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Inspection on 03/10/08 for Trevithick House
Also see our care home review for Trevithick House for more information
This inspection was carried out on 3rd October 2008.
CSCI found this care home to be providing an Good service.
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.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
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: Trevithick House 18 Nelson Street Plymouth Devon PL4 8ND 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: Antonia Reynolds Date: 0 3 1 0 2 0 0 8 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. They reflect the things that people have said are important to them: 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: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information
Document Purpose Author Inspection report CSCI
Page 2 of 41 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 41 Information about the care home
Name of care home: Address: Trevithick House 18 Nelson Street Plymouth Devon PL4 8ND 01752269431 01752263331 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Regard Partnership Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: 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: Learning disability (Code LD) The maximum number of service users who can be accommodated is 3. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 41 A bit about the care home Trevithick House is privately owned by The Regard Partnership and has been a care home for several years. The home is a three-storey mid-terraced house located in the residential area of Mutley. The home has a small courtyard at the back of the property. There is no dedicated parking for the home and, although on street parking is available nearby, most of it requires a permit to park there. In November 2008 the fee levels started at approximately 1000 Pounds per week but vary depending on the individual needs of each person. Information about the home, including copies of inspection reports, can be obtained from the Manager. The house is the same as other houses in the street. Three people with learning disabilities live at the home. There are lots of steps in
Care Homes for Adults (18-65 years) Page 5 of 41 the house so it is not suitable for people who use wheelchairs. The house is close to shops and the city centre. There is a bus stop near the home where people can take buses into the city centre or other places. People can use trains and taxis to go to other places. There are lounge and dining rooms on the ground floor as well as a kitchen. Care Homes for Adults (18-65 years) Page 6 of 41 Each person has their own bedroom on the 1st floor. No-one has to share a bedroom. There is a bathroom on the 1st floor and a shower and toilet on the 2nd floor. Care Homes for Adults (18-65 years) Page 7 of 41 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 Care Homes for Adults (18-65 years) Page 8 of 41 How we did our inspection: This is what the inspector did when they were at the care home This inspection was carried out by one inspector and consisted of an unannounced visit to the home between 9.10am and 2pm on Friday, 3rd October 2008. We last inspected this service on the 4th October 2006. Throughout this report, the term we will be used as the report is written on behalf of the Commission for Social Care Inspection. An Annual Quality Assurance Assessment (AQAA) was completed by the home prior to the inspection. The AQAA is a selfassessment that focusses on how well outcomes are met for the people who live in the home. We talked to the three people who live in the home. Care Homes for Adults (18-65 years) Page 9 of 41 We talked to two staff members and the manager. Two relatives completed survey forms that had been left in the home for them. Three survey forms were returned from staff members. We looked all round the home. Care Homes for Adults (18-65 years) Page 10 of 41 The care records of three people who live in the home were inspected. Other records about how the home is run were also inspected. This included staff records. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. Care Homes for Adults (18-65 years) Page 11 of 41 What the care home does well The management culture of the home is open, positive and inclusive. The ethos of the home promotes peoples well being by recognising their rights to independence and individuality. Trevithick House is comfortable, clean and homely and people like living there. People feel safe living in the home. Care Homes for Adults (18-65 years) Page 12 of 41 People’s rights, diverse interests and individual lifestyles are supported and respected. The home has a stable, experienced and qualified staff team who have a good knowledge of the support needs of the people who live in the home. This provides consistency and continuity of care and support to the people who live there. The home has a robust recruitment procedure for new staff. People who live in the home are involved in the interview process for new staff. Meetings take place with the people who live in the home so that they are fully consulted about every aspect of their lives. Care Homes for Adults (18-65 years) Page 13 of 41 The staff are always looking for new ways of improving communication and consultation. Some information, such as how to make a complaint, have been produced using big writing and pictures to help people understand what they say. Each person has a support plan that contains very detailed information about care and support needs. Care Homes for Adults (18-65 years) Page 14 of 41 These include short and long term goals and aspirations. People are involved in drawing up these plans and know what they contain. People take part in various activities in the community. Everyone chooses what they want to do each day. The use of public transport is encouraged and promoted. It is easy to get into the city centre. Care Homes for Adults (18-65 years) Page 15 of 41 What has got better from the last inspection The home has been repainted on the outside, including the courtyard walls, and some windows have been replaced. The bedroom flooring has been renewed, some window coverings have been changed and the lounge furniture replaced. The plans detailing each persons support and care needs have been greatly improved. The care plans now contain very detailed information about care and support needs, including short and long term goals and aspirations. Care Homes for Adults (18-65 years) Page 16 of 41 The home has been repainted on the outside, including the courtyard walls. Some windows have been replaced. The bedroom flooring has been renewed, some window coverings have been changed and the lounge furniture replaced. What the care home could do better The manager needs to review the number of staff on duty during the day and increase staffing numbers where required. This is particularly important at weekends when there are only two staff on duty to meet the needs of three people, two of whom have been assessed as needing one-toone support for significant periods of time.
