Inspection on 17/05/07 for Tor Vale

This inspection was carried out on 17th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tor Vale 29/06/09

Tor Vale 15/11/05

Tor Vale 29/06/05

Tor Vale 18/01/05

Tor Vale 19/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Tor Vale Chittleburn Hill Brixton Plymouth Devon PL8 2BJ Lead Inspector Rachel Proctor Key Unannounced Inspection 17th May 2007 9:30 Tor Vale DS0000003613.V327727.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 Tor Vale DS0000003613.V327727.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. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tor Vale Address Chittleburn Hill Brixton Plymouth Devon PL8 2BJ 01752 480950 01752 480950 headoffice@durnford.org 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) The Durnford Society Limited Lesley Amanda Barry Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning Disabilities (18 years and over) Date of last inspection 15th November 2005 Brief Description of the Service: Tor Vale is a purpose-built home for 5 service users with profound learning and physical disability. The staff provide 24-hour nursing care in a supportive comfortable homely environment. The home comprises a lounge, dining room, domestic type kitchen, five bedrooms, two toilets, one bathroom, one shower room, a treatment room and an office. The home benefits from level gardens, and paved seating areas. The mini bus is available to transport service users for leisure and recreational purposes. The home is situated close to the village of Brixton. The home is administered by the Durnford Society Ltd, which is a non-profit making industrial and Provident Society and has the charitable status.... The statement of purpose is available in the office of the home. This had been provided in audio disc (CD) form and as a paper document. The fees are paid through a block contract with the Health Authority that funds the current placements. Individual fees are not stated. Tor Vale DS0000003613.V327727.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 key inspection, which took place on the 17/05/07. One of the people living in the home had their care followed as part of the inspection. This person’s assessment and care plan was viewed. Staff working at the home during the inspection were observed providing care. A tour of the home was completed. Some records relating to the management of the home were viewed. The manager and some of the staff on duty were spoken to during the inspection. Prior to the visit to the home comment cards were received from two relatives and one health care professional. Some of the comments made have been incorporated into the report. What the service does well: What has improved since the last inspection? What they could do better: Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 6 Any improvements the manager makes will build on already good practice. All the standards inspected on this occasion were met or exceeded. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 7 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 Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The competent experienced staff team use a holistic assessment process, which enables individuals’ aspirations and needs to be taken into account when planning care. EVIDENCE: Tor Vale has three people who have lived at the home for several years. One new person has been admitted to the home since the last inspection. One persons care was followed during the inspection. The ongoing assessment process of individual peoples care continues to be of a high standard. Assessment records for the person whose care was followed were being prepared on computer. This provided a comprehensive assessment of the individual’s health, personal and social care needs. These also included risk assessments for activities the person likes to undertake as well as risk assessments for manual handling and provision of care. A clear history of the persons experience of care was available. The manager advised that the assessment is always kept under review and when new things are established that are important to the person these are captured in the assessment. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 9 Each of the people living at Tor Vale has a care plan document, which includes their assessment of the need. There was evidence that assessment of need is reviewed on a regular basis through the formal review process. Records of reviews carried out with individuals included the health professionals involved in their care and their representatives. As part of the assessment process completed for each person a life plan is provided. This provides a pen picture of the individual and their life experiences. It also includes a record of things they enjoy and people that are important to them. Photographs of significant events in their lives are also included. How the individual likes their care provided and what they like and dont like is clearly stated. The manager advised that new members of staff have found these useful when getting to know the people living at home. The way assessments are carried out and updated on a regular basis will ensure that the individual people living at home will receive continuity of care in a way they need and prefer. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager and staff are skilled at developing plans of care for people who live at Tor Vale that will meet their current and changing needs. The people who live at Tor Vale are enabled to experience community activities in a risk manage way by the staff team who care for them. EVIDENCE: The people who live at Tor Vale have plans of care developed for them, which includes risk management. The plans set out how care should be delivered and what is important for the individual. One person whose care was followed had a plan of care which included how this person would best benefit from use of the sensory room. The manager advised that as the people they care for are unable to communicate clearly verbally; the staff are skilled at recognising Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 11 body language and gestures, which indicate whether the person is enjoying an activity of experience. This information, which had been gained over time, has been clearly captured in the care plans developed for individuals. One person who had a tendency for self harm had a plan of care to guide staff how best to reduce the risk of this individual self-harming. A staff member explained how they had built up an understanding of what this person liked and how to prevent or reduce the risk. The record showed that this person liked to be outside and feel the wind on their face. This person was sitting in the patio area during the inspection. They appeared to be enjoying this experience. The manager confirmed that the peoples plans had been put in to an audio format to allow individuals to listen to their care plan. People who live at the home have a named key worker who works with