CARE HOME ADULTS 18-65
Veedale Back Lane Clayton le Woods Chorley Lancashire PR6 7EU Lead Inspector
Mrs Marie Cordingley Unannounced Inspection 27th July 2007 10:00 Veedale DS0000065017.V338687.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 Veedale DS0000065017.V338687.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. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Veedale Address Back Lane Clayton le Woods Chorley Lancashire PR6 7EU 01772 335098 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) Dalesview Partnership Miss Lisa Warburton Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 9 service users to include: up to 9 service users in the category of LD (Learning Disability) 27th July 2006 Date of last inspection Brief Description of the Service: Veedale stands in its own grounds and has open views to two sides. The building is a single storey purpose built establishment, with wide doorways and easy access throughout. It comprises four small units, each with its own kitchen, bathroom and lounge area, allowing service users to enjoy greater privacy. The premises are on the same site as two other homes, Rowandale and Hollydale, which are part of the same group. Veedale can accommodate nine service users with a Learning Disability. The home provides nine single bedrooms. The rooms have been decorated and furnished with specific service users in mind and are all individually furnished. The bathrooms have been specifically designed to provide a suitable environment for assisting service users with physical disabilities. In addition there is a laundry and office. The gardens have been landscaped to the front and sides and there is also a large conservatory and patio, which service users from the three small units can access. The home is situated in Clayton-le-Woods on the edge of a housing estate. There is a range of facilities including a supermarket, library, leisure centre, public houses and park. These are within walking distance and service users from the home access them. Clayton-le-Woods is situated on the A6 which is the main road linking the city of Preston and the market town of Chorley. This means the service users also have access to the facilities offered in these towns. At the time of the inspection the standard care and accommodation fees for this home were £850.00. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection of this home included a site visit which was carried out over 7 hours. During the visit we spoke with residents, staff and the manager and examined a selection of documents including residents’ individual care plans and staff personnel files. We also carried out a tour of the building looking at residents’ communal living areas and private bedrooms. During this visit we also carried out a case tracking exercise which involved us looking very closely at selected residents’ care from the point of their admission to the home. Prior to the visit we asked the manager of the home to complete a comprehensive questionnaire which provided us with a lot of information about how the home is managed. We also sent some written questionnaires to residents and their families asking them about their opinions of standards within the home. What the service does well:
The people we consulted during the visit and as part of our written survey, which included residents, relatives and staff, said some very positive things about the home. We received comments such as; ‘‘ Staff at the home work so very hard to ensure people have a good quality of life.’’ ‘’The standards at this home are excellent.’’ ‘’Lisa (Manager) is excellent and Pat (owner) is fantastic.’’ ‘’I like the staff, I like it when we go out.’’ We observed a number of residents during the visit who were unable to talk to us but appeared very happy and relaxed in their surroundings. We watched the residents spending time with carers which they seemed to enjoy very much. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 6 The home has an excellent approach to assessing the needs of residents and planning their care. Care planning is very much based on residents’ individual needs and their preferences are taken into account to as great an extent as is possible. The residents preferred daily routines are rightly seen as very important and clearly stated in their individual plans. For example, one care plan we viewed gave clear instructions that the resident wished to have a low light on and his bedroom door slightly open at night. There is a comprehensive health care plan in place for each resident which contains very useful information. In particular, information about residents who have epilepsy is of a very good standard. For those residents who experience seizures there is very clear individual guidance in place which covers triggers, signs that the person may be about to have a seizure, what the person would like staff to do when they are having a seizure (one example said ‘talk to me and hold my hand’) and how staff can best help the person to recover (one example said ‘I usually like to lie in a quiet room for a few hours‘). This level of guidance reflects the fact that every person’s experience of epilepsy is different and helps staff to provide care which meets the person’s individual needs. There are particularly good procedures in place to ensure that residents who require help in managing their behaviours are supported. The manager of the home works closely with a behavioural specialist from the local primary care trust who has trained carers at the home and also helped in developing strategies for staff in dealing with challenging situations. This is very good practice and means that the staff can approach situations confidently and consistently. Residents are encouraged to express their views and opinions and the manager has arranged for independent advocates to support them in doing so. Independent advocates also support residents to express their views in relation to their own care planning. In addition, all the people who live at the home are part of a local community advocacy group. The manager ensures that there are sufficient numbers of staff on duty to meet residents’ needs and enable them to take part in activities of their choice. A number of people we spoke to were very complimentary about the staffing levels at the home. One staff member said ‘’There is always someone to ask and some one with a bit of time to help.’’ The home has a very good approach to training with a core training programme in place for everyone. The programme includes all the mandatory training areas such as moving and handling and first aid as well as additional courses relevant to carers’ roles such as positive behaviour management and person centred planning. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 7 All the staff consulted during the visit were very positive about their role within the home and said that they enjoyed working there. Staff members also said that they felt very well supported. In addition, staff confirmed that they were able to attend regular meetings both in groups and individually with the manager. Throughout the inspection the manager demonstrated an extensive knowledge and a good understanding of her role. She also demonstrated a genuine commitment to promoting the rights of residents and constantly improving the service provided. The manager has also been involved in a number of community projects with other professionals assisting her to keep updated about developments in services for people with learning disabilities. What has improved since the last inspection?