Page 17 of 41 Care Homes for Adults (18-65 years) The manager also needs to apply to be registered with the Commission for Social Care Inspection. The registration process ensures that the manager is qualified, competent and experienced to run the home. Staff assist the people who live in the home to withdraw money from their bank accounts using debit cards, which means the staff member has knowledge of the PIN (personal identification number). However, the bank statements were not being reconciled against the receipts from the bank and this needs to take place to ensure that a proper audit trail is in place and that only authorised monies are being withdrawn by staff. Overall the practice of medication administration was safe but the audit trail could be clearer by recording the number of tablets held in the home on each new record sheet. This would mean that it would be easier to see exactly
Care Homes for Adults (18-65 years) Page 18 of 41 how many tablets were in the home at any time. It would be useful to document the names of everyone, both staff and people who live in the home, who attend fire safety training and fire drills. This is so that the manager of the home can easily see who has completed this training, as well as the frequency of the training, so that she can check to make sure everyone has completed it. To improve the privacy of the people who live in the home, bathroom and toilet doors should be fitted with locks. These locks need to be suited to the abilities of the people who live in the home but the staff also need to be able to open them from the outside in an emergency.
If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 19 of 41 If you want to speak to the inspector please contact Antonia Reynolds 33 Greycoat Street London SW1P 2QF 02079792000 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 20 of 41 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 21 of 41 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
. People who choose to live in the home can be confident that their support needs are assessed prior to admission and they will have opportunities to visit the home to meet the other people who live there and the staff team. Evidence: The home has a Service User Guide which contains information about the home so that people can read this before they come to live in the home. This guide is available in an easy read version as well as on audio tape so that people have different ways of finding out about the home. The organisations processes ensure that any people who are considering coming to live in the home are assessed prior to admission so that their needs are clearly identified. This process is also to ensure that the staff team have the skills and competence to meet those needs. One person has been admitted to this home since the last inspection and she confirmed that consultation took place prior to the move and that information about the home was provided. Two of the three people living in the home said they had visited the home before they came to live there to have a look round and meet the other people who live there as well as the staff. The manager
Care Homes for Adults (18-65 years) Page 22 of 41 Evidence: confirmed that people are always consulted and involved in the decision to move into this home and that detailed pre-admission assessments are carried out before anyone starts living in the home. Discussion with the manager confirmed that this includes meeting and consulting with the person concerned, their relatives or representatives and any other professionals involved in the persons care, such as social and learning disability services. This assessment is so that people coming to live in the home can be confident that their needs will be met and helps the manager make an informed decision about whether the home is suitable. All pre-admission assessments are documented and were evident in personal files. Care Homes for Adults (18-65 years) Page 23 of 41 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who live in the home are very well supported by the staff team. They are actively involved in devising their own support and care plans and are enabled to participate in, and make decisions about, all aspects of their lives. Evidence: The attitude and approach of the staff team is excellent in that each person who lives in the home is encouraged, enabled and supported to make their own decisions, choices and be as independent as possible. Discussions with the people who live in the home, as well as the staff, demonstrated that the running of the home, and all routines and activities, are organised around the wishes, choices and needs of the people who live there. Two people described their activities during the week and one person said I choose what I want to do and the staff help me to be independent. Each person has a detailed plan of care providing clear information about the support that each person needs. Everyone has documented short and longer term plans, goals and aspirations and people have been actively involved in drawing these up, demonstrating excellent practice. The plan also contains information about what staff must do to keep people safe, based on risk assessments that are regularly reviewed.
