Inspection on 13/09/06 for Ventana

This inspection was carried out on 13th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ventana 30/09/08

Ventana 10/09/07

Ventana 05/10/05

Ventana 03/05/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Ventana 33 Florence Road Boscombe Bournemouth Dorset BH5 1HJ Lead Inspector Stephanie Omosevwerha Key Unannounced Inspection 13 September 2006 10:00 th Ventana DS0000061762.V304072.R02.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 Ventana DS0000061762.V304072.R02.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. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ventana Address 33 Florence Road Boscombe Bournemouth Dorset BH5 1HJ 01202 390209 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) Ventana Homes Ltd Mr Paul Anthony Greenwood Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To be staffed according to Residential Forum Calculation for care hours. All staff to be awake when on duty. Date of last inspection 5th October 2005 Brief Description of the Service: Ventana is a home for up to 8 younger (18-65 years) adults of both sexes, with learning disabilities and who may also have a physical disability. The home is situated in a residential area with 5 minutes easy level walk of the shopping centre at Boscombe, which has good public transport links to other places including Bournemouth and Christchurch town centre. The building is a large detached family house converted for use as a care home. There is a small garden. The building is accessible for service users using a wheelchair and has a wheelchair ramp from the main entrance into the communal hall. Accommodation for service users is provided on the ground and first floors and all service users have single rooms with ensuite facilities. The communal space comprises of a large lounge/diner, a conservatory, a kitchen/diner, a quiet space on the landing upstairs, 3WCs and a bathroom. All ground floor facilities are accessible to those using a wheelchair and the ground floor bedrooms have aids and adaptations suitable for service users with physical disabilities. The first floor rooms are only accessible to those who are ambulant, however grab rails are provided up the stairs. The home is well maintained and decorated and furnished to a high standard. The home is staffed 24 hours a day and provides a range of day time activities both on the premises e.g. art/crafts, small animal care, gardening and in the community e.g. swimming, visiting local shops/cafes/pubs. Current fees provided on 13/09/06 are between £900 and £1500 per week, which is inclusive of day care provision. Fees do not include personal items such as toiletries, hairdressing, cigarettes and sweets. For further information on fee levels and fair terms of contracts you are advised to referred to the Office of Fair Trading website www.oft.gov.uk. The home keeps copies of all inspection reports that are available in the office and can be seen by service users, relatives and professionals at their request. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection of the home and took place over approximately 7 hours. It was carried out as part of the planned inspection programme for care homes undertaken by CSCI and to address the requirements and recommendations made at the previous inspection. This inspection was a key inspection and therefore, assessed all identified key national minimum standards for care homes for adults (18-65). The inspector initially spent time with the registered manager of the home and examined various records and documentation including care plans, risk assessments, staffing records, medication records, health and safety and maintenance records. The inspector conducted a tour of the premises viewing all communal areas of the home and a sample of two service users’ bedrooms. The inspector had the opportunity to talk to two residents and observed other residents during the day who had limited verbal communication skills. The inspector also spoke to the deputy manager and two members of care staff who were on duty. Additional information received by the inspector prior to the inspection was also taken into account. This included a pre-inspection questionnaire completed by the deputy home manager, 4 relative surveys and 4 professional surveys. Feedback from surveys was all positive and included comments such as “we are completed satisfied with the care provided for our (relative) by all at Ventana” and “we are always invited to reviews and have found everyone very helpful”. Other information such as information gathered at previous inspections, monthly monitoring visit reports from the responsible individual of the home and any notification made under Regulation 37 of the Care Homes Regulations 2001 was also included when making judgements about the quality of service. What the service does well: The home benefits from an experience and well-qualified manager. Staff are well supported and are encouraged to put forward ideas and suggestions. This enabling style of management means staff are enthusiastic and motivated feeling they can make a real contribution to service development. Staff are offered a range of training courses and said their experience of induction in the home was excellent. They were not rushed and only took on more responsibilities when they felt competent to do so. There is a high level of interaction between staff and service users in the home. Service users benefit from staff who know their care needs well and it is clear good relationships have been formed. Feedback from service users Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 6 was positive and they said they enjoyed many aspects of living the home including their rooms, the food, the staff and the activities provided. The home has good procedures in place for admitting new service users to the home that give prospective residents good opportunities to test drive the service and feel confident their needs will be met by the home. Service users living in the home have a range of needs including more complex physical and mental health needs. The home liaises well with healthcare professionals to ensure specialist input is carried out as