Inspection on 04/03/09 for The Rookery

This inspection was carried out on 4th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Rookery Rookery House Wells Road Radstock Bath & N E Somerset BA3 3RS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: David Smith     Date: 0 4 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: The Rookery Wells Road Rookery House Radstock Bath & N E Somerset BA3 3RS 01761438610 01761438611 doreenpaisley@priorygroup.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Priory Education Services Ltd Name of registered manager (if applicable) Mrs Doreen Diana Paisley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 18. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: None Date of last inspection Brief description of the care home Rookery House is operated by the Priory Group. The home is situated in Radstock, an ex-market town, approximately eight miles from Bath City Centre and the town of Frome. The home’s Statement of Purpose describes its aims as providing a high standard of quality educational programmes for young adults with Aspergers Syndrome and associated disorders. Each young adult will be looking for continued specialist development to help him or her meet their potential, further develop their life skills, gain independence and integrate into the community. The Rookery is not a Care Homes for Adults (18-65 years) Page 4 of 33 care home 18 Over 65 0 18 Brief description of the care home home for life and support is typically provided on a 3 to 5 year programme for young adults who have come from home, school, college or other care setting. Each young person seeking admission to the service should be self-motivated to progress and have their own ambitions and desire to study and obtain full or part time employment. The current fee level ranges from 64970 pounds to 122640 pounds per year , depending on the support needs of each young adult. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last Key Inspection of this service was completed on 27/06/07. This was an unannounced visit to the home to enable us to complete a Key Inspection of this service. We spent seven and a half hours in the home on the day of our visit. The pre-inspection planning involved reviewing the report of the last Key Inspection completed in June 2007 and the Annual Service Review carried out in June 2008. We also looked at the service history, which details all other contact with the home. We (the CSCI) provided the home with their Annual Quality Assurance Assessment (known as an AQAA). This is a self-assessment, which focuses on how well outcomes Care Homes for Adults (18-65 years) Page 6 of 33 are being met for the people who live at Rookery House. The home sent us their AQAA when we asked for it. It was clear and gave us all the information we asked for. We provided a number of surveys for people who live in the home, their relatives, health professionals and staff members to enable us to carry out the last Annual Service Review. The views of the people who wrote to us have also been included in this Key Inspection report. We spoke informally with some of the people who live in the home and some time was spent in communal areas observing interaction and communication between staff members and young adults. We also spoke with the Manager, Deputy Manager and other staff members and with one Social Worker who was visiting the home to attend a review meeting. We gathered additional information for this report by looking at a number of records within the home such as care plans and associated records, risk assessments, accident and incident reports, medication administration, staffing records and health and safety procedures. We also viewed all communal areas of the home and some of the bedrooms used by the people who live here. The Rookery uses the term young adult to describe the people who live here. We have used this term, together with individuals or people, to replace service user in this report. What the care home does well: What has improved since the last inspection? The Risk Assessment processes have now been reviewed and improved. This helps to ensure there are safe working practices within the home to promote the welfare of young adults and staff. Each member of staff now takes part in regular fire drills and a clear record of every drill is maintained. This promotes the welfare and safety of young adults and the staff team. The home has developed person centred medication profiles and provides medication training for staff members who dispense medication. This ensures a safe system is in place for each person who lives in the home. The home now has concerns, complaints and compliments record. This provides a variety of views in relation to the service provided to each person who lives in the home. Care Homes for Adults (18-65 years) Page 8 of 33 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 33 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There continues to be a thorough and tailored process of information sharing, assessment and visiting which enables the home, young adults and their families to make an informed decision about the placement. Each person understands their rights and responsibilities as they are provided with a statement of terms and conditions. Evidence: The home has both a comprehensive Statement of Purpose and Referrals and Admissions Policy. These provide clear information regarding the range of services and support the home is able to offer. They also clearly describe the expectations placed upon adults who enter the service, especially their desire to develop, gain independence and to move on. Each young adult spoken with or who wrote to us said they were asked if they wished to move to the home and that they did receive enough information to decide if this Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: was the right home for them to live in. People are given the opportunity to visit the home before agreeing to move in for their assessment. This allows them to have a look around the home, meet the people who already live here and some of the staff team. The records we looked at show that individuals usually visit with their parents. One person who recently moved in told us they did visit the home and said they liked it and chose to move. They said it has been really good since moving in. We looked at the records for two people who have recently moved into the home. These contain lots of information about each person, such as care plans or assessments from their Funding Authority, together with a number of other reports which describe their history and their support needs in detail. The home has also completed their comprehensive assessment, carried out by professionals on behalf of The Rookery, which included psychiatry, educational therapy, occupational therapy and speech and language therapy. This process has been improved since our last visit: this is now done over a 12 week period, instead of 3 days. Each person who lives in the home is provided with their own guide to the service and a statement of Terms and Conditions which describe the homes aims, objectives, level of fees and who is responsible for payment, complaints procedure and each persons rights and responsibilities whilst living in the home. This is signed by each young adult and the Registered Manager and forms part of each persons care plan. This is good practice. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and goals are met and reflected in their individual plan. Young adults are supported to make their own decisions and are consulted on, and participate in, all aspects of life in the home. Each person is supported to take risks to enable them to be independent and staff ensure information about them remains confidential. Evidence: We looked at the care records for four of the young adults living at the home. These include detailed assessment information, clear care planning documents, records of reviews together with the outcomes and other specialists reports. Reviews are attended by family members, staff and a representative from the Funding Authority. The young adults are encouraged to attend their review meetings, however, if they do not wish to do so this is respected. Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: Staff also write daily records for each person, which give an overview of each day. Individual targets are noted; each persons keyworker is responsible for ensuring these are tracked and reviewed. These records continue to show the significant progress many individuals have made since living at the Rookery. The young adults we spoke with said they made decisions about their lives. Staff support them, and sometimes help by explaining options or possible consequences, but let them choose. Those who wrote to us said they make decisions about what they wish to do during the week and at weekends and staff listen to them and act on what they say. They are encouraged to become involved in all aspects of home life such as cooking, cleaning and deciding what courses or activities inside or outside of the home they would like to take part in. Each person is encouraged to discuss all aspects of home life and weekly house meetings are arranged. These are generally well attended and the records show that a wide range of topics are discussed and acted upon. An example of this is the withdrawal of some of the filters on the homes computers, which the young adults felt were too restrictive. An independent advocate now supports the people who live here. They visit the home regularly to ensure that each person has access to independent advice or support to make decisions about their lives. Interaction between staff and people who live in the home was observed informally during our visit. These show that staff have a good knowledge of the support needs of young adults and how to communicate with them effectively. Both the people who live here and staff appear relaxed in each others company and at no time did staff appear rushed or unable to give people their attention. Care and support is provided within a risk assessment framework. Healthy risk taking continues to be encouraged and supported, as evidenced within the wide range of opportunities and activities people are able to enjoy. Each of the person centred risk assessments examined are detailed and have been regularly reviewed. Each persons care records are stored securely within the home. Each care plan describes who can have access the personal information contained within it. The manager and each young adult sign this agreement. This is good practice. Care Homes for Adults (18-65 years) Page 14 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each young adult has opportunities and appropriate support to develop independent living skills, access work, leisure and educational facilities both locally and in the wider community. Each person is treated as an individual, their rights respected and responsibilities made clear. They are supported to develop personal relationships and keep in touch with family and friends. People have healthy and well presented meals at a time and place of their choosing. Evidence: Individuals are very well supported to reach their full potential in relation to their personal development. A great deal of importance is placed upon only accepting new Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: people into the home who wish to develop their skills to enable them to return to education, work or to live more independently in the community. The young adults we spoke with or who wrote to us described the wide range of their interests and the activities or courses they chose either inside the home or in the wider community. A number of individuals are enrolled on or have completed educational courses at colleges in Radstock, Trowbridge and the University of the West of England. The courses they are enrolled on include IT, beauty therapy, plumbing, catering, jewelery making and woodwork. The staff team provide appropriate levels of support for each person at college and university. This is an area where the home continues to build upon its considerable success; several people who live in the home have not succeeded previously at school, college or university and may even have been excluded from education or work. Some of the young people who live here are being supported in work placements: the home has developed good relationships with local centres that offer work related training and sheltered work placements. There are a wide variety of placements which people can choose from and the records we looked at show that people are currently working in large DIY or department stores, supermarkets, cafes, florists, day nurseries and volunteering for the local RSPCA. The home employs two staff in the role of teachers: one is primarily responsible for planning external courses, whilst the other oversees the opportunities within the Rookery. The home has a good working relationship with colleges, particularly Norton Radstock. The teaching staff work closely with each young adult, their families and keyworkers and provide feedback to the clinical team at the monthly meetings of each persons progress. One of the teaching staff explained the home is now accessing the Open College Network to support individuals through an independence course. Time is spent with individuals on a 1:1 basis or in small groups. This course works very well as it can be adapted to suit the level and pace each person is comfortable with. On the day of our visit some of the first certificates arrived for the young adults who have completed part of their course. Other courses are available and may be very useful for some of the people who live here. For example, some courses are the same standard as offered at University: they would benefit individuals who have the skills to complete the course but who would not be comfortable attending university. Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: Since our last visit some people have moved to live more independently in the community while others have returned to college or university to complete their studies. Two people who live in the home now have their own flat and another person is in the process of moving to the Coach House; this is part of their programme to develop more independent living skills. One young person said they liked their flat because I have more of my own space and a kitchen. Another person said the are really happy to be moving into the Coach House. Each person can choose how they spend their leisure time. They use community facilities such as the library and leisure centres; people go out to the pub, have meals out or meet with friends. Longer trips out of the home are often planned at weekends, such as to the coast or other places of interest; if people wish to go on holiday, the home supports them with their arrangements. People are treated as individuals and their chosen lifestyle is respected. For example, one person has recently chosen to follow a religion; they have discussed this with staff and their care plan and support has been amended to reflect their new beliefs and practices. Each young adult is supported to develop and maintain personal relationships, both within and outside of the home, and visitors are welcome. Regular contact is maintained with friends and family through a variety of methods such as telephone, email, letters, cards and text messages. The relatives who wrote to us said the home provided the care and support they expect and keeps them informed of important issues. Parents are contacted each week to discuss their relatives progress, but this is only done if the individual agrees. One parent said they have waited several years to find a service like The Rookery for their relative and they are very keen on them staying here as they are developing really well. The health professionals who wrote to us said the home supports people to live the life they choose, responds well to their different needs and respects each persons privacy and dignity. Individuals rights and responsibilities are made clear and confirmed in their guide to the service. The house rules include guidance on acceptable behaviour, smoking, alcohol and the use of drugs. Any breakage of these rules is taken seriously; we noted that some individuals have received written warnings for this and the possible effects this could have on the success of their care programme. The home also has the option to exclude individuals for a short time or terminate placements and has done this in Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: the past. The home employs a cook who prepares and cooks the meals in the home in the main kitchen area. Each individual who lives in the home also has access to a separate kitchen where they can prepare their own drinks, snacks and meals; several people who live in the home attend in-house cookery sessions as part of their life skills support and now choose to cook for themselves. Menus are planed in consultation with the young adults and these show a wide range of food, which provide both a healthy and balanced diet. Care Homes for Adults (18-65 years) Page 18 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Young adults receive personal support in the way they prefer and their healthcare needs are well met. The home supports each person with their medicines in a safe way. Evidence: Care plans provide clear guidance for staff on how they should support those living at the home with their personal and healthcare. All of the young adults are registered with a local G.P., dentist and optician. There are annual OK Health Checks completed for each person, which is a thorough check on all aspects of their health care needs. Staff continue to support individuals to both make and attend health care appointments. The young adults continue to be provided with access to support from a wide range of professionals either employed by or contracted to Priory in line with their individual needs and which forms part of their overall individual care programme. This support includes, speech and language therapy, occupational therapy, and neuro-logistic Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: programming (NLP). A Consultant Psychiatrist and a Specialist in Aspergers Syndrome and Autistic Spectrum Disorder are contracted by Priory to provide support to the home and each of the young adults. These professionals visit the home on a regular basis and attend therapy meetings where each young adults progress is discussed and any concerns or changes in needs are acted upon. Contact with each health care professional is clearly recorded and forms part of each persons care plan. The healthcare professionals who responded by survey said the home does meet each persons health care needs, seeks their advice and acts upon this to manage and improve individuals health care. The home uses a monitored dosage system of medication administration, which is well managed. Each individual has their medication reviewed regularly and we did note that some people have been able to change or reduce their medication since they moved into the home. Each person now has their own medicine profile as part of their care records; these give staff clear instruction and also explain what the medicines are for. Individuals now keep their medicines in their own rooms and safe storage has been provided. This has improved peoples privacy and also reduces the risk of people taking the wrong medicines or not taking them at the right time. The senior member of staff on duty supports each person when they need to take medication. No one currently self medicates, although some individuals will take their medication out of the blister pack and some sign their own records, together with staff. Any staff who assist people with their medicines are trained to do so. Care Homes for Adults (18-65 years) Page 20 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If the young adults have concerns about their care they know how to complain; their views are listened to and acted on. The home safeguards people from abuse, neglect and self harm and takes action to follow up any allegations. Evidence: The home has a formal Complaints Policy, a Safeguarding and a Whistle Blowing Policy, which staff can use in confidence to raise any issue or concern they have regarding the service. The young adults and their relatives said that they know who to speak to if they are unhappy and know how to make a complaint. They are clear on who they would approach and feel they are always listened to and their views are taken seriously. The health care professionals who responded said they have never had cause to complain and had received no concerns or complaints themselves regarding the home. The staff members we spoke with or who wrote to us said they know what to do if a young adult, family member or a friend is concerned about any aspect of the care and support provided at The Rookery. Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: There have been some complaints since our last visit and these are clearly recorded. It is evident that the people living in the home understand their rights and know how to complain, as some complaints are from them. Their views are taken seriously and always responded to in writing, to ensure they are aware of, and are happy with, the outcome. The home works well with the local adult safeguarding team and the Police to ensure individuals are safe and they understand the potential risks they may face. They have a good relationship with their Community Police Officer who has been invited to visit the home to discuss various issues with the young adults. The home has clear guidelines in place for supporting individuals who are distressed or presenting behaviours which may be perceived as challenging the service provided, such as being verbally or physically aggressive or self-harming. These are written within the principles of Team Teach, the behavioural approach used within the home, which is accredited by the British Institute Of Learning Disabilities. If any physical intervention forms part of a behaviour plan, there is a clear description of the interventions which staff may use and when to consider using them. However, none of these plans contain a physical intervention risk assessment and these must be put in place to ensure all risks are either eliminated or reduced as much as possible: the Manager agreed and will ensure these are now completed. Care planning in this area has been improved since our last visit. Young adults, staff and health professionals have helped develop Guidance Notes on how to recognise signs that individuals are becoming distressed. These have helped staff to offer individuals better support, which has led to less of these incidents occurring. Staff are provided with Team Teach training and the home now has two staff who can deliver this training in-house. Staff are also provided with training in relation to safeguarding and are subject to Criminal Record Bureau enhanced disclosures, before they start work in the home. The home maintains thorough records of each accident, incident or other significant event which occurs in the home. We are always notified of significant events together with any other concerns regarding individuals who live in the home. Care Homes for Adults (18-65 years) Page 22 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Rookery is a homely, comfortable and safe environment for young adults to live in. Evidence: Rookery House is a large building, set within its own grounds, which blends in well with the local community. There are car parking spaces to one side of the house. In the grounds of the property is the Coach House, a home for three people who require less intensive staff support. Within the main house there are fifteen bedrooms, all with their own en-suite facilities. There are three bedrooms in the Coach House; the people who live there share the toilet and bathing facilities. There are many communal rooms which people are free to use, including a conservatory, a quiet lounge area and computer room. There is a rear garden with a summerhouse which contains exercise equipment. Some young adults were using this room on the day we visited. All of the communal areas are tastefully decorated and well furnished. The home as a planned maintenance programme: some areas of the home have recently been repainted and new carpet has been laid throughout communal areas and in some Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: bedrooms. The home employs one member of staff to oversee general maintenance. There are several examples of young adults artwork, which have been framed and displayed throughout the home. This not only helps to personalise the home, but also shows the considerable artistic talent some of the young adults possess. There are many photographs of social events and trips, which also help with the homely feel. Each individual is encouraged to choose how they wish their room to be decorated and to make it personal to them. The rooms we were shown all contained pictures, posters, personal items, tvs, cd players and furniture which were chosen by or reflect the interests of each person. Three semi-independent flats have been developed since our last visit. These have an area for basic cooking and include a mircowave, fridge and a kettle. They have been created for individuals who said they would like more independence or for them to experience what it might be like to live alone. One person who has moved into one of these flats said I have moved rooms lots of times. This is the best as I have more of my own space. Each person who lives in the home is expected to help keep the house clean and tidy. This forms part of the homes commitment to developing independent living skills for each person living here. A housekeeper is also employed and was seen working in the home during our visit. Each young adult who wrote to us said the home was generally kept fresh and clean. Care Homes for Adults (18-65 years) Page 24 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Young adults are kept safe and are supported by an effective, competent and well trained staff team. Thorough checks are carried out on new staff to ensure they are suitable to work in the home. Evidence: The staff team continue to demonstrate a strong commitment to providing a good level of support to the young adults who live in the home. This is evidenced by the considerable progress many individuals have made since moving to The Rookery. Staff interact extremely well with people who live in the home and those spoken or who wrote to us have a good understanding of the support needs of each person in the home. The roles and responsibilities within the staff team are clear and the current staffing structure works well. The young adults we spoke with or who wrote to us said staff treat them well, listen to them and act on what they say. Both the relatives and health professionals who wrote to us said staff have the right skills and experience to support people. Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: Staff who wrote to us said they are always given up to date information about the needs of the people they support. Newer staff said their induction covered the things they needed to know when they started working in the home. They confirmed they are well supported in their role and receive appropriate training. There are a variety of meetings which staff attend. A general staff meeting is held weekly and the Senior Support Workers also meet separately each week. Night staff have their own meetings, held every two weeks. Minutes of each meeting are kept and staff unable to attend the meetings are required to read the minutes. A small number of staff also attend the young adults house meetings, to ensure their views are listened to and acted upon. The home operates a robust recruitment process. The personnel records of staff who have recently joined the team contain a recent photograph, a copy of their application form, documents proving their identity and eligibility to work in the UK, at least two satisfactory references, a health assessment and Enhanced Criminal Record Bureau Disclosure. Young adults have become more involved in the recruitment of new staff: they have written a list of interview questions which are now being used. They also have the opportunity to show people interested in applying for a post around the home. The home provides a number of training opportunities for staff. The Foundations for Growth programme is accessed and completed on line by all staff. This has a number of units including fire safety, food hygiene, infection control, equal opportunities, ethnicity and confidentiality. The home also actively seeks external courses to provide staff with additional skills and abilities. Clear records are kept on each staff members training record of their progress in completing each of the training modules available. The home has made significant progress in supporting staff to gain a National Vocational Qualification (known as an NVQ). In addition to a number of staff members who already hold this award, 16 staff are currently working towards their qualification. Each staff member has a Management and Support Development Contract, which describes clearly the scope, purpose and frequency of supervision meetings. Staff are provided with regular supervision meetings and appraisals; a clear record of each one is kept on their personnel file. Care Homes for Adults (18-65 years) Page 26 of 33 Care Homes for Adults (18-65 years) Page 27 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and the young adults benefit from how it is managed. Young adults views are central to the review and development of the service. They are safeguarded as the home keeps clear records, staff understand the way things should be done and health and safety practices are carried out. Evidence: The Manager, Mrs.Paisley, has been in post for approximately 3 years. She is a Registered Learning Disability Nurse, has attained an Advanced Certificate in Special Education (Autism), NVQ Level 4 and is also a qualified NVQ Assessor. She keeps herself well informed and aware of best practice by attending training courses and appropriate conferences. The management team consists of the Registered Manager, her Deputy, one Senior Team Leader and eight Senior Support Workers. The roles and responsibilities at each Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: level of the management team are clear and the members of this team spoken with said this structure continues to work well. The management team meet each week. This meeting is used to discuss management issues, progress of young adults, new referrals to the home and the progress in addressing any issues within the service. Records of these meetings confirm that attendance is good. There are also monthly meetings, which the clinical team and the homes management team attend. These are used to discuss the progress of each young adult. The views of the people who live in the home are sought together with the views of families and others who are involved with the home. The house meetings, described earlier in this report, remain a key part of this process as does supporting each person to air their views or supporting individuals to use the formal complaints procedure. The home has an annual development plan based on aims of the service and the outcome of the surveys young adults complete each year. The home produces a regular newsletter, which is sent to each person involved with the home and regularly hosts Partnership Days where each young adult, their families and friends, together with professionals involved with the home, are able to meet in an informal way during these social events. The Rookery has a number of policies and procedures to ensure the safety of the people who live or work in the home. These are also used to ensure the home complies with the law and remains up to date with best practice or new ways of working. Details were provided by the manager in the AQAA she completed for us. There are efficient management systems and structures in place to ensure the home runs effectively. The quality of record keeping in the home is good, with all records required during our visit easy to access and stored securely when not in use. The registered providers representative visits the home to conduct an audit each month. They complete a very detailed report following their visit, which describes which records they have looked at and who they have spoken with. There are recording systems in place to support Health and Safety within the home, which are used consistently. The home has a Health and Safety Action Group who meet every 12 weeks. They discuss issues within the home and develop and review an action plan to ensure health and safety remains a high priority. Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: We looked at the fire safety records. These contain a Fire Risk Assessment, which was last updated in February 2009. The alarm system is tested each week and both staff and young adults take part in regular drills, so they know what to do in the event of a fire. The home has now improved the way risks to people are assessed and managed. New and additional Risk Assessments to promote the welfare and safety of people who live in or work at the home are now in place. Each different section of the home has their own, for example the ones which relate to maintenance are kept by that member of staff. These are now clearly written and subject to regular review. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 31 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 13 The registered person must 04/05/2009 put in place a risk assessment for each young adult who may require physical intervention to support them if they become distressed or display aggressive or dangerous behaviour. This would promote the welfare and safety of each individual and staff members. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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