them. The six monthly reviews provided in one persons care plan were viewed during the inspection. The manager confirmed that each person has their care formally reviewed six monthly. The record of review showed that healthcare professionals involved with that persons care were asked to provide reports and/or attends the review. At the review the goals for the next six months for the individual are agreed. These are set out clearly and show the achievements the person has made and what has worked well. The staff at Tor Vale are skilled at building up an understanding about what is important to individual people who live at the home. The way individual care plans are recorded show that the individual’s personal preferences, which have been demonstrated over time, have been taken into account. One person who enjoyed listening to music had a collection of CDs that they like to listen to. Staff assisted this person to listen to the music they had chosen during the inspection. People who live at Tor Vale have their own building society accounts. Although none of them are able to manage their own financial affairs. Records were available of expenditures made on behalf of individual people who live at the home. The money held for one person was checked against the records as being kept correctly. The care planning system identifies risks that a person may have when undertaking activities or receiving care. The risk assessments are followed up with a plan of care that identifies how staff can minimise the risk to the person. This includes using the minibus, which staff use to take people on holiday or days out. A comprehensive system for managing the persons medication while they are away from the home is in place. This enables the person to receive the care and treatment they need by using a risk managed process. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Tor Vale are given the opportunity to experience a variety of leisure activities in the community. The staff team are caring and skilled at organising things that meet the individual’s preferences and needs. EVIDENCE: The people living at Tor Vale do not have the ability to participate in jobs or complete household tasks. One person was being encouraged and facilitated to keep in touch with people they had known before moving into Tor Vale. The manager advised that she felt this has enabled the person to settle into the way of life at Tor Vale. One relative comment card stated In the real home Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 13 from home which Tor Vale is their relative enjoyed the most fulfilling lifestyle it was possible to have Individual people have a personal diary where the key worker looking after them records their activities. One persons diary was viewed during the inspection. This showed that this person had had a holiday with staff and had had several trips out to local attractions since the beginning of the year. The diary also included the things that they did each day when there were staying at home. The use of the sensory room and how the individual had reacted to the time they had spent there had also been recorded in the diary. Tor Vale has its own minibus, which can take up to two people and their wheelchairs with members of staff. The manager advised that the activities arranged for individuals have been those that the staff know the individuals enjoy. Staff work 12-hour shifts to allow the people living at the home to have the same member of staff with them all day. Staff also accompany the people who live at the home on holiday. This ensures they have continuity of care from staff who understand their needs. The manager advised that this gives the people opportunity to mix with others who do not have their disability. The daily routines of the home are planned around the needs and wishes of the people who live there. During the inspection people were getting up in their own time. The manager advised that people are encouraged to chose the time they get up and go to bed. She also commented that if a person wants to spend time alone in their room this is facilitated. Staff were observed asking people what they wanted. One staff member offered to help, this person accepted the help offered by holding the staff members hand and going with them to their room. The staff were explaining what they were doing and what was happening in the home to people as they cared for them. Staff were trying to involve the people who lived at the home in any discussions they had regardless of whether the person was able to respond to them or not. The lunchtime meal was shared with two of the people who live at the home and the staff on duty. The meal was unhurried with the people eating their meal at their own pace. They were being offered assistance by staff discreetly who were encouraging them to eat and drink. The menu proved showed that the people who live at Tor Vale have a varied nutritionally balanced diet. Meals are prepared fresh each day using fresh produce where possible. The mealtime was a social occasion for the people who lived at the home and the staff. One person who staff had established liked being outside was given their meal while they were sitting in the patio area. The manager provided a copy of the environmental health report completed since the installation of the new kitchen. This showed that the kitchen and the practices staff used were meeting the required standard. Staff training information showed that staff had completed food hygiene training. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff team at Tor Vale are skilled in the care of people with complex health and personal care needs. The people, who live at Tor Vale and their representatives, can have confidence. A competent caring staff team who have their best interests at heart will provide health and personal care in a way that meets their needs. EVIDENCE: The individuals who live at Tor Vale have their personal support provided in a way that maximises their privacy and dignity. The staff observed providing care for people during the inspection were involving the person as they worked with them. The people receiving care were responding to the staff positively. The daily routines of the home are flexible, this allows the people who live at the home to choose the time they get up and go to bed. The way staffing is organised allows individual people to go out with a member of staff for the day to local attractions or events. A staff member was seen asking one person Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 15 what they would like to ware that day. They gave them the opportunity to choose what they wore. This person’s daily diary showed that staff had taken them to buy new clothes and they had been encouraged to chose these themselves. Specialist wheel chairs, beds and bathing equipment had been provided for the people who needed this. One person had a bed that provided the right height for the person to get in and out of bed independently. The involvement of