Inspection on 04/08/06 for Wade Bungalow Residential Home

This inspection was carried out on 4th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wade Bungalow Residential Home 21/02/06

Wade Bungalow Residential Home 17/10/05

Wade Bungalow Residential Home 18/01/05

Wade Bungalow Residential Home 23/08/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Wade Bungalow Residential Home Wade Bungalow Residential Home The Pightle Needham Market Suffolk IP6 8AQ Lead Inspector Deborah Seddon Announced Inspection 4th August 2006 10:00 Wade Bungalow Residential Home DS0000024518.V299365.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 Wade Bungalow Residential Home DS0000024518.V299365.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. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wade Bungalow Residential Home Address Wade Bungalow Residential Home The Pightle Needham Market Suffolk IP6 8AQ 01449 722681 01449 723762 h2002@mencap.org.uk www.mencap.org.uk Royal Mencap Society 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) Miss Marleen Van Marcke Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Wade Bungalow was opened in 1992 for four service users with a learning disability. The bungalow is spacious, with four bedrooms, two bathrooms and an additional toilet. There are three communal rooms; one large sitting room, a music room and a smaller sitting room with access to the rear garden. The kitchen is also in the dining area and a separate utility area is provided. There are gardens on three sides of the building. The staff office contains a bed for staff undertaking sleeping in duties. Wade Bungalow is situated in a cul-de-sac close to the centre of Needham Market and is close to shops, pubs. Churches and other local amenities. Local transport is within easy access for routes to Ipswich, Stowmarket and Bury St Edmunds. The home has a detailed statement of purpose and service users guide. These documents provide information about the service and give details to prospective service users how to obtain a summary of the most recent Commission for Social Care Inspection (CSCI) report. The property is owned and structurally maintained by Sanctuary Housing Association and Mencap provides the direct care. Each service user is provided with a licence to occupy setting out their basic rights and responsibilities with the housing association and Mencap. Service users pay rent to Mencap to live in the home. The current rent charged is £62.35 per week. The gross weekly fees vary for each individual service user, fees range from £303.53 to £328.06. Not included in these fees are service users own personal items such as toiletries, clothes, personal electrical equipment, personal leisure activities and meals outside of the home. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an announced on a weekday starting at 9.30am and lasted eight and half hours. This was a key inspection, which focused on the core standards relating to adults, aged 18-65. The report has been written using accumulated evidence gathered prior to and during the inspection, including information obtained from the residents ‘Have your say about’ comment cards. The home’s Statement of Purpose and Service Users Guide were reviewed and a number of records held including those relating to service users, staff, training, health and safety records and policies and procedures. Time was spent with two service users, the area manager, manager, two staff and a relative who was visiting during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The service user guide needs to be redesigned in a format that the service users can read and understand. Risk assessments need to be undertaken and recorded in a way that promotes the service users independence and not be restrictive. Currently assessments identify the risks and process for minimising hazards, however they do not give sufficient detail of the support and action required to promote the service users involvement in their chosen activity. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 6 Action must be taken to remove the risk of service users being scolded by the hot water supply in two of the service users bedrooms and the bathroom where water temperatures are in excess of the recommended 43 degrees centigrade. To prevent the spread of infection hand towels need to be replaced with paper towels in all bathrooms and toilets in the home. A risk assessment of the security of the premises and safe keeping of money and valuables must be completed and actions taken to protect the health and safety of the service users and staff. 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. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1.2.3.4.5. Quality in this outcome area is good. Prospective service users can expect to be fully consulted and receive information about the home before making a decision about where they live, however the Service User Guide needs to be redesigned in a suitable format to meet their individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence for these standards has not changed since the previous inspection. There have been no changes to the occupancy at Wade Bungalow. The home is still registered for four service users with learning difficulties. The complex behavioural needs of one resident have restricted the home taking in a fourth service user. The frequency and duration of incidents of behaviour increased when the new manager and new staff were introduced to the home, this was as a result of disruption to their usual routine. Discussions with the manager and staff and the reduction in the number of incident reports reflect that the service users behaviour is being managed as detailed in their behavioural support plan. The Statement of Purpose and Service Users Guide were reviewed, these need to be updated to reflect the new manager and current rent payable and rate of fees charged by the home. The Service User Guide needs to be redesigned into a format that prospective and current service users can understand. Each service user has been issued with a copy of the complaints procedure on audiotape. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 9 The area manager informed the inspector that Social Services and Mencap are still in the process of evaluating the service and service users with regards to de registering the service and moving towards a supported living scheme. Once this has been established Mencap intend to review Wade Bungalow with regards to the compatibility of the service users that remain living in the home. The statement of purpose has a very detailed account of selection of residents, application and assessment and a trial period before agreeing a permanent placement, however it has not been possible to assess standards 2 and 3 as there are no new needs assessments to review. The fact that the there has been a reluctance to admit another person into the home demonstrates that the management team and staff are aware of the responsibility of meeting the needs of service users. Also the service manager and manager were very clear that the introduction of another service user into the home will have to be carried out sympathetically. The characteristics of the service users remaining in the home will need to be taken into account and a very gradual introduction made of any new service user, which would include visits to the home and short stays. Evidence of a tenancy agreement (licence to occupy) was seen on one service users file outlining the responsibility of the housing association and Mencap. This document had been produced in a pictorial format called ‘a basic guide to your tenancy or licence agreement’. This agreement had been signed and dated by the service user. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9, Quality in this outcome area is good. Service users can expect to have their needs assessed and have behavioural management plans which identify where they require support to protect themselves and other people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans of two service users were tracked during the inspection. Full and comprehensive care plans are in place, which cover all aspects of their health, personal and social care. Although the care plans were very detailed they contained a lot of out of date information. This was discussed with the manager who informed the inspector that staff had recently attended Person Centred Planning training. Each of the service users key workers will be working with them to implement new care plans based on the Person Centred Planning approach. Old information is to be removed from the existing care plans and archived. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 11 Each of the service users has support plans in place identifying the level of support required to enable them to undertake specific tasks. For example, one service user has a plan in place to make their own sandwiches. Each of the identified tasks are linked to a risk assessment. The risks assessments seen identified the risks and hazards but limited the actions that promoted the service users independence. A new format needs to be introduced to reflect where service users are able to take responsible risks and the actions that will support them to achieve their goals. Evidence was seen on both care plans that behavioural management plans are in place, which focus on positive behaviour to minimise the number of incidents where their behaviour may prove a significant risk to themselves or the other service users. For example, one service user has recently had a review of their medication, a support plan has been introduced which includes strategies to support them through this change and to cope with unexplained changes in their behaviour. The plan has been written with the service user and describes how they want staff to support them. Their goal is to get through this period of reducing their medication so that they will benefit from an improvement in their quality of life and be able to achieve more on a daily basis. Due to the complexities of the individual needs of the service users they need support to manage their finances. A financial folder and personal money records of all transactions are maintained. The folders and balances of each of the service users money was checked and found to be accurate. The financial folders showed that service users are in receipt of benefits including disability living allowance (DLA), income support and severe disability allowance (SDA). Time was spent talking with a member of staff and one of the service users on their return from day care. Evidence was seen that service users are supported to make everyday decisions about their lifestyle. The service user was asked what they wanted for their tea, they made a choice of omelette but also requested to go out for the evening to the pub, and agreed a time with the carer. Additionally the area manager informed the inspector that all three of the service users are booked to attend a training session on what Person Centred Planning means. A morning session has been arranged at a local hotel on 26th August 2006 where the service users will discuss their life history, complete a life map and focus on a lifestyle plan using materials such as pictures of activities to help them make their own choices. From this session each service user will devise their own action plan to be used as part of their new person centred care plan. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16, Quality in this outcome area is good. Service users can expect that they will have their rights respected and be supported to take part in appropriate leisure activities within the local community and have the opportunity to mix with other adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are supported to access opportunities for further development. As previously mentioned the service users are being involved in a training session for Person Centred Planning. Another service user had a certificate of attendance for a course on personal relationships, which they had completed in November 2005 whilst at the Stowmarket Resource Centre. Two service users attend the Stowmarket Resource Centre on a daily basis Monday to Friday. Each has a pictorial and written timetable of the week’s activities. One of the service users spoken with confirmed that they had taken part in a core group activity, art group and a relaxation and sensory session in line with their activity programme. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 13 Another service user continues to receive additional funding to provide them with one to one day care support. During the inspection they had a hair appointment at a local hairdressers and then an appointment at a beauty salon to have a massage. The service user appeared happy and excited about the forthcoming weekend as they were going to spend the weekend with a relative for a family celebration. Two members of staff share the day care hours and have implemented an activities programme, which is reviewed with the service user on a regular basis to include activities such as swimming and a Jacuzzi. The service user likes travelling on public transport to visit other towns, such as Cambridge, Norwich and Ipswich. Some of the day care hours are also used to spend time at home supporting the service user to undertake domestic tasks such as cleaning their room. With the exception of other service users bedrooms service users are free to move around the home. However due to the routine agreed as part of the behavioural plan to support one resident when returning to the home after day care the other service users are encouraged not to enter the lounge until the service user has had time to relax. This was discussed with the manager and a member of staff that this disadvantaged the other service users by not having the freedom to access the lounge. In recognition of this a relief member of staff is employed between the hours of 4-8pm to provide additional support. This has been working well, as each service user has individual one to one attention during this time. Staff commented that there have been improvements in service users behaviours and all service users have spent time socialising together in the lounge. There has also been times where all three service users have been out as a group, for Sunday lunch, a day trip to Shotley and to the local pubs and coffees shops. The service users are well known within the community of Needham Market where one service user chooses to attend the local Methodist Church on a regular basis. Evidence was seen that service users are supported to maintain links with their family and friends. A relative of one of the service users arrived during the inspection and spent time talking with the inspector. They were very satisfied with the care their relative received at the home. They were particularly impressed with the good active social life they had and commented “my [relative] is never in when I ring”. Service users have the opportunity to spend time on their own in their rooms if they choose, they can lock their bedroom doors for privacy, staff have a master key to override the locks in an emergency. Service users take it in turns to choose the evening meal. The home has a cookbook with the pictures of each dish so that service users can make an informed choice of which meal they want. The fridge and cupboards seen held a good stock and variety of food. A member of staff is responsible for overseeing the weekly menu choices to ensure they meet the specific dietary requirements of each service user. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21, Quality in this outcome area is good. Service users can expect to have their personal and physical needs met as identified by them and according to their assessment plans. Service users can also expect to have good access to healthcare services. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Full and comprehensive care plans are in place for each service user, which cover all aspects of their health and personal care. Support plans identify individual tasks, for example bathing, cleaning my room and medication and include detailed instructions on service users preferences, likes and dislikes which are linked into their behaviour management plans. Records are kept of visits to the general practitioner (GP) and other health professionals. All service users are registered and have access to the doctor’s surgery in Needham Market. A record of visits to the GP was seen in one service users care plan. They had recently seen the GP for a review of their medication. The service user has been taking the medication for many years; the consultant has advised that the reduction in the medication will improve their quality of life in the future. However in the mean time the service user is having some problems adjusting to withdrawal of the medication and has been displaying some ritualistic and intimidating behaviour. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 15 To help support the service user and the staff the consultant has made a referral to the intensive support team, a community-based service, which specialises in behavioural modification and support plans. Evidence was seen that regular health checks are undertaken, one service user has yearly blood tests to test for toxic levels and renal function. The service users weight was also being monitored. The service user was being encouraged to eat a healthy low fat and low cholesterol diet. Their weight record showed that since January 2005 they have lost 3 stones in weight. In conjunction with healthy diet the service user has had support from a physiotherapist who had put together an exercise plan to help manage their weight and help improve their mobility. Due to the high and complex needs of the service users none of them self medicate. Medication is kept locked in the manager’s and staff office. The home uses the monitored dosage system (MDS). The medication Administration Record (MAR) charts were seen and found to contain no gaps in staff signatures. At the front of each service users MAR charts is a pen picture, describing the medication, why the service user took it and when and the possible side effects. At the front of the medication folder there is a copy of the procedures for the control and use of medicines produced by Mencap. The policy covered the arrangements for the safe ordering and returns of unused or soiled medication. One care plan seen had details of service users wishes in the event of their death. The issues around what would happen to their bodies when they died had been explained and discussed with the service user and recorded in their care plan. Another care plan reflected the service users wishes to have a local service and burial. Wade Bungalow Residential Home DS0000024518.V299365.R01.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): 22,23, Quality in this outcome area is good. The home has a clear policy and procedure in place for making complaints and dealing with allegations or suspicions of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of Mencap’s complaints procedure is made available to the service users and their relatives in the service User Guide. The inspector was informed that each service user had been issued with an audiotape of the complaints procedure. A relative spoken with had not had any reason to make a complaint but was aware of the complaints procedure. The complaints book was seen; there have been no complaints received by the home or at the Commission for Social Care Inspection (CSCI) since October 2003. The organisation’s policy and procedure are very clear and detailed on staff’s responsibility to report allegations or suspicions of abuse, which includes informing the local authority vulnerable adult protection committee and commission for social care inspection (CSCI). A recent incident of theft of service users money was reported in line with the procedure the area manager. The appropriate agencies were notified of the incident and an investigation into the circumstances is in process, the area manager provided the inspector with evidence that a Protection of Vulnerable Adults referral was made. All staff attended protection of vulnerable adults training in January 2006. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 17 Evidence was seen that four staff had attended a level 4 re accreditation day in May 2006 for Unisafe training. The training gives staff the skills to deal with service users where physical intervention may be required. The home does not use restraint as an option although they do have a series of agreed intervention techniques. Incident reports reflected that staff applied deescalation techniques where appropriate and as described in their behaviour plan in line with Unisafe training. Wade Bungalow Residential Home DS0000024518.V299365.R01.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): 24,25,26,27,28,30, Quality in this outcome area is adequate. Service users can expect to live in a welcoming environment, which provides a good range of personal and communal space. However, action must be taken to ensure service user safety with regards to hot water temperatures and the security of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a purpose built bungalow. It offers good-sized accommodation with enough communal and private space for service users to spend time on their own or be involved in a group activity. There are three sitting areas; these are well furnished with comfortable sofas and armchairs. All lounges are equipped with entertainment including television and music systems. Service users have their own rooms, which are decorated and personalised to reflect their individual tastes. Since the last inspection, the lounge and hallway have been redecorated. New furniture to replace the suites in the lounge and sitting room has been purchased. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 19 The kitchen has been redecorated and new kitchen cupboards have been fitted. The bungalow has enclosed gardens with a patio area for barbeques in the summer months. The home was planning a bar-b-que for the coming weekend to celebrate a significant birthday of one of the service users. The home has a lot of wear and tear due to the complex behaviours of the service users; generally the home is clean, airy and comfortable. The décor is bright and cheerful with photographs of the service users on display around the home. However the heading tape needs to be repaired on the curtains in the small lounge and the room would benefit from a new carpet, the existing carpet has a lot of stains. The decorative border in the shower room is torn in places and is peeling from the wall. Attention needs to be given to overhead cleaning such as the air vents in the ceilings in the toilets and bathrooms. To prevent the risk of cross infection, terry towels need to be replaced with disposable paper towels in all areas where hand washing facilities are sited in bathrooms, toilets and the laundry. A discussion was held with the manager about the security of the premises following a recent theft of a service user’s money. The manager showed the inspector a key register and raised concerns about the number of front door keys that have been issued to staff and not returned, in particular employees that have left. The area manager agreed that a risk assessment would be undertaken to ensure that safe systems are in place to protect the health and safety of residents and staff. The locks will be replaced and a system will be introduced whereby no staff are issued with individual keys, a central bunch of keys will be held at the home. Wade Bungalow Residential Home DS0000024518.V299365.R01.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): 31,32,33,34,35,36, Quality in this outcome area is good. Service user can expect to be cared for by a staff team who are trained, supported and available in sufficient numbers to meet their needs and are protected by the home’s recruitment procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Wade Bungalow has 7 contracted support workers supported by a team of 5 Mencap relief workers. The staff roster was seen and reflected two members of staff had been on duty on the early and two going up to 3 staff were on the late shift with a member of staff sleeping in. Two members of staff share the day care hours of one service user. The hours are generally between the hours of 9am and 3pm. An additional relief member of staff is now employed between the hours of 4-8pm to provide additional support. Three staff files were inspected; evidence was seen that each member of staff is issued with a job description and role definition, which clearly sets out their roles and responsibilities. One member of staff has been designated as the peer practice supervisor for cascading Unisafe practice techniques. They hold in house training sessions at staff meetings to ensure staff apply the techniques set by Unisafe and as agreed in the service users behavioural plans. They have recently attended Level 4 Unisafe re accreditation training. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 21 The home benefits from being part of a large organisation, which has developed its’ own induction and foundation learning programme for all new staff in line with the sector skills council for social care training. Staff spoken with confirmed that they had taken part in equal opportunities training as part of their induction. Three staff files were inspected; each had a training and development plan for basic training and additional training supporting their ongoing development. Recent training had been undertaken which included fire safety, first aid, moving and handling, challenging behaviour, Unisafe reaccreditation, person centred planning and adult protection. Two members of staff had commenced a National Vocational Qualification (NVQ) Level 3. The manager informed the inspector that additional dates for training had been arranged for first aid, moving and handling and training in disciplinary investigation. There had been no new contracted staff employed since the last inspection in February 2006, however the staff files seen demonstrated that the home had the necessary checks in place for the safe recruitment of staff. All three files looked at had records of the staffs criminal records bureau check (CRB) and relevant documents. A discussion was held with the manager about having a process of renewal of CRB’s to include checks against the Protection of Vulnerable Adults (POVA) list. Although there has not been any new staff employed, one member of staff transferred with the new manager from a previous Mencap scheme. Other staff have been introduced to Wade Bungalow as Mencap relief staff. The manager has produced a Mencap relief and agency pack for senior staff to use to induct staff new to Wade Bungalow of local procedures. The new manager has started to undertake supervisions with staff, this was confirmed looking at the supervision file and records held on staff files. A member of staff spoken with felt supported by the new manager although they had not yet had a formal supervision session. Evidence was seen that staff have received an annual performance and development appraisal setting out objectives for the coming year. Team meetings are held fortnightly, although the manager could not find the minutes of the last meeting during the inspection. Staff had also attended a team-building day with area manager. Wade Bungalow Residential Home DS0000024518.V299365.R01.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): 37,38,39,40,41,42,43, Quality in this outcome area is good. People living in the home can be assured that the home is well managed and run in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Laurinda Woodgate was appointed as the new manager in April 2006. The Commission for Social Care Inspection (CSCI) would be welcome an application from Laurinda to become the registered manager of the home. Laurinda informed the inspector that she is in the process of completing her application to undertake the Registered Managers Award. Staff spoken with have found the new manager to be supportive and approachable. There is a calm and relaxed atmosphere at the home. A discussion took place with the manager about the systems for quality assurance monitoring. Questionnaires were distributed to seek the views of service users and their relatives, and other stakeholders connected with the service to measure how the home meets its objectives. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 23 The area manager provided the inspector with the outcomes of the most recent quality assurance survey undertaken in April 2006. The outcomes measured against areas covering, information, support, health, respect, choice, where you live, activities, safety, adult protection, overall service and support. Ratings in all of these areas were good or very good. The area manager also conducts monthly audits. A copy of their report is forwarded to the Commission for Social care Inspection (CSCI). The last report received in the office was in December 2005. The area manager apologised for not sending the reports and provided copies to the inspector at the inspection. Mencap have issued each home with an improvement action plan. Standards are listed with detailed information on how the home is to meet the standard and what they need to do to improve. Evidence was seen at the inspection that the action plan was being used and updated where improvements had been made. For example a requirement that had been made at the inspection in October 2005 was for staff to receive adult protection training and guidance on the procedure for referring allegations of abuse. Training had taken place in January 2006; this had been reflected in the action plan. Generally the home is well managed and service users health, safety and welfare is protected by the home’s policies and procedures produced by Mencap. These are accessible and held in the manager’s and staff office with the personnel records relating to staff and service users. The fire log book showed that the alarm system had been serviced in May 2006 and the fire fighting equipment had been serviced in July 2006. Regular fire drills were taking place, one took place in June with the service users involvment and another for staff took place in July 2006. Weekly fire tests and emergency lighting are undertaken. Records showed that monthly electrical checks are undertaken. However, water temperatures were tested at random, a high temperature of 46 degrees centigrade was found in one service users room, further testing of the water temperatures reflected that the hot water outlets in two service users rooms and the bathroom were found to be above the recommended 43 degrees centigrade. The inspector has been informed following the inspection by the area manger that a plumber has been requested to carry out the work and that daily checks on the temperatures are being carried out and recorded, until the work has been completed. New food standards legislation introduced in January 2006 was discussed with the manager. The home has procedures in place relating to the Hazard Analysis Critical Control Points (HACCP) which monitor the arrangements for receipt, storage, preparation and cooking of food within the home, however the records management file ‘Safer food, better business’ was not being used to reflect that temperatures and checks are taking place. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 24 The area manager discussed the external management report (EMR) for Wade Bungalow. Wade Bungalow stands alone on it’s own budget and with the exception of an overspend on staffing; due to the increase in hours between 4 and 8pm to support service users. The home is on target to meet the budget forecast. Mencap have an organisational business and financial plan, which includes Wade Bungalow. The budget and targets are discussed at team meetings. Staff have access to the weekly expenditure on the computer so that they can check at any time how much money is available for food, cleaning materials, social and leisure activities and gives them ownership of the budget and day to day running of the home. Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 25 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 2 2 3 3 3 4 3 5 3 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 2 25 3 26 3 27 3 28 3 29 X 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 2 3 Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 26 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 YA1 Regulation 6 Requirement Timescale for action 30/09/06 2 YA9 13 (4) (b) The service user guide must be reviewed and provided in a format appropriate to the needs of the service users. A new risk assessment format 30/09/06 needs to be introduced to reflect where service users are able to take responsible risks and the actions that will support them to achieve their goals. Terry hand towels must be replaced with paper hand towels in order to prevent the spread of infection. The home must undertake a risk assessment to ensure the health and safety of service users and staff including the security of the premises, and the safe keeping of service users money based on an assessment of their vulnerability. The hot water supply in two of the service users rooms and the bathroom were above the recommended 43 degrees centigrade. 30/09/06 3 YA30 13 (3) 4 YA42 13 (4)(c) 16(2)(l) 04/08/06 5 YA42 13 (4) (a)(c) 04/08/06 Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 27 All parts of the home which service users have access must be free from hazards to their safety, and unnecessary risks are identified and so far as possible eliminated. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Wade Bungalow Residential Home DS0000024518.V299365.R01.S.doc Version 5.2 Page 29 - 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. 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