appropriate. Staff work hard to ensure all service users have choices in their daily lives. Residents are treated respectfully and personal care is carried out in a sensitive way promoting service users’ dignity and privacy. Ventana is decorated and furnished to a high standard offering service users a comfortable and homely environment. The home is conveniently located near to the local shops and amenities of Boscombe and service users are able to access the community on a regular basis ensuring service users have a range of social, leisure and educational opportunities. What has improved since the last inspection? What they could do better: There have been some breaches in staff recruitment procedures that need to be addressed to ensure good standards of recruitment are maintained and to safeguard the welfare of service users in the home. As a minimum a member of staff must have 2 written references and a POVA first check prior to commencing work in the home. If a full enhanced CRB has not been received the member of staff must be supervised by a designated person on the rota until a satisfactory CRB check is obtained. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 7 The home is able to provide healthcare for service users with more complex physical and mental health needs, however, they need to ensure that appointments for basic healthcare needs are also carried out for all service users as identified on their care plans. The home has a quality monitoring system in place, however, they must produce a development plan on an annual basis setting out action points/targets to identify further improvement that could be made to the quality of service in the home. The home’s current written strategies for managing risks are limited and more consideration needs to be given to providing an assessment framework that promotes and extends service user independent living skills. It is important that where restrictions are necessary these are clearly evidenced by a written risk assessment and that these are regularly reviewed to ensure service user have the opportunities to learn new skills. Some minor improvements to care plans were advised to give a more comprehensive picture of service users care needs. Further minor recommendations included medication is signed and dated when it is opened to avoid duplication, a copy of the Department of Health “No Secrets” guidance is kept in the home, and a record is kept of the times of fire drills to ensure these take place at different times of the day. 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. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home considers its ability to meet prospective service users needs based on professional assessments and appropriate introductory procedures are in place to let service users “test drive” the service. EVIDENCE: There had been one service user admitted to the home since the previous inspection. Examination of this resident’s file showed there was a care management assessment in place. The home had also completed their own moving in assessment to ensure they could meet the service users care needs. The service user had been given the opportunity to make introductory visits to the home prior to moving in, including one overnight visit. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have care plans that reflect their needs and ensure they are appropriately support by members of staff. Staff promote service users choices ensuring they are able to make decisions about various aspects of their daily lives. Written strategies for managing risks are limited and more consideration needs to be given to providing an assessment framework that promotes and extends service user independent living skills. EVIDENCE: A sample of two resident’s personal files was case tracked as part of the inspection. Both service users had person centred plans that identified most of their care needs and the support they required. At the last inspection it had been recommended that information was included on residents’ abilities to Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 11 manage aspects of their care such as finances and medication. This had not been fully implemented. When resident’s need support with these tasks it should be stated on their care plans in order that this can be reviewed to see if service users can work towards gaining more independent skills in these areas. Service users goals had been recorded on their care plan such as improving communication skills and independent living skills. There was further guidance for staff to give them strategies for managing behaviour such as agitation. Staff spoken with during the inspection demonstrated a good knowledge of service users needs and personal preferences. Discussion with service users during the inspection confirmed they were able to make decisions in their daily lives. This included decisions about activities, visits to family and friends, personal appearances and the style and contents of their bedrooms. Observation of practice showed that service users were offered choices by members of staff including what activities they wanted to participate in and choices about food and drink. Information about local advocacy groups is prominently displayed in the home and service users are encouraged to attend local groups where appropriate. The home has a risk assessment file, however, previous inspections have assessed this as being limited. There was evidence some reviews had been carried out but the home still needs to consider how to improve their risk management strategies to ensure service users are not unnecessarily restricted in their daily lives. For example, one resident had been assessed as unable to leave the home at all times without a member of staff in 2003, although the risk assessment had been reviewed it was still considered appropriate. However, the manager told the inspector that the service user could in fact walk to the local shop and back by himself. It is important that where restrictions are necessary these are clearly evidenced by a written risk assessment and that these are regularly reviewed to ensure service user have the opportunities to learn new skills and increase their independence in a framework designed to manage and minimise risks. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have an appropriate programme of activities and are encouraged to access the local community on a daily basis ensuring service users have a range of social, leisure and educational opportunities. The home is sensitive to and supportive of service users personal relationships and family/friends are welcomed into the home. Service users’ rights are respected and independence, choice and freedom of movement are promoted in the home. The home provides a balanced and varied selection of food that meets service users tastes and choices. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 13 EVIDENCE: Each service user had a weekly plan recorded on their personal files. A range of activities were offered with some residents attending a day centre or college and others following an in-house programme including activities such as swimming, shopping, arts and crafts and accessing local leisure amenities. There were opportunities to access the local community and service users told the inspector they visited the local shops, cafes, pubs, beaches and leisure centres. There was evidence of good liaison with relatives and all family details were recorded on service users files including contact details and birthdays. Service users could make regular visits to their families and friends and family were welcome to visit the home. Discussion with service users confirmed they had regular contact with their relatives. Service users rights were recognised and their responsibilities to domestic tasks were identified on their care plans. Observation during the inspection showed service users had opportunities to help in the kitchen, clean their bedroom and do their laundry with staff support where appropriate. Some service users had keys to their rooms; however, it was previously recommended that it be recorded in their files when it had been assessed that they were unable to use a key and therefore, what arrangements were in place to safeguard service users’ property/privacy. This had not been carried out and is repeated in this report. Observation throughout the inspection showed that staff interacted fully with service users who were treated with respect. Service users were seen to have unrestricted access to all communal areas of the home and could choose to spend time in the privacy of their rooms. A sample of menus was viewed as part of the inspection. These were found to be varied and nutritious. The manager said residents were involved in the planning of the menu and picture formats were used to assist service users in making choices. Healthy eating was promoted in the home and special diets catered for such as managing Type 2 Diabetes through diet. Residents spoken with told the inspector that they liked the food and there were “plenty of fresh fruit and vegetables” available. They said the staff mainly cooked although they were encouraged to help with preparations and make drinks and snacks when appropriate. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Personal care is offered in a sensitive way that respects service users privacy and personal preferences. The home is able to provide healthcare for service users with more complex physical and mental health needs. However, they need to ensure that appointments for basic healthcare needs are also carried out for all service users. The administration of medication is generally well managed in the home promoting the service users’ health. EVIDENCE: Service users personal care needs were noted in the care plans. Service users’ likes and dislikes were recorded and discussion service users confirmed times for getting up/going to bed, baths and meals were flexible. Observation of practice in the home showed staff undertook personal care tasks in a sensitive way respecting individual’s privacy. The home operates a system of Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 15 designated keyworkers to provide consistency and continuity of support to service users. Staff spoken with during the inspection demonstrated a good understanding of the personal and healthcare needs of service users living in the home. Each service users physical and mental health needs are identified in their individual care plans and a record of any medication is listed. In addition there is further guidance to staff about the management of particular medical conditions such as diabetes. Service users have copies of the personal health records (yellow books) that also list their up-to-date needs and a record of any appointments with healthcare professionals. The inspector noted that one service user’s care plan identified they needed appointments arranged for their hearing, eyesight and general health check, however, there was no evidence that this had been followed up. The other service user that was case tracked had attended appointments as appropriate. The home needs to ensure that all service users attend appointments as identified in their personal care plans. There was evidence that the home liaised with healthcare professionals where appropriated. For example support from a psychologist to provide strategies of intervention for dealing with “challenging” behaviour. The home has a written policy and procedure for the administration of medication. Medicines are kept securely in a locked cupboard. A monitored dosage system is used and records were checked and found to be mainly accurate and up-to-date. One minor error was noted but this was addressed with the member of staff on the day of the inspection and found to be an oversight in recording and not a medication error. The inspector found 2 boxes of nasal spray had been opened and used for one service user. It is recommended that medication is signed and dated when it is opened to avoid duplication. This also facilitates monitoring of medication to ensure it is not out of date. Staff receive training in the administration of medication and are only given the responsibility after completing an assessment of competence, which is signed off by the manager. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a clear complaints procedure and service users are encouraged to express their views about the home. The home has satisfactory arrangements in place to ensure that staff are aware of adult protection issues providing a safe environment to protect service users from abuse. EVIDENCE: The home has a complaints procedure that complies with the regulations. A copy is available in an accessible format and this is placed on the office door where all service users can view it. Information about advocacy services is also available in the home and service users are enabled to access this service to help them express their views. Service users informed the inspector that they were aware of how to complain and felt confident about approaching members of staff. A record book is kept of all complaints, which was checked, and there had been no complaints since the previous inspection. The home has policies and procedures in place for protecting vulnerable adults including Protection and Prevention of Abuse, Bullying, Aggression to Staff and Whistleblowing. Whilst the manager is aware of the “No Secrets” guidance, a copy of this was not available in the home on the day of the inspection. It is recommended that a copy be kept in the home so staff can refer to it if necessary. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 17 Staff are made aware of the policies as part of their induction and are required to sign to indicate that the have read and understood them. Staff spoken with were clearly aware of the procedures and demonstrated a good knowledge of how they would be put into practice. Since the last inspection staff have attended a training course in an introduction to adult protection run by the local authority. Staff have also received some training on physical intervention and one of the proprietors has trained as a tutor in control and restraint techniques. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Further investment to the environment ensures the home maintains a good standard of décor providing residents with an attractive and homely environment. The standard of cleanliness is good with procedures in place to prevent the spread of infection providing service users with a hygienic environment. EVIDENCE: A tour of the premises was carried out as part of the inspection including all communal areas of the home and a sample of 2 service users bedrooms. The premises were well maintained and decorated in a homely way that was suitable for its stated purpose, i.e. providing care and support to adults with learning disabilities. The home has a large, comfortable lounge and a kitchen with a dining area. Since the previous inspection, a conservatory room has been finished providing additional communal space. This has French doors Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 19 that open onto a newly built patio area and the garden. Attached to the conservatory is a new separate laundry room and the home have recently purchased a new industrial washing machine. The hall and lounge had been re-carpeted and there was new flooring in the kitchen. Service users were observed to have unrestricted access to all communal rooms in the home and told the inspector they liked their living environment. Service users bedrooms were clearly individual reflecting the personalities of the occupants. This was clear from the colour choices of the rooms, the furniture and the personal possessions inside. Residents expressed a high degree of satisfaction about their rooms. On the day of the inspection the home was seen to be clean, hygienic and free from offensive odours. A policy and procedure was seen for the control of infection and staff had attended training courses on this topic. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home has a well qualified workforce and service users have confidence in the skills and experience of the care workers. There have been some breaches in staff recruitment procedures that need to be addressed to ensure good standards of recruitment are maintained and to safeguard the welfare of service users in the home. The home provides training courses that equip staff with skills and knowledge they need to meet service users’ care needs. EVIDENCE: The home currently employs 11 members of care staff who have a range of skills and experience. There is a mix of male and female staff and most staff had previous experience of working in social care. There are currently 6 members of staff who hold a qualification of NVQ level 2 or above. Rotas showed that there were at least 3 members of staff working throughout the day with one waking staff at night. The staff skill mix was such that there was always an experienced member of staff on duty on each shift. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 21 Staff spoken with during the inspection had a good understanding of their roles and of the homes aims and values. They said they enjoyed working in the home and observation throughout the day showed excellent relationships had been developed between staff and service users. The home has a policy for the recruitment of staff. As part of the inspection a sample of 3 staff records was seen. The inspector noted there had been a breach in the regulations as 2 members of staff had commenced employment prior to the receipt of satisfactory CRB checks and written references. Although this documentation was in place, this should have been obtained prior to the members of staff commencing employment. The manager stated that he had not carried out these checks immediately as the staff had been recommended by an employment agency who had previously carried out these checks. However, these documents are no longer transferable and it is the home’s responsibility to obtain these documents prior to employing members of staff. As a minimum a member of staff must have 2 written references and a POVA first check prior to commencing work in the home. If a full enhanced CRB has not been received the member of staff must be supervised by a designated person on the rota until a satisfactory CRB check is obtained. Staff have access to a range of courses and certificates are held on a staff training file. The manager monitors the training in the home and ensures staff up-date statutory training as necessary. In addition to courses in fire training, first aid, manual handling, medication, adult protection and food hygiene, staff have had the opportunity to undertake courses linked to the specialist needs of service users such as Makaton, challenging behaviour and epilepsy. The manager has set up an in-house induction programme that covers topics such as the aims of the home, fire precautions, health and safety and the care of the residents. The inspector informed the manager about the new guidance from skills for care setting out standards for a new 12-week induction programme and advised the manager to ensure his current induction was updated if necessary to accommodate this. Staff told the inspector they felt they had good access to training and that they felt the induction was thorough and set at a pace to ensure they felt confident and well supported. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home benefits from an experienced and well-qualified manager whose style of management encourages both service users and staff to contribute towards service development. Systems are in place for monitoring the quality of the service and gaining feedback from service users. This now needs to be included in a formal plan setting out aims and objectives for future service development. Management and practices in the home ensure that the health and safety of service users is promoted and protected. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 23 EVIDENCE: Paul Greenwood is the registered manager of Ventana. He is a qualified Learning Disability nurse and has substantial experience of working with adults with learning disabilities. There was evidence from discussion that he keeps up-to-date with current legislation and good practice issues. There was further evidence that he was up-dating his training and he had completed courses in Makaton, Manual Handling and Epilepsy since the last inspection. He was also booked to go on an Adult Protection course the week following the inspection. Staff told the inspector they felt well supported by the management and able contribute ideas towards the development of the service. Service users benefited from a good relationship with the manager and observation showed he was accessible and approachable. The registered manager has produced an annual quality monitoring audit and development plan which is designed to measure how well the service is meeting identified needs focussing on user centred practice. A service development plan had been drawn up in January 2005, however, this should be done on an annual basis. A recent service user survey had been carried out and the results were available for inspection. This now needs to be collated and incorporated into an annual development plan setting out the service’s aims and objectives for the forthcoming year. Reports from the Dorset Fire and Rescue Service and the Environmental Health Department confirm the home meets their requirements. Records showed that services and equipment was being inspected at the required intervals. Records of fire drills and safety checks were up-to-date, although it recommended that the times of fire drills were recorded to ensure these took place at various times of the day. The Manager is aware of the relevant legislation regarding health and safety and policies and procedures reflected this. Certificates were in place confirming staff had undertaken various courses in safe working practices and observation of practice throughout the inspection demonstrated staff followed correct procedures. There was a “Health and Safety Assessment Policy” and risk assessments had been undertaken e.g. fire risk assessment and radiator risk assessment. Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 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 2 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 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 2 X X 2 X Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO 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 YA19 Regulation 13 Requirement The home needs to ensure that all service users attend health care appointments as identified in their personal care plans. The registered person must obtain all information and documentation as specified in Schedule 2 of the Care Homes Regulations 2001 prior to care workers commencing employment in the home. Specifically POVA first checks and 2 written references. The registered person must produce a development plan on an annual basis setting out action points/targets to identify further improvement that could be made to the quality of service in the home. Timescale for action 31/12/06 2. YA34 19 30/11/06 3. YA39 24 31/12/06 Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations It is recommended that additional information such as service users’ abilities to manage their finances and medication are included in service users care plans to identify the support they require in these areas. It is recommended that where restrictions are necessary these are clearly evidenced by a written risk assessment and that these are regularly reviewed to ensure service user have the opportunities to learn new skills and increase their independence in a framework designed to manage and minimise risks. It is recommended that it be recorded in service user files when it had been assessed that they were unable to use a key and therefore, what arrangements were in place to safeguard service users’ property/privacy. It is recommended that medication is signed and dated when it is opened to avoid duplication. This also facilitates monitoring of medication to ensure it is not out of date. It is recommended that a copy of the Department of Health guidance “No Secrets” be kept in the home so staff can refer to it if necessary. It is recommended that the times of fire drills are recorded to ensure these take place at various times of the day. 2. YA9 3. YA16 4. 5. 6. YA20 YA23 YA42 Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ventana DS0000061762.V304072.R02.S.doc Version 5.2 Page 28 - 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. 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