physiotherapists, psychologists, speech therapists, occupational therapists and dentists for individual people’s care had been recorded. Where recommendations had been made by one of the multidisciplinary team the person’s plan of care had been up dated to reflect this. The physiotherapist had made recommendation for one person, which would assist them to maintain their optimum mobility. The plan of care showed how this person’s mobility had improved over a period of time. One person needed specialist health care treatment and equipment to reduce the risk identified. They had a clear record of the how the equipment should be used to provide therapeutic benefit for the person. Staff were seen using this with the person during the inspection. The training staff had received included use of this specialist equipment. The manager confirmed that the people who live at Tor Vale continue to have access to health care professionals including their GP. The plan of care for the person whose care was followed had a clear record of the involvement of the multi-disciplinary team and any treatment they had recommended. Two people health care plans were seen. Both contained clear information for staff, which would enable them to provide care in a way that the person chooses and needs. How one person’s tendency to self-harm was managed was clear. This showed the actions staff could take to reduce the risk and manage incidents to reduce the risk of injury. None of the people who live at Tor Vale are able to manage their own health care. They rely on the skill of the staff to understand their care needs. The way individual who were unable to communicate clearly had their plans of care recorded reflected the understanding and skill of the staff. The manager advised that staff had built up a picture of what was important to the individual and how they like their care provided. The medication records for one person were checked. These have been recorded as expected. The controlled drug the register was checked against the stock for one person as correct. A record of medication disposed off was being kept. Two members of staff had signed this. Medication disposal bins provided by a clinical waste disposal company were seen in the treatment room. The nurse advised that the medication for disposal is kept in one area in a locked cupboard until it can be disposed of. The treatment room had been fitted with new cupboards and shelving since the last inspection. This provided ample storage for wound dressings and other Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 16 treatments the people needed. Staff were keeping the treatment room locked when not in use. Lockable storage for the medicines and a lockable drug fridge was provided in the treatment room. The nurse confirmed that none of the people living at Tor Vale were able to manage their own medication and relied on the nurses to manage this for them. Since the last inspection the manager has provided training for senior health care assistants (senior support workers) for administration of medication when people are away from the home. A clear record of the medication taken out of the home by staff was being kept. Some of the medication taken outside the home was for emergency use. When this had not been needed it was signed as returned by the member of staff. Individuals medication continues to be organised to allow them to have trips outside the home or go away on holiday. The manager confirmed that key staff have received training in the use of emergency medication. Clear policies procedures and protocols for medication are available for staff use. Reference material for staff regarding medication was easily available in the treatment room. The nurse advised that the pharmacy would be providing a new British National Formulary (BNF) for medication. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Tor Vale and their representatives can have confidence that any concerns they have will be dealt with sensitively by a staff team, who have their best interests at heart EVIDENCE: Since the last inspection the complaints procedure has been provided in pictorial form. This is available in the reception area of the home. Two comment cards received from relatives indicated they knew how to make a complaint about the care provided at the home if they needed to. One commenting although I have never had needed to. The manager confirmed that a record was being kept of all concerns and compliments made about Tor Vale. She also said that the feedback they had received from professionals who visit the home had been complimentary about the way care was provided at the home. The Commission has received no complaints or concerns since the last inspection. The training of staff had received was provided with the pre inspection information. The manager confirmed this included adult protection training. Policies and procedures were in place to guide staff regarding adult protection issues. The contact details for adult protection referrals were provided in the office of the home. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 18 The recruitment processes in the home are robust and should protect the people who live at Tor vale from unsuitable staff. Comment cards received indicate that people are well cared for and their relatives feel they are protected. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Tor Vale have a pleasant well-maintained, clean fresh environment to live in, that has been decorated and equipped in a way that takes their individual tastes and care needs into account. EVIDENCE: Tor Vale is a purpose-built one-storey home. The environment is bright, airy and homely. All the peoples individual rooms are larger than square 12 square metres. The furniture and furnishings are domestic in character. The beds individual people use can be electronically adjusted to the correct height for the resident. One person had been provided with a new specialist bed that made it easier for them to maintain independence getting in and out of bed. Tor Vale has an adapted minibus capable of transporting people and their wheelchairs. The manager advised that this had been used early in the week to take one person on a trip to Dartmoor accompanied by members of staff. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 20 The manager confirmed that staff are trained to drive the minibus. Copies of insurance details for staff were seen in the staff files seen during the inspection. The gardens outside the home, which had been replanted at the last inspection was full of colourful flowers and shrubs. The patio seating area out side the lounge had a gazebo canopy over it. This provided a pleasant area for the people to sit with visitors or on their own to enjoy the summer sunshine. One person was sitting here during the inspection; they were humming a tune to themselves and appeared to be enjoying being there. The home was pleasantly decorated, two individual peoples rooms had been redecorated since the last inspection. The kitchen area had also been refurbished with new units and flooring. The manager advised that the next job would be to improve the disabled access bathrooms provided. She also advised that the sensory garden planned for at the rear of the home should be completed this year. The home was fresh and clean at the time of the inspection. Relatives comment cards indicated the home is always clean and well presented. Policies and procedures are in place for infection-control practices. The manager confirmed that this had been up dated and revised since the last inspection. The home has a disinfecting sluice and a washing machine with the sluice cycle. These reduce the risk of cross infection. Cleaning materials and protective clothing were available for staff use; these were stored appropriately and easily available. Staff training includes infection-control practices. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A well-trained knowledgeable staff team care for the people who live at Tor Vale. A manager who has the skills, qualities and experience to ensure people who live there benefit from a well run home leads the staff team. EVIDENCE: The preinspection information provided indicates that 60 of the health care assistants (Support workers) employed have achieved an NVQ level 2 in care or above. Discussion with one new member of staff indicated that as well as working towards NVQ level 2 in care they had also completed a learning difficulties induction training course. The homes records show that they employ eight registered nurses and nine healthcare assistants as well as having one bank registered nurse and one bank healthcare assistant to support them covering the duties for the home. The manager confirmed that the home is fully staffed and she has not had to rely on agency cover. She further Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 22 commented that if a member of staff was sick the rest of the staff team covered shifts to ensure the people living at the home had staff working with them who understood them. The observations made during the inspection showed that staff were skilled at communicating and caring for the people at Tor Vale. One person who was unable to speak or communicate using alternative communication tools had a clear plan of care in place. Their plan of care identified the body language staff used to identify the persons needs. The plan of care explained what this person liked and how to facilitate this for them. Staff observes caring for this person were responding to the body language they were using by ensuring they were able to experience something they knew they enjoyed. The person whose care was followed had clear evidence in their plan of care that the multidisciplinary team had been involved. This included a physiotherapist, speech therapist and psychologist to advise and support the staff in the care of this person. Two staff files were viewed during the inspection. These contained the information required. Each had two references, an application form, their terms and conditions of employment and a record of police check. The manager confirmed that new staff dont start work at the home until all the pre-employment checks are completed. She also stated that new staff complete a probationary period prior to being offered a full-time post. A member of staff who had joined the home since the last inspection confirmed that the pre-employment checks were taken before they started work. They also advise that they had completed their three-month probationary period and had been confirmed a full-time member of staff. The home has a robust recruitment policy in place, which protects people who live at the home from unsuitable staff. The recruitment process is based on equal opportunities. The staff spoken to during inspection said they had plenty of support to complete any training they needed to help them to do their work better. The type of courses they had completed included mandatory training such as manual handling, fire safety and food hygiene. A commitment to providing training for staff specific to people with learning disabilities had also been provided. A member of staff advised that they had attended a training course about a specific disease process and how they should be managed. This was linked to the care needs of one of the people living at home. The information provided by the training course had been incorporated into their plan of care. Both staff files reviewed had a record of the supervision and support they had received. When the staff were asked about supervision they said they found this very useful and had been able to plan their development with the Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 23 manager. The manager confirmed that all staff have a training and development plan which is linked to the needs of the people living at Tor Vale. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a way that protects and promotes the health, safety and welfare of the people who live there. EVIDENCE: The registered manager is qualified, competence and experience to run the home. She is the first level registered nurse with several years experience in the learning disabilities field. Discussion with the manager revealed how she had kept herself up to date with current practice. She had made reference material available for the staff relating to the disease processes of the people living at home. This should ensure that the people who live in Tor Vale continue to be cared for by a knowledgeable staff team. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 25 All the staff spoken to during the inspection were complimentary about the managers management style and the support she gave them to do the work. One commenting, the manager at help them develop their skills to care for people with learning disabilities. The lines of accountability within the home were clear. There are clear policies and procedures for staff to follow which are updated on a regular basis. Three new policies have been added to the policy folder since the last inspection and others have been updated and reviewed to ensure they met current practice. The health and safety audit seen at the last inspection continues to take place. The organisation regularly audits the quality of the services provided. Copies of these were available during the inspection. A record of health and safety checks for equipment and fire safety had been recorded. Accident records were being completed as required. The manager confirmed that she continues to audit the record of accidents and any changes that can be made to reduce the risks are carried out. Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 26 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 X X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 X 3 X X 3 X Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tor Vale DS0000003613.V327727.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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