Inspection on 10/10/08 for Unity Care

This inspection was carried out on 10th October 2008.

CSCI found this care home to be providing an Adequate 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.

Other inspections for this house

Unity Care 29/09/09

Unity Care 18/10/07

Unity Care 15/09/06

Unity Care 30/11/05

Unity Care 17/06/05

Unity Care 09/02/05

Unity Care 23/07/04

Unity Care 26/01/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Unity Care 90 Gravelly Hill Erdington Birmingham West Midlands B23 7PF     The quality rating for this care home is:   one star adequate 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: Gerard Hammond     Date: 1 5 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 30 Information about the care home Name of care home: Address: Unity Care 90 Gravelly Hill Erdington Birmingham West Midlands B23 7PF 01216864406 01216864406 enquiries@unitycare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Wayne Hamilton Type of registration: Number of places registered: Mrs Sylvia Hamilton care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 3 Date of last inspection Brief description of the care home 90,Gravelly Hill is a large terraced style property, lying back from a busy main road close to Spaghetti Junction on the M6 motorway. The area is well served by public transport links, with a bus stop immediately outside and rail station close by. The home is registered to provide personal care, support and accommodation for up to three adults who have a learning disability. Staff are on duty at all times and sleep-in night cover is provided. There are three bedrooms on the first floor. Bathing facilities and toilets are situated on both ground and first floors. At the front of the house is a Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 3 Brief description of the care home communal lounge. There is a bedroom on the ground floor that is currently unoccupied. Towards the back of the house is a dining area leading into the kitchen. Doors from the kitchen give access to the rear of the property where there is a paved area to the side and a steeply inclined lawn to the back. There is limited off street parking at the front of the house, and parking restrictions apply on the road outside. The house sits in an elevated position from the road making access difficult for people with restricted mobility. It is recommended that information about current fees and charges is sought directly from the care home. Care Homes for Adults (18-65 years) Page 5 of 30 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the homes first key inspection in the current year 2008-9. Information was gathered from a number of places to help inform the judgements made in this report. The Manager completed an Annual Quality Assurance Assessment (AQAA) and sent it to us. Two visits were made to the home. We met both of the residents and were able to talk with them in private. The Manager and staff on duty were also interviewed. We looked at records including personal files, care plans, previous inspection reports, staff files, safety records and other documents. We also had a look around all of the home. Thanks are due to the residents, Manager and staff for their co-operation and support throughout the inspection process. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Documents about what the service provides need to be finished, so that people have all the information they need to decide if it is what they want. Work on improving peoples care plans needs to continue, so that they become more person-centred. People need more support to set clear goals, and these should be checked regularly. Doing this well will mean that people get the help they need to achieve the things that are important to them. The way in which peoples activity opportunities are planned and recorded continues to need improvement. This is to make sure that the things people get to do help them to achieve their goals. Further developing peoples health action plans could help to make sure that their healthcare is more organised and better planned. This is so that they get all the support they need to stay healthy and well, and to take as much responsibility for this as they can. The work that has been done to improve the management of staff records needs to be Care Homes for Adults (18-65 years) Page 8 of 30 completed. The staff training plan should be developed. This will make it an effective tool for managing staff development more efficiently. Evidence for training completed and work towards staff achieving NVQ qualifications also needs to improve. This is to make sure that all staff have the knowledge and skills, and get the support they need, to do their jobs well. Addressing the issues raised above will help make sure that the conduct and management of the home improves. A proper system for quality assurance and monitoring should be put in place. This will show clearly how the views of people using the service have been taken into account in its review and development. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the service needs to be complete, so that peoples choices can be fully informed. Residents strengths and needs are properly assessed, and people thinking about using the service can visit and try it out first. People have current written contracts. Information about fees and what people have to pay for themselves needs to be clear, so that everyone understands their responsibilities. Evidence: There have been no new admissions since the time of the last inspection, and the home still has one vacancy. Both of the men currently resident have lived there for several years. The Manager provided copies of the homes Statement of Purpose and Service Users Guide. Some work has been done on these documents since last year, but some information is still incomplete. This includes current fees, room sizes and arrangements for visitors to meet in private. It was also recommended that information about social and leisure activities clearly shows what residents are Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: expected to pay for themselves, where appropriate. A previous recommendation to update residents contracts has been met. Sampling of peoples personal records showed that assessments of their support needs have been reviewed and updated since the last inspection visit. As noted in previous inspection reports, the Manager advised that people considering using the service are able to visit and try it out for themselves, before making any decision about moving in. Care Homes for Adults (18-65 years) Page 12 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning needs to be improved to include clear goals that are easy to measure. These should be reviewed regularly to see what is working and what might need changing. This is to make sure that people get the support they need to achieve the things they want. Evidence: Both residents personal files were sampled and contained care plans, as required. It is clear that the Manager has worked to develop plans since the last inspection. There is evidence of the introduction of some person-centred approaches, and this should be commended. As previously reported, care plans are structured to a set formula. It was suggested that a proper index would make information easier to find. Files also include old or superseded information. It was recommended that this should be archived or disposed of as appropriate. This should help to ensure that records are current and concise documents, and that important information is easier to find. One person has epilepsy, but his care plan did not provide guidance about how he should be Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: supported. An epilepsy management plan was present in another place on his record: the care plan should include a signpost to this. Some work has also been done since the last inspection to include residents goals in their care plans, as recommended at the last inspection. Examples of these included make a snack three times a week, have a better understanding of money,do independent living skills three times a week. Setting goals by using the SMART model was discussed with the Manager. This model proposes that goals should be specific, measurable, achievable, realistic and time-limited. It is clear that some elements of this are present in the work already done to date. As previously reported, it is important that goals have clear outcomes that can be measured. This is so that it is possible to see whether or not each goal has been achieved. For example have a better understanding of money should show how this person is to be supported to achieve this.It is not clear how the goals set are being evaluated. This is an integral part of the process, if setting goals is to have any value. This is so that judgements can be made about what is working (or not), to make sure that people get the support they need to achieve the things they want. Developing this was discussed with the Manager. He said that he was already working with staff to take this forward. It was suggested that goals should be evaluated and reviewed on a regular basis, and that designated key workers could take responsibility for doing this. This could help make care management more systematic and better organised than it is currently. It has to be recognised that the support needs of the current residents present particular challenges. Residents confirmed that they are able to get involved in day-today things around the house if they wish. Staff were observed encouraging them to tidy their rooms, get drinks and asking them what they wanted to do.The Manager and staff report that residents motivation and levels of understanding of their individual responsibilities are variable. It should be acknowledged that this can impact on the ways in which they are supported and on the levels of co-operation experienced with agreed care plans. However, this reinforces the need for plans and goals to be clear and specific, so that all parties know what they have agreed to. A previous recommendation that risk assessments and care plans be accurately crossreferenced has now been met. It was noted that current risk assessments were not present on residents files. However, the Manager was able to produce these subsequently, when requested. Care Homes for Adults (18-65 years) Page 14 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to do things they value, keep in touch with people who are important to them, and be a part of their local community. However, the ways in which activities are planned, structured and recorded needs to improve. Doing this properly will ensure that people get the support they need to achieve their goals fully. Evidence: In his written response to the Annual Quality Assurance Assessment (AQAA) the Manager shows that residents go to college, and make use of local centres for karaoke, singing, acting as DJ, dancing and socialising with their peers. They are also said to enjoy going shopping, eating out, going to the pub and out for country drives. One resident said that he attends college three times each week, while the other goes on one day only. They both confirmed that they are able to keep in touch regularly with the people who are important to them. When at home they said they enjoy watching Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: television and DVDs, and listening to music. They are able to do this in the communal lounge or in the privacy of their own rooms, if they so wish. Concerns were expressed at the