Inspection on 02/11/06 for The Watery Lane Project

This inspection was carried out on 2nd November 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Watery Lane Project 05/01/06

The Watery Lane Project 20/07/05

The Watery Lane Project 08/03/05

The Watery Lane Project 17/05/04

Similar services:

5 Seafield Road

Honeybourne House

Longrun House

Bodley Community Care Support Centre

Thomas Pocklington Trust

Chantry Gardens

Penkelly House

25-27a Alexandra Road

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Watery Lane Project RNID Poolemead Centre Watery Lane Twerton Bath Bath & N E Somerset BA2 1RN Lead Inspector David Smith Key Unannounced Inspection 2 and 9th November 2006 09:40a nd The Watery Lane Project DS0000049993.V302987.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 Watery Lane Project DS0000049993.V302987.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 Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Watery Lane Project Address 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) RNID Poolemead Centre Watery Lane Twerton Bath Bath & N E Somerset BA2 1RN 0207 296 8000 0207 2968199 informationline@rnid.org.uk RNID Mr Nicholas Foskett Care Home 3 Category(ies) of Sensory impairment (3) registration, with number of places The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 3 people of either gender with dual sensory impairment aged 18-64 who require personal care only. 5th January 2006 Date of last inspection Brief Description of the Service: Watery Lane Cottage accommodates three people with dual sensory impairment, aged 18- 64, who require personal care and intensive staff support. The building, which is situated on the main RNID Poolmead site, is on one level with en-suite bathrooms with specialist baths and showers, which enables service users to maintain and maximize their independence. There is a large spacious open plan room, which is designed for easy access and movement into the living area, dining area and kitchen. The hallway has support rails, which enable service users to access different sections of the home independently. Externally there is a ramp with support rails on both sides, which lead to a spacious, enclosed garden and patio area, which has been raised to enable service users to grow their own vegetables and flowers. There are many features around the home of a therapeutic and tactile nature, which offer stimulation and a positive environment for service users. The current range of fees ranges from £2049.00 to £2492.00 per week. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of a Key Inspection of this service. The inspector gathered information during this visit through discussions with service users, the Registered Manager and Support Workers. Interaction and communication between staff and service users was also observed during the course of the inspector’s visit. Care plans and associated records were examined together with Risk Assessments, accident/incident reports, complaints log and health and safety records. The inspector was also provided with a tour of the home. Other sources of evidence have been used as part of the Key Inspection process. These include the home’s action plan in response to the last CSCI inspection, the providers own monthly auditing of the service and notifications of significant events which have occurred within the home. The Commission also provided the home with a Pre-inspection questionnaire, Service User Survey Forms and a range of Comment Cards for stakeholders prior to this visit. The Pre-inspection questionnaire was completed and returned, all three service users completed and returned a Survey and three Comment Cards were also returned. The inspection was concluded with a meeting with the Registered Manager on 9/11/06. What the service does well: Each service user who responded by survey said they liked living in the home and chose what they would like to do. Each person who responded by comment card said service users support needs were known and were well met. Each also said they were satisfied with the overall care provided by the home. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 6 The Manager and the care team have a good knowledge of the support needs of service users and encourage them to lead fulfilling lives. They advocate appropriately for service users with higher levels of support needs. Staff receive specialist training to enable them to support the service users who do require a specialised service particularly in the area of communication. The service works actively with external agencies and Health Care Professionals to develop and improve the support provided to service users. The views of service users are sought and the manager has been innovative in arranging adapted methods of communication to enable these views to be expressed and acted upon. There is an effective Quality Assurance process in operation. This helps to accurately measure the quality of the services provided and ensures the home remains committed to improve the service wherever possible. The quality of record keeping within the home is excellent. This helps to ensure a competent and accountable service for all stakeholders. What has improved since the last inspection? What they could do better: All staff must be supervised regularly and a clear record kept within their personnel file. This would help to ensure all staff are supported to provide a quality service. Equal opportunities training for all staff should be considered. This will provide staff with relevant information to support the service users. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 7 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 Watery Lane Project DS0000049993.V302987.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 Watery Lane Project DS0000049993.V302987.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 5. The quality in this outcome area is adequate. Prospective service users are provided with information they need to make an informed choice of where to live. Service users now either have a personal contract detailing the terms and conditions of occupancy, or have this explained to them by staff. EVIDENCE: The home’s Statement of Purpose contains all information as outlined in the National Minimum Standards. The document is well presented, including photographs of the home, garden, and communal areas. The document has also been developed in Braille. The Statement of Purpose is currently being reviewed and updated by the Manager. Each service user who responded by survey said they had enough information to help them decide if they wanted to move to Watery Lane and confirmed it was their choice to move into this home. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 10 One service user has an agreement, which details the terms and conditions of occupancy and includes the fee they are expected to pay for their service. This document is written in plain English, contains many picture symbols and has key information in Braille. The other people who live in the home do not have this type of agreement as this could not be adapted into a format which would be meaningful to them. Staff however work hard to ensure they communicate relevant information to the other service users, using their preferred mode of communication. The Manager told the inspector that there are still no copies on contracts with the relevant Funding Authorities available. This is being addressed nationally by the organisation and it is anticipated these will be in place within the next few months. There have been no new admissions to the home, since it opened in 2003. The Watery Lane Project DS0000049993.V302987.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. The quality in this outcome area is good. The care plans examined provided good information in how to support each service user. There was a clear review process evident. The home has an experienced and skilled staff team who provide appropriate levels of support to service users. Staff also advocate appropriately for service users. There are Risk Assessments in place. These are now reviewed on a regular basis and form part of each care plan to promote the safety of each service user. EVIDENCE: All three service user care plans were examined and these provided comprehensive information on the areas of support each person required. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 12 This information is contained in the ‘Care File’. This file contains a photograph of each service user, a summary of relevant information and the ‘Service Users Plan of Care’. Each of these plans is written in a person centred way and only includes the areas of support relevant to each person, such as independence, hygiene, medication, aggression, decision making and finances. Each care plan is signed by the Manager, Keyworkers and the service user, if they are able to do so. This is good practice. There is an effective review process. Regular reviews are held, which include service users, their families, Social Workers and Keyworkers. These are clearly recorded and the outcomes used to update individual care plans. In addition to this, the home reviews care plans internally and assesses the progress made towards goals and objectives. Keywork teams also meet regularly, ‘Watery Lane Cottage Care Team Meetings’, to ensure each service user is being provided with consistent and effective support. Either of these additional review processes can lead to care plan updates. Interactions between staff and all three service users were observed at various times during the inspection. These demonstrated the staff had a good knowledge of the support needs of service users and how to communicate and guide them effectively. Discussion between the inspector and staff members also confirmed this. The home provides a service for people who have a variety of complex needs, however each service user is encouraged and supported to make informed choices. Care plans clearly describe how to support each person with this process. One service user spoken with told the inspector they were well supported by staff and that they were able to make choices. Each service user confirmed in their survey that they could choose what they wanted to do each day. Staff ‘always’ listened to them and acted on what they said. Each service user has a number of person centred Risk Assessments, which support them to take risks as part of their lifestyle. These form part of each person’s care plan, are clearly written and are now subject to regular review. The Watery Lane Project DS0000049993.V302987.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. The quality in this outcome area is good. Service users are well supported by staff to use facilities both within the Poolemead site and in the wider community. Service users are well supported to enjoy holidays, visits to family and friends. Visitors to the home are welcomed. Service users rights are recognised and promoted in their daily lives. A healthy, balanced and varied diet is promoted. EVIDENCE: The home has a person centred approach in supporting each service user to develop. The records maintained within the home enable each persons progress to be assessed and the support provided adapted accordingly. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 14 All service users have the opportunity to attend daily Educational Development Studies. Facilities available in the wider community are also used, including swimming, horse riding, going for walks, trips to local pubs and going out for meals. There are several photographs in the home of trips or events, such as the recent helicopter experience flight for two service users and the party held in the home’s garden during the summer. During the inspector’s visit, service users were supported to access both facilities on the main Poolemead site and the community. One service user was supported to purchase train tickets for a planned trip to London and another went shopping for ingredients for their cooking session. One service user told the inspector they really enjoyed going out to the coffee shop, where they could relax and chat to staff. Each service user is supported to choose, organise and attend holidays. Staff told the inspector these are tailored to individual needs and wishes. Recent trips include holidays to Italy and Spain, as well as a shorter break to Norfolk. Staff continue to support those living at the home to maintain family links and friendships inside and outside of the home; information seen linked into care plans in place. In individual’s files was information of significant and important relationships and their contact details. Visitors to the home are welcome at any time, although most visitors usually give notice of their visit. One service user has demonstrated both through discussions with staff members and his own actions that he requires support with personal relationships and the expression of his sexuality. This issue has been discussed at recent reviews. The home continues to work