiday had been booked for the Summer. A regular programme of activities that had taken place was recorded in each care file, along with pictures. People went on regular overnight stays with their families. Parents told us that the people living in the home were always pleased to return there, which indicated that they were happy and settled. Indirect observations of the people living in the home showed that they were displaying outward signs of positive well being such as smiling, being physically active and engaging in activities. Wherever possible, peoples’ rights were upheld. All bedroom doors could be locked and staff used a risk-assessment based approach when determining whether or not people were safe to have keys. Bathrooms and toilets had privacy locks. Peoples preferred form of address was recorded in their care files. Staff used non-verbal cues to determine whether or not people wished to participate in activities. Staff communications with people were appropriate and respectful. The environment of the home allowed people freedom of movement and personal space. Meals were planned to promote maximum independence and choice. Both people went out for lunch with staff on the day of this Inspection. Activity records showed this was a regular occurrence. Records of meals served and menus planned showed that people were offered a varied and nutritious diet. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18-20 and supplementary standards 19.6 and 19.7 for care homes accommodating young people aged 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples’ healthcare needs are met and they receive personal support in the way they prefer and require. The management of medicines promotes the safety of people. EVIDENCE: The input from family members in the development of care plans ensured that peoples’ preferences with regard to daily routines were upheld. Both people had a separate health care section within their plan of care that detailed their health care needs. People were able to keep their own dentist and attended the GP surgery for health checks. Care files documented liaison with Hospitals for check-ups where needed. Health promotion formed part of the educational plan for one person. Complementary therapists were being used to enhance peoples’ well being and the visitors book showed these attended weekly. One parent told us ‘health wise (x) looks fantastic’. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 16 Medication records were kept. Medications had been signed for when given supporting that people received the medication they required. Some hand written entries had not been signed, this would enable a clear audit trail should a query arise. Although there were no controlled drugs on the premises, a controlled drugs cupboard is advised for this eventuality to ensure medications are stored safely at all times. Some staff files contained a certificate of attendance at medication training. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 17 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): Standards 22, 23 and supplementary standards 23.7-23.19 for care homes accommodating young people aged 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples’ rights are upheld although gaps in staff training and documentation have the potential to create unnecessary risk to welfare. EVIDENCE: The manager told us there had been no complaints since the home was registered. We have received no complaints about this service. The information about the home included a section on how to complain. This was also written in Makaton. Because of the specific difficulties in gaining the views of people living in the home, one had been appointed an independent advocate through the National Youth Advocacy Service (NYAS). This supported that staff were attempting to find alternative ways of keeping people safe and upholding their rights. Parents told us that staff were approachable and would be able to address any concerns raised. They felt confident that staff would deal with any problems as they arose. There were both internal and local authority procedures for safeguarding children and adults kept at the home. Staff had a copy of guidelines in their personnel files and had been asked to read these as part of their induction. Some staff had received safeguarding adults and children training, but staff training records showed that more than half had not had this. Staff confirmed this. Such training would ensure that staff were able to keep people safer. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 18 The Department of Health ‘No Secrets’ guidance was not available in the home, this would help staff gain a clearer idea about local inter-agency policies, procedures and joint protocols which will draw on good practice nationally and locally and offer better safeguards for people living in the home. There had been 1 safeguarding incident at the home since the service was opened. We had been notified of this appropriately and staff had also followed correct procedure and informed Social Services and parents. This matter was being concluded at the time of this visit. One parent told us that staff had been very quick to keep them informed of the event and felt that staff had done more than required in terms of communicating with them. This meant that people were being kept safe in the home. There was a behaviour management policy for staff to reference. Where needed, care plans detailed individual behaviour management programmes linked to a reward scheme. Staff had a clear understanding of how to implement this scheme and the focus was on rewarding positive behaviour rather than sanctioning negative behaviour. The managing director stated this had been effective in diffusing potentially aggressive behaviours. A bullying policy was present in the staff policy file; this had been translated into Makaton, to make it more understandable for people living in the home. Staff had access to a policy on use of sanctions and this detailed which sanctions were prohibited by the Children’s Act. This helped to ensure that staff did not withhold peoples’ basic rights when sanctioning negative behaviours. There was a restraint policy for staff and MAPA (Management of Actual or Potential Aggression) restraint techniques were used if needed. The managing director stated there were MAPA trainers within the organisation who delivered a programme of training for staff including refresher training. Not all staff had received training, but had received some verbal instruction as part of their induction. The restraint policy advocated the use of non-interventive techniques in the first instance, and staff were able to describe situations where they had followed this guidance. Equipment that carried an element of restraint was being used to keep one person safe. The managing director was able to describe pro-active approaches that were being used to reduce the use of such equipment and promote the rights of the person. However, documentation did not support all the pro-active interventions verbally described by staff. There was guidance for staff on the Mental Capacity Act and training on this subject was being cascaded to staff. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 19 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): Standards 24 and 30 and supplementary standards 25.9-25.11 for care homes accommodating young people aged 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a well-maintained environment that is suited to their needs and fulfilling the aims and purpose of the home. EVIDENCE: We had recently registered the building and it provided a clean and wellmaintained environment for people living there. The grounds were private and spacious allowing people freedom of movement and personal space. People had been actively involved in the choice of décor and furnishings. Laundry equipment was domestic in nature and suited to the aims and purpose of the home. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 20 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): Standards 32-36 and supplementary standards 32.7, 33.12 and 35.9 for care homes accommodating young people aged 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are cared for by sufficient numbers of staff. Gaps in training and recruitment means that people are not fully protected against unsuitable or poorly skilled workers. EVIDENCE: Because the home was newly opened, many staff had recently been employed. This meant that the level of training and competencies that had been collectively achieved was reduced. Staff training records showed that less than 50 of care staff had National Vocational Qualifications to level 2 or above. Records also showed that much of the mandatory training had not been completed. Staff told us they had received some training such as fire safety and MAPA restraint, which was supported by certificates in staff files. However, less than 50 had received all their required training. One of the company directors was able to describe how this would be achieved within the next 12 months and confirmed the Company was registered with Skills for Care which The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 21 would assist them to access training. Until all staff have received their required training the wellbeing of people living in the home could be compromised. Staffing rotas showed there were enough staff to meet their contractual obligations for the people living in the home. Staff also had oversight from the manager and company directors who often worked alongside them but were not recorded as part of the staffing complement on the rotas. This would be useful to support the level of management oversight in the care of people. All staff providing care for people under 18yrs were aged over 21. Parents told us they were happy with the way that staff cared for the people living in the home. They said that they had the right skills to communicate with the people they looked after. Staff recruitment files were seen. These largely contained the required information. All staff had received satisfactory police clearance so people living in the home had been protected to some degree. However, written references were missing from some files and staff were not recording why people had left previous employment that involved work with children or vulnerable adults. Gaps in recruitment meant that people were not fully protected against unsuitable workers. Staff said they had worked with a more experienced member of staff when they first commended their employment. One member of staff was observed working as supernumerary during an activity session. However, staffing rotas did not record this time. This would help to support that inexperienced workers are not involved in the care of people. Staff files contained a short induction checklist had been completed. A more comprehensive induction booklet was seen that the manager intended to put in place. This newer version would offer better safeguards for people living in the home. Staff told us they felt supported although support following exposure to physical attacks tended to be informal, and not recorded. This would demonstrate that action is taken to ensure incidents do not affect the future care of people living in the home. Staff records showed that the manager had put in place a system for ongoing formal supervision. Which was recorded. This meant that systems were in place to identify any poor practice and to support staff to develop good practice, within a supportive framework. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 42 and supplementary standard 41.4 for care homes accommodating young people aged 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed to ensure the general safety and wellbeing of people. EVIDENCE: The manager of the home had registered with the Commission for Social Care Inspection. She had an NVQ 4 in care and was undertaking the registered managers award. She had 8 years experience of working with people with challenging behaviour and attended regular training updates. We had not received an annual quality assurance assessment (AQAA) from the service at the time of this visit; the deadline to return this had not expired. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 23 The managing director told us he would send it as requested. He was able to show ways in which he would be using records made at the home to make assessments as to how the home could improve care. Such records included monitoring of the behaviour management programme. At the time of this Inspection the manager had not put into place any systems to formally gain views of parents and/or people who used the service. However, regular reviews of care were taking place with placing authorities and parents. Visiting professionals involved in the care of people living in the home told us that staff kept them regularly updated about the service and that care reviews occurred. Records of one such review recorded ‘X was able to show their pleasure at being at the home’. Parents also told us they regularly communicated with staff and felt able to express their views about the care provided. The Company intended to commence the ISO 9000 Quality Assurance programme within the next few months. Ongoing service records were being maintained and environmental risk assessments had been completed. Health and Safety advice was kept in areas were cleaning products were stored. Advice was relevant to the type of product in use. All this showed that the environment was being safely maintained for the people living and working there. The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 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 2 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 2 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x The Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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 YA7 Regulation 16(2)(l) Requirement Records of financial transactions must be checked and signed for in line with the homes’ policy. Because all staff have access to peoples’ money, this will ensure that people are fully protected. Staff must all have safeguarding adults and children training to ensure people are kept safe. Staff must all receive training on the system used by the home to manage aggression. Timescale for action 30/06/08 2. YA23 13(6) 31/08/08 3. YA23 13(7) 31/07/08 4. YA32 YA35 18(c) 5. YA34 19 and Schedule 2 People who have not received this training must not be left unsupervised when working with people living in the home, to ensure people are kept safe. Staff must be suitably trained 30/09/08 in National Vocational Qualifications and in mandatory subjects to ensure that the wellbeing of people living in the home is not compromised. Staff must not be employed 30/06/08 until all required recruitment DS0000071119.V364438.R01.S.doc Version 5.2 Page 26 The Old Vicarage (Notts) (including checks are completed to amendments) ensure that people are fully protected against unsuitable workers. 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 YA2 Good Practice Recommendations The in-house pre-admission assessment form should include a section to record pre-admission visits, the potential impact of the admission on other people already living in the home and the outcome of the assessment (ie: whether or not the admission was appropriate and their needs could be met). All of which would support that people are admitted appropriately. Basic information required by schedules 3 and 5 of the care homes regulations 2001 should be accessible within peoples’ files in case of an emergency situation or for staff to quick reference. Keeping this information accessible would offer better safeguards for people. A controlled drugs cupboard should be provided to ensure medications are stored safely at all times. The Department of Health ‘No Secrets’ guidance should be available in the home, this will offer better safeguards for people living there. Documentation should be able to support the pro-active interventions in place to reduce the use of equipment that carries an element of restraint. The hours that the directors and manager work at the home should be recorded on the staffing rotas. This would support the level of management oversight in the care of people. Staffing rotas should record induction supernumerary shifts worked to support that inexperienced workers are not involved in the care of people. Support meetings should be offered to staff following exposure to physical attacks and should be recorded. This will demonstrate that action is taken to ensure incidents do not affect the future care of people living in the home. Systems to formally gain views of parents and/or people who use the service should be put into place. DS0000071119.V364438.R01.S.doc Version 5.2 Page 27 2. YA6 3. 4. 5. 6. YA20 YA23 YA23 YA33 7. 8. YA35 YA36 9 YA39 The Old Vicarage (Notts) Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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 Old Vicarage (Notts) DS0000071119.V364438.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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