time of the last inspection about the standard of activity recording, and this continues to be the case. It is difficult to make informed judgements about the quality of activity opportunities that residents enjoy, on the basis of available evidence. As reported at the last inspection, it is hard to assess what choices people have been offered, or how decisions have been made, from the information presented in their activity records. Some of these are poorly written so that they are barely legible. There should be clear links between individuals agreed goals and the things they get to do. Their activity opportunities are a prime indicator of the quality of life that they enjoy. Both men have care plans that show they should be doing activities to develop their independent living skills. As reported above, it is not possible to see how this goal is currently being evaluated. It is suggested that each person should have his own programme, so that opportunities are provided to build on their existing strengths and learn new skills as appropriate. This should be done in a structured way, and on an individual basis. This has to be a jointly agreed process, so that residents and staff are both clear about what they are signing up to, and accepting their respective responsibilities. Conversations with the Manager and staff members suggest that motivating residents to accept their responsibilities is a problematic issue. It has to be acknowledged that residents different levels of learning disability, mental health, strengths and support needs all contribute to making this a far from simple undertaking. That is precisely why it is important that the approach to dealing with this aspect of their care is not haphazard but structured. Regular review and evaluation will help to ensure that goals are relevant, and show if these are working or need to be changed. Members of the staff team must also recognise their responsibilities in this, and the importance of keeping full and accurate records. It may be that this is an issue requiring additional training or support. Problems relating to individual members of the staff team should be dealt with through formal professional supervision. Food stocks were sampled. These were ample and included fresh produce, fruit, vegetables, and salad. It was noted that a number of packages of food stored in the fridge had not been labelled with the date of opening. Menus provided evidence of variety and choice, and included Afro-Caribbean meals, in recognition of both residents cultural background. Both men said that they enjoyed their food and could have what they wanted. Care Homes for Adults (18-65 years) Page 16 of 30 Care Homes for Adults (18-65 years) Page 17 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples basic care needs are generally well met. Planning to meet peoples healthcare needs could be improved, to make sure they get the support they need to stay healthy and well. Evidence: Both residents are generally self-sufficient with regard to their personal care, with support mainly being given in the form of prompts. Both men were well dressed in clothing of good quality that was age and gender appropriate. Interactions between residents and staff were relaxed and friendly: as noted at previous inspections, they appear at ease in each others company. Both residents said that they get on well with the staff and that they are treated with respect. The residents are male and of AfroCaribbean origin: the current staff team reflects this, providing them with gender and culturally sensitive support. Sampling of residents personal records provided evidence that they have been supported to attend health related appointments throughout the past year. These include visits to the GP, Consultant Psychiatrist, Community Nurse, Dentist and Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: Optician. Both men are diagnosed with epilepsy. One persons condition appears well controlled with medication. The others is under regular review by the Consultant: an epilepsy management plan and record of seizures is in place. Health action plans continue to require further development. It is recommended that professional support be sought in order to address this effectively. Goals set are currently limited to get enough sleep (at least 8 hours per night) and eat properly (3 meals per day) and exercise... x1 per week. Goals should seek to proactively promote peoples health and wellbeing. These could also provide a more structured framework for planning and monitoring health related appointments - for example, ensuring that regular check-ups are not overlooked. They should also provide individuals with opportunities to take responsibility for their own health, according to their personal capabilities. Neither of the residents currently self-medicates. The Manager says that the home has a good working relationship with a local Pharmacist, who supplies most of the medication in blister packs. The Annual Quality Assurance Assessment shows that all staff have received accredited training. The Medication Administration Record was sampled: this had been completed appropriately. Sampling of stocks held (including non blister-packs) tallied with the record. The medication store was clean and tidy, and secure. Care Homes for Adults (18-65 years) Page 19 of 30 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 are confident that their concerns are listened to and taken seriously. They are protected from abuse, neglect and self-harm so that they feel safe and secure. Evidence: The home has a complaints policy and procedure in place: this is also available in pictorial format. In the written response to the Annual Quality Assurance Assessment, the Manager showed that no complaints have been received since the last inspection. We have not received any complaints in respect of this service either. Conversations with both residents showed that they know that they can complain, and to whom. They said that if they were concerned about anything, they would talk to staff about it, or go directly to the Manager. Staff records show that all staff have completed adult protection training and sampled files included current checks with the Criminal Records Bureau (CRB). Staff on duty were interviewed. They were able to identify the ways in which people might be abused, and to describe things that might lead them to suspect that abuse had taken place. They were also clear about their responsibilities to report any incidents or concerns in this regard. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well maintained so that residents can enjoy living in a house that is comfortable clean and homely. Evidence: A tour of the house was completed in the company of the Manager. The home is a large terraced house, set back from a busy main road and a short distance from the Gravelly Hill Interchange (Spaghetti Junction) on the M6 Motorway. There are good public transport links to the neighbourhood. The house is on an elevated position from the road. To the rear of the property is an enclosed garden, and this is steeply sloped. These features mean that the home would not be suitable for people with significant mobility difficulties. At the front of the house on the ground floor there is a large, comfortable lounge. The kitchen and a separate dining room are situated to the back of the house. Also on this floor is the (currently) unoccupied bedroom, separate w.c., shower room with further w.c., and the laundry room. On the first floor are the residents bedrooms, staff sleepin room, and main bathroom with w.c. As previously reported, residents rooms are comfortably furnished, individually styled and contain personal possessions and other effects. Both men said they like to spend time in their rooms when they want privacy Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: or peace and quiet, to watch TV, DVDs, listen to music or play computer games. On the second floor is the homes office. The homes maintenance and renewal plan was requested, but not available, on the day of the inspection visit. However, the house is generally well decorated, furnished and maintained. The residents said that they were comfortable in their home, which was clean and tidy with a good standard of hygiene maintained throughout. Care Homes for Adults (18-65 years) Page 22 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are looked after by staff whom they know well, so there is continuity of support. Organisation of staff training and supervision needs further improvement. This is to ensure that staff have the knowledge and skills and get the support they need to do their jobs well. Evidence: As previously reported, the majority (though not all) of the staff team are members of the Managers extended family. Unity Care is a family-orientated organisation, and the staff team reflects this. There is usually one member of staff on duty per shift, and the Managers hours also include some hands on care, in addition to his management responsibilities. The staff group has remained stable: the Annual Quality Assurance Assessment shows that only one person left since the last inspection. Vacant shifts are normally covered from within the team and no staff from external agencies have been used, promoting continuity of care for the residents. Staff interviewed showed they have a good understanding of residents needs and personal preferences. Staff files were sampled. These contained completed applications, written references and CRB checks as required. It was noted however, that one staff members file only included one reference. It was recommended at the last inspection that staff files were Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: in need of improved organisation. Some work has been done to achieve this, but this needs to be completed. A requirement was also made that the Manager devise a staff training and development plan. This has been done, but some improvements were recommended. These include showing (for each staff member) qualifications gained and the date when training refreshers are due. These recommendations were also previously made at the last inspection. The desired goal is to have an effective tool that can provide the manager with an effective overview of staff training and development at any given time, and support future planning. Information provided by the Manager on the day of the inspection visit shows that two of the current staff team hold qualifications at NVQ level 2 or above. A further three staff members are said to be working towards this. Action needs to be taken to ensure that staff complete this training, in order to meet the National Minimum Standard target of 50 . Also, though there were some certificates for past training completed on staff files, it was difficult to verify recent training as this was not certificated. Sampling of staff records showed that improvements have been made to formal staff supervision, so that the recommended minimum of six meetings in any twelve-month period has now been met. Staff on duty confirmed that they receive supervision on a regular basis. However, one persons record showed monthly supervision meetings until May 2008, but nothing subsequently. Care Homes for Adults (18-65 years) Page 24 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some aspects of the overall conduct and management of the home continue to need improvement. This is to ensure that peoples views are fully taken into account and that they get the support they need to achieve their goals. People living