Care Homes for Adults (18-65 years) Page 24 of 41 Evidence: Discussion with the people who live in the home, two staff members and the manager confirmed that staff are fully aware of the needs of each person. The people who live in the home participate in all aspects of the day to day running of the home, including domestic activities and tasks, with staff support where necessary. Staff support people to make decisions about their lifestyle, activities and movements both inside and outside the home. Discussion with the manager, as well as documentation, confirmed that people are encouraged to administer their own finances, with staff support if necessary. The home looks after the personal spending money of the people who live in the home and one person commented that the staff help her to save money so that she can buy big items when she wants to. Staff usually accompany people to the bank to withdraw money using a debit card. The records of expenditure were well maintained and regularly checked by the manager, however bank statements were not being checked against receipts from the bank to ensure that there is a proper audit trail in place and that only authorised monies are withdrawn by staff. Care Homes for Adults (18-65 years) Page 25 of 41 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People who live in the home are supported to lead active lives, participate in community and leisure activities, choose their own daily routines and maintain regular contact with their families. Evidence: Discussion with the people who live in the home, two staff members and the manager, as well as documentation, showed that people are enabled to live as full a life as they wish to. People have opportunities for personal development, risk taking and decision making. The ethos of the home is based on promoting opportunities to broaden experiences, support people to develop socially and emotionally and to understand responsible risk taking. People are encouraged to participate in all the domestic activities in the home and to take part in leisure activities of their choice. Two people described their weekly activities and, whilst these were different, they included going to a social club and college, shopping, visiting friends, arts and crafts, doing puzzles, going swimming and going to church. One person said they have been on trips out
Care Homes for Adults (18-65 years) Page 26 of 41 Evidence: such as to Paignton, The Hoe and into town. One person said they had been to the cinema to see Mama Mia and Duchess. A survey from a relative commented that staff are not always aware of facilities available in the community and thought this could be improved on. One person, who had lived at the home for a few years, said they had never been on a holiday. The manager said she was not sure about the organisations policy for holidays and agreed to find out and discuss the possibility of a holiday with the people who live in the home. As the home supports young adults, people are supported to be as independent as possible and participate in educational opportunities, in the local community. A survey from a staff member said I feel we provide a good service to all who live here .... to ensure the service users have a high quality of life in and out of the house, making full use of community services. Discussion with the manager confirmed that opportunities are also sought for paid or voluntary employment although this is not always possible due to the specific needs of the people who live in the home. The home does have a car but people are encouraged to use public transport wherever possible. Contact with relatives and friends is encouraged and promoted. Wherever possible, people are supported to visit their families and relatives also visit the home. If visits are not possible, for example, due to distance, people are encouraged to maintain contact by telephone and letter. In a survey form, a relative said I telephone weekly but return calls are a rarity. However paper communication is improving, ie birthday cards etc. Privacy is respected and bedroom doors have locks that people may have a key to if they wish to have one and subject to risk assessment. Discussions with people who live in the home, as well as documentation, showed that people choose their own meals, do the shopping and are supported to prepare and cook meals at a time of their choice. People said that special diets are catered for and food likes and dislikes are taken into account when planning menus. Care Homes for Adults (18-65 years) Page 27 of 41 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
. People who live in the home can be confident that personal support is provided in the way, and at the time, that they want and need. Health care needs are addressed as soon as they are identified. Evidence: Discussions with the people who live in the home confirmed that they receive personal support in the way they prefer and require. Each person has a support plan that provides information about personal, social, emotional and health care needs. People said they have contact with representatives from Social Services, Learning Disability Services, doctors, dentists and various other healthcare professionals and consultants. Information contained within personal files, as well as discussion with the manager confirmed that external professional advice and guidance is sought when necessary from local health care professionals or social services. One of the people who lived in the home said that the staff had taken her sight impairment into consideration and had taken positive action to ensure that she received the proper treatment, resulting in sight in one eye being restored. A survey from a relative said that health needs are always dealt with promptly. The people who live in the home said that they decide what time they get up and go to
Care Homes for Adults (18-65 years) Page 28 of 41 Evidence: bed, have meals, bathe and go out during the day or evening. Through discussion and observation it was clear that timings are flexible and the choice of the people who live in the home. None of the people who live in the home administer their own medication because they are not safe to do so, or do not feel confident in doing so, therefore this is done by staff. People said they were in agreement with this practice as they did not want to keep medication in their rooms. Medication was locked away safely and regular medication reviews with health professionals take place. Records pertaining to the administration of medication were up to date and the practice of administering medication, described by a staff member, was found to be safe. However the number of tablets held in the home of two particular medicines was not being transferred from one medication record to the next so it was not clear exactly how many tablets were being held in the home at any one time. Discussions with a staff member and the manager showed that they knew what to do in the event of someone refusing their medication and that unused or contaminated medication has to be returned to the pharmacy for safe disposal. Care Homes for Adults (18-65 years) Page 29 of 41 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