hard to provide in house support in this area and staff are advocating appropriately to ensure both funding for and access to specialist advice and support is secured. Observation during the inspector’s visit and discussion with staff evidenced that each person who lives in the home is treated with respect and dignity. Each person is seen as an individual and treated as such. The menus are planned in advance and are displayed in the kitchen area. These show a wide range of food, which provide both a healthy and balanced diet. One staff member told the inspector the menus are currently being reviewed and it was hoped that the new menu plans would help to reduce fat intake and include more vegetarian options. It is apparent that service users are being involved in this process. One service user was supported to cook cakes during the inspector’s visit and another helped to prepare the evening meal. Staff used a ‘hand over hand’ method of support when appropriate. The inspector noted that each staff member provided sufficient time and space for service users to make the best The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 15 use of their own skills and abilities and only provided assistance when necessary. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 16 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 and 20. The quality in this outcome area is good. The care plans clearly explain the support each service users requires in relation to their personal and health care. Experienced staff have a good knowledge of each service user and how to provide appropriate levels of support. A monitored dosage system of medication for service users is in operation and this is well managed. EVIDENCE: The care plans in place for service users provided clear guidance for staff on how they should support those living at the home with their personal/health care. The care plans examined showed that service users were registered with a local GP, dentist, optician and chiropodist. Other specialist services are accessed when an identified need arises. These are provided by Bridges Community Learning Disability Team. Care records show the Occupational Therapist, Psychiatrist, and Community Psychiatric The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 17 Nurse regularly support the home. Contact with these professionals was clearly recorded in each service users file and the outcomes acted upon. The home has an experienced staff who have a good knowledge of service users health care needs. Staff would act on any concerns they have and the quality of the record keeping in this area would help identify areas of concern. The inspector observed staff interacting and guiding service users within the home. Staff spoken with displayed a good knowledge of the personal care they need to provide to service users and it was evident that they are sensitive to their personal/healthcare and emotional needs. Three health care professionals who responded by comment card said the home ‘communicated clearly and worked in partnership’ with them. Staff demonstrate a clear understanding of each service user’s care needs and any specialist advice they give is acted upon and forms part of each persons care plan. One service user is currently being supported in the reduction of anti psychotic medication. This has become possible due to the consistency of staff support and the progress this individual has made since living at Watery Lane Cottage. Both staff spoken with and records examined confirmed that the service user, their family, staff, their GP, the Consultant Psychiatrist and Funding Authority are all actively involved in this process and regular reviews are being held. The home uses the Boots Monitored Dosage System of medicine administration. The medication records show profiles of each service user, recent photograph, details of their medication, times of administration and manufactures notes on each of the prescribed medications administered within the home. Each service users’ medication record was correctly completed, with no gaps evident in the records. Two staff are required to check the medication administered to service users and sign the appropriate records. Staff records examined show that staff have received training by Boots on this system and they also have in house instruction and a medication assessment prior to dispensing medication to service users. Permanent staff are also provided with ‘Protocol’ training, which is accredited by the City of Bath College. This is in the style of an NVQ unit and contains four elements; introduction to medicines, care workers role, administration and medicines of differing client groups. Each health care professional who responded by comment card said they felt service user’s medication was appropriately managed by the home. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 18 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 and 23. The quality in this outcome area is good. Service users are enabled to communicate their views and they can be confident that they will be listened to and their views acted on if necessary. Service users are protected from abuse, neglect and self-harm. The staff team are provided with training and support to ensure the welfare and safety of service users. EVIDENCE: The complaints log was examined during this visit. There have been no complaints recorded since the last inspection. CSCI have not received any complaints direct regarding Watery Lane. One service user who spoke to the inspector explained that they would feel able to talk to staff if they had a problem or felt unhappy. They were sure staff would be able to help. They told the inspector that they did not have any problems and were happy living at Watery Lane. Each service user said on their survey that they knew who to speak to if the were unhappy and knew how to make a complaint. The three health care professionals who responded by comment card had never had cause to complain and had received no complaints themselves regarding the home. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 19 The home has clear guidelines, known as ‘Methods of Approach’, and risk assessments in place for supporting service users who are distressed or presenting behaviours which may be perceived as challenging the service provided. Staff receive training in responding to these using the NAAPI system, which is accredited by the British Institute of Learning Disabilities. Some staff have also recently been trained in using the ‘MAPA’ (Management of Actual or Potential Aggression) system and this may eventually replace NAPPI, once all staff have had the appropriate training. Staff record each incident of challenging behaviour. The home also maintains records of all other accidents and incidents and notifies CSCI of any significant events which occur in the home. Staff are also provided with training in relation to the Protection of Vulnerable Adults, Child Protection and are subject to Criminal Record Bureau enhanced disclosures. Due to the vulnerability of the people living in the home, they would also rely on staff raising concerns on their behalf. Staff spoken with demonstrated a good knowledge of the action they would take if they suspected or witnessed abuse. They also use their daily interactions and observations when supporting people who live in the home to help alert them to any physical signs or changes in behaviour, which may cause them concern. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 20 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, 29 and 30. The quality in this outcome area is good. The home is well maintained and has several adaptations which complement both the skills and abilities of the service users and help to promote their independence. The home was clean and tidy during the inspectors visit. EVIDENCE: Watery Lane Cottage is a large, detached bungalow. It is located on the main Poolemead site, however it detached from other services on the same site and has its own attractive grounds. There have been no changes in the services and facilities provided at the home since the previous inspection. The location and layout of the home is suitable for its intended purpose. The home is well maintained and provides a homely environment. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 21 The open plan kitchen/lounge/dining area promotes the service users independence. The inspector observed service users using these areas at various times during his visit. This particular lay out allows staff the opportunity to observe service users without the need to guide unnecessarily or restrict their movement around the home. This helps the homely feel and promotes service users independence. This is supported by the specialist equipment in place. Flashing fire alarm system, a buzzer call system, lower light switches, tactile symbols and textile surfaces, and support rails both within the home and outside the front and rear of the house. A number of pieces of service user artwork are displayed throughout the home, together with several photographs of recent holidays. These items help to personalise the home and help with the homely feel. The Manager told the inspector that they would like to have a new kitchen fitted. The cost for this will be considered by the RNID for inclusion within the home’s budget for the next financial year. Service users are supported to engage in domestic tasks. These are noted in each person’s care plan. Staff are also responsible for ensuring the home is clean and tidy. Each service user confirmed in their survey that the home was ‘always fresh and clean’. Outdoor space is ample, and the surrounding garden contains a patio and vegetable plot. There is also a raised area, which provides tactile stimulation for service users with higher levels of support needs or mobility problems. There are various seating areas within the gardens and the grounds are maintained to a very high standard. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 22 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): 31, 32, 33, 35 and 36. The quality in this outcome area is good. Service users are supported by an experienced staff team who have a good knowledge of their support needs. Staff are provided with training both by the organisation and external agencies. A clear action plan in relation to supporting staff to obtain a National Vocational Qualification has now been implemented. All staff must be supervised on a regular basis and a clear record maintained in their personnel files. EVIDENCE: The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 23 There is a core of well-established staff with varying abilities who are skilled and experienced to meet the needs of those living in the home. Staff members spoken with were able to demonstrate a clear understanding of their role and responsibilities within the team and their own personal role and accountability. Discussions with staff members and observation of their work practice demonstrated that they were approachable, good communicators and were comfortable with individuals living at Watery Lane who were at ease with them. Each service user survey said that staff ‘always treated them well’. Staff members spoken with told the inspector that the staff team were extremely open, honest and supportive. Each commented on how nice it is to work in the home. Staff are inducted into the service and the initial instruction is recorded on an induction checklist. One staff member had initially been recruited to the home’s relief staff bank and now works full time. They explained to the inspector that they spent two days in the home undergoing their induction. Areas covered included a tour of the home, fire procedures, health and safety, medication, care plans, job role and ethos of the service. This member of staff commented that the induction was thorough and they had been extremely well supported by all of the staff who work in the home since they commenced employment. Staff are provided with a variety of training opportunities. Training is provided either by the organisation or external training providers. The home maintains a comprehensive staff training matrix, which is regularly updated, and copies of all training certificates are kept as part of each staff member’s training records. Discussions with staff and examination of training records show that staff are provided with mandatory training, such as First Aid, Food Hygiene, NAPPI, Manual Handling, together with more specialist training such as Deaf Awareness, Deaf Blind Communication, British Sign Language, Epilepsy, Active Support and Risk Assessment. It was noted there are various training opportunities planned for staff during November 2006 and these sessions will ensure that all newer staff members complete their mandatory training. Following previous inspection recommendations, consideration should still be given to providing Equal Opportunities training for all staff. There are regular staff meetings, where staff can agenda topics for