and working in the home are generally protected to stay safe and well. Evidence: The Manager is appropriately qualified, holding NVQ level 4 and the Registered Managers Award. He has several years experience of working with people who have learning disabilities, and of managing the service. As previously reported, staff say that he is an approachable individual, and very supportive. Reference has been made in this and previous inspection reports of aspects of the conduct and management of the service that require attention and improvement. These include care management, health action planning, and effective goal-setting and evaluation. Record-keeping, in particular those relating to residents activity opportunities, continue to be in need of development and improvement. The Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: management of staff training and development, supervision and records all require further work to bring them fully up to standard. It should be acknowledged that efforts have been made to address some of these issues, and some progress has been made since the last inspection. The Manager also needs to address the issue of service quality assurance and monitoring. This was discussed during the inspection visit. The Organisation previously gained the Investors in People Award, but this is now up for renewal. The Manager advised that another system is also under consideration, but a decision has not yet been taken about this. The outcome for this standard is that people are confident that their views underpin all self-monitoring, review and development by the home. It was suggested that continued development of person-centred planning, effective goalsetting, and proper evaluation in care management could make a significant contribution to this. Monitoring this should form part of the reporting required under Regulation 26 (Care Homes Regulations 2001) carried out each month. Safety records were sampled. The fire alarm and emergency lighting systems have been checked regularly, and a complete written record maintained. The systems have also been serviced.Training records show that staff have received fire safety training and mandatory health and safety, food hygiene and infection control training. Certificates are in place for gas installations and electrical circuits. Some packages of food stored in the fridge had not been labelled with the date of opening. This is accepted good practice in residential care homes, to help staff monitor stored food effectively and prevent potential related health problems. The COSHH store was secure. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 1 Complete Statement of Purpose and Service Users Guide so that these contain all the information people need to make a choice about using the service. Ensure that people have clear information about fees and charges for activities, so that all parties are clear about their responsibilities. Develop care planning so that goals set are clearly measurable and evaluated regularly. This is to ensure that people get the support they need to achieve their goals. Develop the use of person centred approaches, so that people get the guidance and support they need to make decisions about their lives, and the things that are important to them. Develop care planning and recording to show clear links between peoples goals and their activity opportunities. Review activity recording regularly to ensure that written records are legible and appropriately detailed. Doing these things will help to ensure that people are properly supported to make decisions and achieve their agreed goals. Label packages of food stored in the fridge with the date of opening. This will help to ensure that food items are consumed while still fresh, and prevent ill health. Page 28 of 30 2 5 3 6 4 7 5 12 6 17 Care Homes for Adults (18-65 years) 7 19 Develop health action planning so that it is more structured and proactive. Set clear goals and evaluate them regularly. This will help to ensure that peoples health and wellbeing are more actively promoted. Take action to ensure that staff currently said to be working towards gaining NVQ qualifications complete this training, so that at least 50 of the team is qualified to NVQ level 2 or above. Complete work on reorganisation of staff records, to ensure that all required documentation is available for inspection. This is so that appropriate evidence is available to demonstrate robust recruitment practice, helping to ensure the safety of people using the service. Develop the staff training and development plan so that it includes details of staff qualifications, and when refreshers are due. Ensure that certificates for all training completed by staff are filed in their individual records, and available for inspection. These actions should help the Manager organise and plan training more effectively, and provide clear evidence that training has been done. Ensure that formal staff supervision takes place at regular intervals, so that staff get the support they need to do their jobs well. Develop systems for monitoring and assurance of service quality. This is to ensure that the views of people using the service underpin its review and development. Take action to improve the standard of record keping in the home. Monitor this regularly and deal with any issues through formal staff supervision. Tidy up files and remove old material for archiving or disposal as appropriate. Improving standards of record keeping will help to ensure that important information can be found quickly and easily, and support better care management. 8 32 9 34 10 35 11 36 12 39 13 41 Care Homes for Adults (18-65 years) Page 29 of 30 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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