We found during this inspection that a number of requirements and recommendations that were made following the home’s last inspection had been addressed. There has been a review of the activities that are offered to residents and efforts are now being made to include more community based activities. This approach gives residents an increased choice and the opportunity to make new relationships. In addition, a vehicle has been purchased to assist residents to access local facilities. The manager of the home has put arrangements in place to ensure that all residents receive support from independent advocates. Evidence was seen that advocates work regularly with residents to ensure that they are given the opportunity to express their opinions and views. All the residents who live at this home are part of an advocacy group which is independent of the home and meets on a regular basis. The manager has considered ways in which the residents can be more involved in the running of the home and as a result, a number of changes have been made. These include the development of the ‘service user council’, a group of residents who meet on a regular basis to discuss various issues such as activities and menus. In viewing minutes of the meetings held by the council it was evident that issues they had raised had been acted upon by the management of the home. For instance, the purchasing of a vehicle was one idea that the council put forward and this was acted upon straight away. Steps have been taken to provide residents with various pieces of equipment to assist them in every day life such as electronic communication aids. At the time we visited, residents were undergoing assessments in partnership with a
Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 8 speech and language therapist to determine what types of equipment they would benefit from. It was confirmed that plans were in place to purchase the equipment following this process. Staff training has been reviewed and a core training programme has been implemented. This includes all the mandatory training areas such as moving and handling and also covers additional areas such as positive behaviour management. In addition, all staff have now received training in the safe handling of medication. Procedures have now been put in place to ensure that in line with Regulation 37 of the Care Homes Regulations 2001, any significant events are reported to the Commission for Social Care Inspection in a timely fashion. What they could do better:
All prospective residents are provided with a very useful document called a Service User Guide which gives information about daily life at the home such as the activities available and the people who work there. The home provides the document in various formats including an easy read pictorial version. It is recommended that the guide is also made available in a video format. There is a procedure in place which advises people how to make a complaint and what will happen if they do so. Currently the home provides the complaints procedure in a number of formats including an easy read pictorial version. It is recommended that the procedure is also made available in a video format. Whilst residents’ bedrooms are all lockable, we confirmed during this inspection that no residents hold a key to their room. All residents should be offered a key for their bedroom unless a risk assessment determines otherwise. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 9 Parts of the home’s garden have become overgrown and require attention. We were advised that this was due to a fault with recent gardening work that had been carried out to a poor standard. We asked the manager to address this as soon as possible. When checking staff files we found that the manager was generally very thorough in ensuring that the correct checks were carried out prior to offering a candidate a post within the home. However we confirmed that two staff who had moved to England from overseas had been appointed without Criminal Records Bureau Disclosures (although they did have police clearance from their country of origin). Following discussion with the manager we were satisfied that this had been due to a misinterpretation of the Care Homes Regulations, 2001. We made a requirement that these Criminal Records Bureau checks be carried out as soon as possible. Some of the residents at the home have some health care requirements and arrangements are in place to enable specifically trained staff members to provide this care. There are excellent written protocols in place for each individual resident which describe the care they require and how this should be carried out. However, in these circumstances it is good practice to have a written agreement with the local primary care trust in place. We were unable to confirm such an agreement was in place at the time of our visit. We recommended that such an agreement be implemented as soon a possible. Currently approximately 40 of staff hold National Vocational Qualifications in care at level 2 or above. This means that the home are falling slightly short of the national minimum standard of 50 . However measures are being taken to address this short fall and all carers at the home are enrolled on the course. 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. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 10 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 Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 11 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): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering a move to this home are given a good deal of information so that they can make an informed choice about whether they want to live there. Staff receive comprehensive information about new residents so that they can plan care which meets their individual needs and preferences. EVIDENCE: The home provides a good amount of information to prospective residents which includes a Service User Guide. This document gives a picture of daily life at the home such as activities provided and information about the people who work there. Currently the home provides the Service User Guide in a number of formats including a pictorial easy read version. We talked to the manager about other formats that may be useful and made a recommendation that a video guide be produced. In discussion with residents, staff and the manager we were able to confirm that there are processes in place to enable people who are considering a move to the home to visit on as many occasions as they wish. The visits are usually
Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 12 built up from a few hours, to full days and overnight stays and give the prospective residents the chance to get a feel for the home and meet other residents and staff. As part of the case tracking exercise we examined the care of one resident who had lived at the home for a week. There was a very comprehensive assessment in place for this person which contained a good deal of information to help staff provide the right care for him. It was apparent that a great deal of attention had been paid to ensuring that the person’s individual preferences had been taken into account when carrying out the assessment. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 13 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, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a person centred approach to care planning which means that care is provided in line with peoples’ individual needs and preferences. Residents are encouraged to be involved and express their views about the running of the home. EVIDENCE: As part of the case tracking exercise we examined a number of residents’ individual plans. The plans we viewed were of an excellent standard, covering all areas of daily life and having a strong emphasis on peoples’ individual needs and preferences. Preferred daily routines were covered in great detail and included information such as the person’s preferred sleeping and eating arrangements. This level of information would assist staff to provide person centred care which is tailored to each individual.
Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 14 We case tracked a resident who had only lived at the home for a week and we were very impressed with the amount of information already included in his individual plan. Discussion with the manager confirmed that there are procedures in place to ensure that individual plans are put in place prior to a resident’s arrival or as soon a possible after if they have been admitted in an emergency. The manager has put arrangements in place to ensure that all residents have access to advocates who are independent of the home. These are people who are trained to support individuals who may need some assistance in expressing their views and opinions. Advocates are involved in care planning where appropriate, which is an additional measure to ensure that the home are planning care which is in line with residents’ individual preferences. Through viewing individual plans and through discussion with the manager we were able to confirm that there is a very positive approach to risk taking at this home. There is an understanding that well managed risk taking is positive and often necessary for personal growth. As such there are processes in place to ensure that risk assessments are carried out where appropriate and clearly identify any action required by staff to reduce identified risks to an acceptable level. We saw evidence that there are a number of measures in place to involve residents in the daily running of the home and encourage them to express their views. Such measures include the newly appointed ‘service user council’. This council is made up of a number of residents who meet regularly to discuss issues such as activities and menus. Several examples were available to demonstrate that the management of the home had taken on various ideas which had been put forward from the council. For example the council had put forward an idea that they would like a vehicle to access the community. The management of the home acted upon this straight away. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 15 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. People living at this home are provided with regular opportunities to take part in fulfilling and enjoyable activities. EVIDENCE: There is a lifestyle manager employed at the home who oversees all the provision in this area and constantly updates the programmes that are made available. Records of activities carried out by residents demonstrate that there is an appropriate balance between leisure and fun time activities and skills training or educational activities. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 16 Activities regularly accessed by residents include music, drama, aerobics and arts and crafts. In addition, a number of residents attend their local college to do courses such as cookery, animal care and photography. Whilst a large amount of activities are held within the home there have been efforts made since the last inspection to support residents to also enjoy activities in their local community. Residents regularly enjoy trips out to their local pubs, shopping trips, bingo and weight watchers. One resident who regularly attended a local church decided that he would like to become involved in more music based worship. Staff carried out research and were able to locate a church in the area which met the resident’s needs. We saw a number of examples of residents receiving support to maintain their valued relationships. For example, one resident whose relatives live in Canada, has been supported to get a computer and a web cam so he can talk to his family regularly. Staff have helped him learn how to use the computer and send emails. There is good information in residents’ individual plans in relation to their nutritional needs and preferences and this was reflected in discussions with staff who showed a very good understanding of these needs. Records held within the home confirm that a number of different meals are regularly served confirming that residents are always given a choice about what they have to eat. Residents are given the opportunity to contribute to the shopping list as it is prepared each week. Discussion took place with the manager about the possibility of residents becoming more involved in the grocery shopping and it was agreed that she would look into this. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including a visit to this service. Residents’ health and well being is closely monitored by staff. Support is provided to enable residents to access health care when they need it. There are good systems in place to ensure that residents’ medication is carefully managed. EVIDENCE: There is very comprehensive information in place about each resident’s health care needs, particularly in relation to epilepsy. For residents who have epilepsy there is an individual assessment in place which describes triggers, signs that a person is about to have a seizure, what the person would like a carer to do while they are having a seizure and the best way to help them recover. Some residents require specific health care which is carried out by care staff within the home. There are excellent individual protocols in place in relation to these health care techniques which give staff very clear guidance. In addition, all staff who carry out the techniques have been provided with specialist training.
Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 18 In these circumstances the general practice is for a written contract to be in place with the local primary care trust which covers issues such as the responsibility for quality assurance and assessing staff competency. The manager was unsure whether such a contract existed and as such, we recommended that she ensure that a contract is implemented. In viewing residents’ individual plans we were able to determine that they are supported to access advice and treatment from health care professionals when they require it. In addition, residents at the home receive regular input from a physiotherapist and speech therapist who are privately employed there. Individual plans contain very good information about the support that people require in relation to their behaviour. Individual protocols were in place where appropriate, giving staff very in depth information about how to approach challenging situations. Each person’s individual plan contains in depth information about their communication. For residents who do not communicate verbally, there is guidance in the ways they express themselves. This information assists staff greatly in getting to know residents and understanding their needs. Communication passports which contain this type of information in more detail are currently being introduced for each resident. Residents who live at this home have recently been assessed by a speech therapist and a consultant from a company that supply various equipment including electronic communication aids. It was confirmed by the manager that plans are in place to purchase appropriate equipment for residents. When in place, these aids should make a great difference to peoples’ lives and assist them to carry out more daily tasks independently. We viewed the home’s medication store and examined a number of medication administration records. These were all found to be in good order and medicines were stored safely and securely. All carers at the home have now been provided with training in the safe handling of medication. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home are encouraged to express their concerns. There are systems in place to protect residents from abuse. EVIDENCE: The home has a complaints procedure in place which explains to people how to raise concerns and what will happen if they do. The complaints procedure is provided in a number of formats including a pictorial easy read version. We discussed this with the manager and it was agreed that a video procedure would be very useful for some residents. The manager agreed to look into this. Records viewed and discussions with the manager confirmed that there have been no complaints received at the home since the last inspection. In addition, there have been no complaints received at the Commission for Social Care Inspection since the home’s registration. There are written procedures in place which give staff guidance on the action they should take if they become aware or suspect that an incidence of abuse has taken place. Staff we talked to had a good understanding of this guidance and all said that they would have no concerns in raising an issue with their senior. One staff member said ‘’I know for a fact that they (the managers) would want to know if there was anything like that going on and I know they would stop it straight away.’’ Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 20 Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 21 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. Residents at this home are provided with a good standard of accommodation which is well maintained and nicely furnished. EVIDENCE: Veedale is a purpose built home which has been specifically designed for the use of young adults with learning and physical disabilities. The home is spacious with a number of communal areas for the use of residents including a large conservatory. We viewed residents’ bedrooms which were nicely decorated and contained lots of personal items such as pictures and ornaments. All the residents at the home have their own bedroom which is lockable. However, we were advised that no residents currently hold a key. We recommended that all residents be provided with a key to their room unless a risk assessment determines otherwise.
Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 22 We also recommended that each resident be provided with a lockable place in their bedroom for the storage of valuables such as money or jewellery. When we viewed the garden area we noted that in parts, it had become overgrown and required attention. The manager explained that there had been some issues with the landscaping which had caused this problem. She was in the process of arranging for the necessary work to be carried out to improve the area. The home has a well equipped laundry and comprehensive procedures in place giving staff guidance in infection control. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 23 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. The home has a thorough recruitment procedure in place to ensure that only suitable people are recruited to work with residents. This procedure needs to be extended to all new staff members to fully protect residents. EVIDENCE: We viewed a selection of staff files which were well organised and contained the necessary information such as original application forms and full employment histories. We also noted that the necessary background checks had been carried out for the majority of staff including references and Criminal Record Bureau checks. However, two files viewed did not contain Criminal Records Bureau checks although they did have police clearance checks which had been carried out in the country that the staff member had moved from. This issue was discussed with the manager and following these discussions we were satisfied that this shortfall had occurred due to a genuine misinterpretation of the regulations. We made a requirement that Criminal
Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 24 Records Bureau disclosures be obtained for the two staff members in question as soon as possible. There are procedures in place to involve residents in the recruitment of new staff. Currently residents are asked to take part in setting interview questions for prospective staff members. Discussion took place as to how this could be developed further. We recommended that consideration be given to involving residents in interviews. There is a good approach to training at this home with staff being provided with a standard induction which is in line with Skills for Care standards. Ongoing training includes all mandatory areas such as moving and handling and first aid as well as additional courses such as person centred planning. Currently there are 8 staff members who hold National Vocational Qualifications in care at level 2 or above. The home is falling slightly short of the recommended 50 at this point in time, however all the remaining staff team are currently undertaking the qualification. All the staff that we spoke to demonstrated a good understanding of their role and said that they enjoyed working at the home. In addition, staff members told us that there was a good sense of teamwork at the home and spoke highly of the manager, describing her as very supportive and approachable. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This a well managed home which is run in the best interests of residents. EVIDENCE: The homes registered manager has extensive experience in working with people with learning disabilities as well as a number of relevant qualifications including the Registered Manager’s Award. Throughout our visit she demonstrated a very good knowledge of her role as well as an obvious commitment to providing a good quality service. The office was very well organised with all required documentation and records in place and well maintained.
Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 26 All the staff we spoke to felt very well supported and said that the manager was very approachable. In addition, staff we consulted confirmed that they were provided with one to one supervision on a regular basis. There is a good approach to quality assurance with a number of measures in place to assist the manager in monitoring all areas of the service. Such measures include regular audits, self assessments and resident satisfaction surveys. An unannounced visit is made to the home by one of the owners on a monthly basis. The Commission for Social Care Inspection regularly receive reports of these visits which demonstrate that residents and staff are consulted throughout them. Following the last inspection, procedures have been put in place to ensure that any incidents which are notifiable under regulation 37 of the Care Home Regulations, 2001 are reported to the commission without delay. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 3 2 3 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 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x x 3 Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 28 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. 1. Standard YA34 Regulation 19 Requirement Criminal Records Bureau checks must be carried out prior to any staff member staring work in the home. Timescale for action 27/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5.
Veedale Refer to Standard YA1 YA22 YA12 YA24 YA24 Good Practice Recommendations The Service User Guide should be provided in video format. The complaints procedure should be provided in video format. Residents should be given the opportunity to be involved in the grocery shopping for the home. All residents should be provided with a key to their room unless a risk assessment determines otherwise. All residents should be provided with a lockable space in
DS0000065017.V338687.R01.S.doc Version 5.2 Page 29 6. 7. YA24 YA19 their bedroom for the storage of valuables. Intercoms/listening devices should only be used as a last resort and after risk assessments and consultation with significant others. In relation to health care tasks, there should be a formal written agreement in place with the local primary care trust which details the responsibilities for assessing quality and training staff. Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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. Extracts may not be used or reproduced without the express permission of CSCI Veedale DS0000065017.V338687.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