. People who live in the home are protected from abuse, neglect and self-harm. People can be confident that any concerns or complaints will be listened to, taken seriously and acted upon immediately. Evidence: The people who live in the home said that they feel safe there, they trust the staff, and would tell the manager if they had a problem or concern. These discussions, as well as discussions with two staff members and the manager, demonstrated that the open culture of the home and the recognition of peoples rights, ensure that people are protected from harm. All staff have undertaken training in safeguarding adults, including the training provided by the Local Authority, and discussion with a staff member confirmed that she knew what action to take should she suspect that any person in the home was being abused or not treated respectfully. Surveys from three staff members also confirmed that they knew what procedure to follow. There was written guidance in the home for the staff to follow should they need to. There was also information for the people who live in the home, produced in an easy read format to help people understand what it says. The home has a complaints procedure and discussions with the people who live there showed that they know how, and to whom, to make a complaint if they need to. The homes complaints procedure has been produced in an easy read format to help people understand it. Regular house and key worker meetings are held where any issues can be raised and dealt with immediately, although it was also clear from
Care Homes for Adults (18-65 years) Page 30 of 41 Evidence: discussion that people may raise any issue at any time with the staff and management team. The manager was knowledgeable about the processes to follow to safeguard vulnerable adults, and the effects of discrimination and the rights of individuals to be treated respectfully in a non-judgemental way. Care Homes for Adults (18-65 years) Page 31 of 41 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
. Trevithick House is a clean and comfortable home and the standard of the decor is good, providing people with an attractive and homely place to live. Evidence: The people who live in the home say that they like living there, the home is comfortable and there is enough room for them. The home was also found to be safe, clean and well maintained, providing a homely environment for the people who live there. The house is no different from any other house in the area and blends well into the neighbourhood. Each person has a single bedroom on the 1st floor, none of which have en suite facilities although they all have wash hand basins. Bedrooms are individually furnished and decorated, containing many personal possessions. The people who live in the home said that they choose the decor and furnishings for their bedrooms. Bedroom doors are fitted with locks, that can be opened from the outside in an emergency and each person may have a key to their own bedroom, depending on risk assessment. Bathroom and toilet facilities are adequate for three people and staff. The home has a bathroom on the 1st floor consisting of a bath with an over bath shower, toilet and wash hand basin and there is a separate toilet as well. There is also a shower and toilet on the 2nd floor, accessible through the office, that people may use if they wish to. Hot water is thermostatically controlled to a temperature that suits the people who
Care Homes for Adults (18-65 years) Page 32 of 41 Evidence: live in the home but reduces the possible risks of scalding. The bathroom and toilet doors are not fitted with locks therefore people cannot guarantee privacy, although the people who live in the home and the staff always know if the bathroom or toilet are in use. There are shared rooms on the ground floor consisting of a kitchen, dining room and lounge room. All these rooms are attractive and homely, well furnished and clean. There is an office on the 2nd floor that is also used as a sleeping in room for staff if required. The home has a ‘no smoking’ policy. Laundry facilities are in the kitchen at present, although the manager said this may change in the future, and people are encouraged and supported to do their own laundry. There were no concerns at this inspection about the risk of any cross infection, based on the needs of the people living in the home. The home does not have a garden but there is a small courtyard at the back of the house and the walls have recently been repainted which makes it look fresh and clean. Care Homes for Adults (18-65 years) Page 33 of 41 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
. Recruitment procedures are robust and people who live in the home benefit from a consistent, well supported and supervised staff team. However there are not always enough staff on duty to meet the identified support needs of the people who live in the home. Evidence: The people who live in the home said that they liked the staff and described them as nice, polite and said they get on well with them. One person said the staff help her to be independent. They said they are always there to help them if they need it but they also leave them alone if they want to be private. In a survey a relative commented that staff have sometimes made decisions on behalf of people who live in the home, with detrimental effects, however the manager did address this. The manager confirmed that there is a small staff team, some of whom have worked at the home for several years. All the staff were women because the home only accommodated women at the time of inspection. A relative commented that the staff are particuarly good at listening to my [relative] when she is sometimes upset. Two staff files were inspected and these contained all the required information such as written references and criminal records bureau checks. People who live in the home are involved in the interview process when new staff are recruited. Information in the AQAA said that during the recruitment and selection process we ensure that potential