discussion regarding the general running of the home and other issues relevant to the service users and the staff team. Staff spoken with feel these meetings are The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 24 important and valued. Staff have also attended Team Away Days in March 2006. The home has made good progress in supporting staff to commence/gain a National Vocational Qualification and has provided CSCI with an up to date action plan. There are currently five staff working towards NVQ Level 3 and one towards NVQ Level 4. The assessment of candidates is being shared by the Registered Manager, Deputy Manager and external assessors. Staff are supervised and annually appraised on a 1:1 basis. Each staff member has a supervision contact, which explains the purpose of these meetings and how often they should take place. Each supervision meeting is clearly recorded and this record is then signed by both the supervisor and supervisee. Although generally records show that staff are supervised regularly, a small number of supervision meetings have become irregular. The Manager discussed this issue with the inspector and confirmed this is being addressed with one supervisor and will be improved. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 25 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, 38, 39, 41, 42 and 43. The quality in this outcome area is excellent. The home is very well run and has effective procedures in place to provide service users with the support they require to lead fulfilling lives. The manager is qualified and competent to run Watery Lane, and meet its statement of purpose, aims & objectives. The ethos of the service remains clear and this is communicated throughout the service. The views of service users are actively being sought in relation to the quality of the service. The progress made in providing information in formats accessible for service users continues to be reviewed by the home. The health, safety and welfare of the service users is promoted and protected. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 26 EVIDENCE: The Registered Manager, Mr.Foskett, has completed NVQ Level 4 in Care and the Registered Managers Award. He is a qualified NVQ Assessor and has attained both CACDP Level 1 and 2 in British Sign Language. He also undertakes periodic training to maintain his knowledge and update his skills and level of competence. The management approach is open and positive, with a clear sense of direction and leadership. Staff spoken with said their views are listened to, and that they are well supported by the manager. The ethos of the service remains person centred. This is clearly communicated throughout the service and there remains a strong commitment to reviewing and improving the service for each person who lives in the home wherever possible. Service users have regular house meetings, which involve them in discussions regarding their home and the support provided by the staff team. Records show that their views are listened to and acted upon. Service users spoken with said they are supported to air their views and felt that they were listened to and acted upon. Each who responded by survey said staff ‘always’ listen to them and act of what they say. The home’s ‘Quality Assurance Programme’ actively seeks the views of service users and other stakeholders regarding the quality of the service provided. The manager has developed questionnaires, for service users, relatives and other professionals. Each response examined was seen to be positive. There are other systems in place to measure the success in achieving the aims, objectives and statement of purpose of the home. These include the ‘Operational Plan 2006-2007’, which states clear objectives for the continuous development of the service. The registered provider’s representative makes regular visits to the home, and produces a comprehensive report of their findings, which is send to the Commission on a monthly basis. The Manager shared the prototype ‘complaints and feedback game’ with the inspector, which the Manager has developed with a colleague. It is hoped this game will support service users to air their views, opinions and any concerns they may have regarding their service by involving them regularly in this ‘game’. This focuses on seven principle areas; garden, RNID, environment, activities, music, food, and bedroom. This appears to be a positive and The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 27 potentially an extremely valuable development. The home will implement this game shortly and the outcomes will therefore be focused upon during the next inspection process. The management systems and structures are very efficient. The record keeping is of an excellent standard. Files and documentation are very well organised, easy to access and stored in accordance with relevant legislation. There are recording systems in place to support Health and Safety within the home, which are being used consistently. Records examined included hazardous products used within the home, portable electrical appliance testing and generic weekly health and safety checks. All of these records were in order and checks were up to date. The fire logbook was examined and this showed that all fire tests are carried out in accordance with the Fire Brigade guidance. All staff take part in regular drills and evacuations. It was also noted that the home has produced an excellent in-house Fire Action Plan. There are a number of generic Risk Assessments in place. These are comprehensive and subject to regular review. The Watery Lane Project DS0000049993.V302987.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 X 3 X 4 X 5 2 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 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 2 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 3 3 X 3 4 3 X 4 3 3 The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? YES 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 YA36 Regulation 18(2) Requirement All staff must be supervised regularly and a clear record maintained. (This requirement is repeated from the last inspection report). Timescale for action 09/11/06 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 YA35 Good Practice Recommendations Equal opportunities training for staff should be considered. The Watery Lane Project DS0000049993.V302987.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Watery Lane Project DS0000049993.V302987.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!