Care Homes for Adults (18-65 years) Page 34 of 41 Evidence: staff subscribe to the core values of respecting equality and diversity across the board ... [and]all staff undertake appropriate training. The rota showed that there are usually two or three staff members on duty in the mornings on weekdays and two staff members on duty in the afternoon and early evening until 8pm. At night there is one waking member of staff. However, discussion with the manager and information contained in peoples personal files showed that one person should receive 1:1 support for 8 hours a day and another person should receive 1:1 support for 12 hours a day. The manager said that, during the week, she acts as a third member of staff so that people receive their 1:1 support. But, at weekends, there are only two staff members on duty for the three people who live in the home, therefore people cannot be receiving the 1:1 support, on a daily basis, that they have been identified as needing. Discussion with the manager, as well as documentation, confirmed that staff meetings are held regularly and she has devised a programme for individual supervision sessions with staff members. The organisation operates an on call system, where members of the management team are available both in and out of office hours. Discussion with two staff members and surveys from three staff members, as well as training records, showed that staff are expected to attend a variety of training relevant to their roles including qualifications in working with people with learning disabilities. The AQAA showed that nine out of eleven staff members have achieved a level 2 or above National Vocational Qualification, and the other two staff members are working towards this, which is an excellent record of staff training. Care Homes for Adults (18-65 years) Page 35 of 41 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 management approach is open, inclusive and positive, providing clear leadership and guidance. The rights, health, safety and welfare of people who live in the home are protected and promoted. Evidence: The manager has been working at the home since April 2008 and was in the process of applying to be registered with the Commission for Social Care Inspection. She said she has previous experience of working with people with learning and physical disabilities and has relevant qualifications. The people who live in the home said that they liked the manager and thought she was nice. They said they could talk to her about anything at all. This discussion, as well as a discussion with a staff member, confirmed that the ethos of the home is excellent because the management approach is open and inclusive with the home being organised to meet the needs and aspirations of the people who live there. A survey from a relative said since the arrival of the new Manager in April 2008 she has made improvements and taken charge appropriately. One staff member said that she feels well supported by the management and staff team and surveys from three staff members indicated that they also feel well supported. Feedback from one staff member said I feel we provide a good service to
Care Homes for Adults (18-65 years) Page 36 of 41 Evidence: all who live here, the experienced staff work well as a team to ensure the service users have a high quality of life in and out of the house. Lines of accountability are clear and the organisation has a management structure that enables it to cover absences when required, and provide an effective on call system to support staff. The organisation has a quality assurance system in place which includes consultation with the people who live in the home as well as their relatives and representatives. The home receives a visit once a month from the organisations Area Director who talks to the people who live in the home, the staff and management team as well as checking that documentation is up-to-date and finding out if the home needs any maintenance or decorative work. The reports written after these visits are produced in an easy read version to help everyone understand them. Health and safety checks, including fire equipment, gas safety and portable electrical appliances are carried out regularly. Fire safety training is carried out with staff and discussion with a staff member confirmed that she knew what to do in the event of a fire. Two people who live in the home described what they would do in the event of a fire, that is, leave the home as quickly as possible, and said they have also attended training in what to do in the event of a fire. However the names of people who have received training in fire safety were not documented. Other fire safety checks are carried out regularly by a staff member. The manager, as well as staff training records, confirmed that all staff complete training in emergency first aid, health and safety and food hygiene. The manager confirmed that all hot water taps, used by the people who live in the home, have been fitted with thermostatically controlled devices to make sure that the water does not get hot enough to scald people. All accidents and incidents are recorded and the manager monitors these to look at the cirumstances of each incident and look for any patterns that may emerge so that the staff team can take action to prevent a recurrence. Care Homes for Adults (18-65 years) Page 37 of 41 Are there any outstanding requirements from the last inspection? Yes ï£ No ï 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 38 of 41 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 Description Timescale for action 1 33 18 The number of staff on duty during the day must be reviewed, particularly at weekends, and increased where required. 03/01/2009 This is to ensure that there are enough staff on duty to meet the needs of the people who live in the home, particularly those people who have been identified as needing 1:1 support. 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 Description Timescale for action 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 1 7 Where staff are withdrawing money using debit cards from a persons bank account, the manager should check the bank statements against the receipts issued by the bank. This is to ensure that a proper audit trail is in place and that only authorised monies are being withdrawn by staff. Care Homes for Adults (18-65 years) Page 39 of 41 2 20 The number of tablets held in the home should be transferred from one record sheet to the next. This is so that there is an accurate audit trail of the number of tablets being held in the home at any time. Bathroom and toilet doors should be fitted with locks, suited to the abilities of the people who live in the home, that can also be accessed from the outside by staff in an emergency. This is so that people can be guaranteed privacy when using the bathroom or toilet. The manager should apply to be registered with the Commission for Social Care Inspection. This is to ensure that the manager is qualified, competent and experienced to run the home. The names of people who attend fire safety training and fire drills should be documented. This is so that the management of the home know who has completed this training and the frequency of the training so that they can check if anyone has not completed it. 3 27 4 37 5 42 Care Homes for Adults (18-65 years) Page 40 of 41 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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