Inspection on 14/09/06 for Warnford House

This inspection was carried out on 14th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Warnford House 10/09/08

Warnford House 25/01/06

Warnford House 01/02/05

Warnford House 29/07/04

Warnford House 16/02/04

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

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

CARE HOME ADULTS 18-65 Warnford House Warnford Close Gosport Hampshire PO12 3RT Lead Inspector Isolina Reilly Unannounced Inspection 14th September 2006 09:00 Warnford House DS0000011846.V304245.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 Warnford House DS0000011846.V304245.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. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warnford House Address Warnford Close Gosport Hampshire PO12 3RT 023 9260 1533 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) Southern Focus Trust Henry Joseph Dillon Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: Warnford House is a purpose built home situated in a quiet cul de sac in Gosport. The home is registered with the Commission for Social Care Inspection (CSCI) to accommodate and provide personal care to 12 service users with mental health problems in the younger adults category. All the bedrooms are single; there is a lounge on the first floor with access to a computer for service users. There is a lounge and kitchen/ dining room on the ground floor. The home is situated close to local amenities in Gosport and within easy reach of Portsmouth city. The provider makes information available about the service, including a statement of purpose and service user guide and the commission’s report to prospective residents on request. Copies of these documents are available at the home and may be sent out by post on request. The manager confirmed by telephone on the 29th August 2006, there is one fee of £359.60 per week but service users need to pay for their own personal items, Magazines, newspapers and confectionary and toiletries. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over one day. The inspector looked around the home, viewed records and procedures, spoke with the service users, staff and observed the interaction between them. The manager helped the inspector during the visit. Information has also been taken from correspondence with the home and monthly reports on how the service is doing, sent in by the area manager. What the service does well: The service users liked their home and stated that the support workers were for them when they need it. The home has a good system for assessing if it can meet the needs of service users before they come to the home. This includes medical and personal care needs. There are good records in place that help staff to support the service users as they wish to be. The staff are caring, respectful and are mindful of peoples need for privacy and dignity. They encourage individuality and independence within the limits dictated by the service users needs. The staff support individuals to make decisions about their lives and service users are fully involved in planning their lives and care. There is an attitude of rehabilitation, with service users personal development aimed at them moving on to independent living. They are encouraged to express their own opinions and participating in the local community, work, education and other leisure activities. With the appropriate support from staff individuals will plan, shop and cook their own meals at times that suite their day. The service users are invited and receive training to participate in consultation, projects and recruitment of staff within the organisation. The home has an open and good process in place for dealing with complaints, concerns and compliments. The staff team at the home is skilled and receive regular training to help them give the support needed by service users. The home has a logical and thorough process for recruiting new staff, which service users can become involved in. There are good systems in place for making sure that the service is run in a safe manor for all. The residents indicated that they feel safe and comfortable Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 6 at the home and their opinions are sought and valued. The organisation has a good system in place for monitoring the quality of the service being delivered at the home. What has improved since the last inspection? What they could do better: 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. Warnford House DS0000011846.V304245.R02.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 Warnford House DS0000011846.V304245.R02.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): 2 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 good admission process that is well managed and prospective service users’ individual aspirations and needs are assessed. EVIDENCE: The service users spoken with stated that they had been made welcome when they first came to live at the home and a visitor confirmed this. The staff confirmed there is a process of varied visits before a potential service user decides to move into the home. The service users spoken with confirmed that they had had their contract fully explained to them prior to agreeing to sign. The inspector tracked four service users’ records and each file contained a detailed assessment. The records showed individual aspirations, health and personal care needs, potential restrictions, choice, freedom, information of family and friends, their cultural and faith needs, physical and mental health care and treatments. Written assessments on the files were relevant and reflected support needs assessments completed by Adult Service’s care managers and health professionals like the community mental health team professionals including the community psychiatric. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 9 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 good. This judgement has been made using available evidence including a visit to this service. The home has good systems in place that fully involves service users in decision-making, taking reasonable risks, assessing changing needs and meeting personal goals. EVIDENCE: The inspector observed one key worker working with the service user reviewing part of the individual’s care plan. This was done in a respectful manor and the service user was fully involved in the process. The records seen for the four service users tracked were detailed, clear and relevant. The staff spoken with stated that the care plans have evolved over a period of time and were a necessary tool provided a transparent way of supporting service users to work towards their own independence with pre agreed behaviour management strategies with service users. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 10 The care plans are reviewed regularly and are amended as appropriate. The service users are fully involved signing their own plans. One service user stated his key worker must liaise with them before any aspect of the plan can be changed. The home also holds formal six monthly detailed reviews with the service user where the relatives, carers along with health and social care professional are invited to contribute. The four service users spoken with were fully aware of the contents of their care plan and agreed that the plan accurately reflected there needs and identified their support needs. Further records on file included relationships, work and education, social and recreational activities. These records were detailed and reflected risk assessments and support instruction. The staff spoken with stated the care plans are very much owned by the service users who are fully involved with update their care plans. The staff spoken with had a good knowledge of the individuals’ needs, aspirations and level of support. One staff member said that the home was very flexible and providing an appropriate risk assessment and actions had been undertaken, recorded. Risk assessment seen were informative and contained clear instruction to staff. They covered all aspects of support, personal care and behavioural strategies provided both in and outside the home. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 11 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. The service is good at providing support for individuals to take part in age appropriate, peer and cultural activities with the home and access to the local community. They encourage appropriate personal, family and other relationships whilst respecting and empowering individuals rights and dignity. The service users enjoy varied balanced meals in a relaxed atmosphere. EVIDENCE: On the day of the visit, the inspector observed service users coming and going enjoying music, watching a film entertaining visitors. The manager explained that service users are supported to access facilities, services and activities in the local community. One service user explained that the home had been very supportive and enabled to continue their relationship with their long-term partner. Information and agreed strategies regarding this relationship were appropriately recorded and consulted on. The manager confirmed that the Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 12 home has recently replaced two single beds with double size beds to allow for choice to express sexuality should the individuals wish to. Care plans seen also detailed other activities individuals involved including housework tasks, attending college and one service user is in their first year at university doing a BA in Art. The service users and staff spoken with confirmed this. One service user stated they attended a day centre and enjoyed the various clubs they belonged to. Another service user stated that they attended church regularly. One service user confirmed that they had completed a course on ‘voluntary work’ and were looking for employment. The manager confirmed that currently one service user works locally, four service users had completed a ‘voluntary work’ course and another service user has recently changed their voluntary work place. This was confirmed in records seen. Individuals’ hobbies and leisure activities were recorded in records seen. One service user enjoys Karaoke and goes out to social events. Another service users stated that they enjoy swimming and regularly attend the local sports centre. The home allows service users to keep certain pets such as budgies and fish. Two service users showed the inspector their pet. The home also has a cat that everyone looks after. Care plans include risk assessments and an agreed strategy for individual support needs which includes meal planning, food shopping and cooking. Staff and service users confirmed that they are aware of healthy eating. Records seen showed planned menus, shopping, to do lists and budget support. The home has two cookers that enable more than one person to cook at any time. Meals are prepared to suite the individual’s plan for the day. The home allocates a food budget and money to each individual toward buying their food. These agreements are recorded in detail on the individual’s care plan. The service users spoken with liked the arrangement and feel that they are in charge and control of their own meals. The staff are supportive and help them to budget and plan menus. Two service users stated that they only cook twice a week and the rest of the time they assist staff with the meal preparation and cooking. One care plan seen had an assessment for healthily eating and reduction diet set out by a dietician. It was observed that service users are relaxed when preparing and eating meals. There were various health and safety procedures in place within the kitchen including colour co-ordinated chopping boards, cleaning rota, pro-biotic wipes for surfaces, gloves, temperature recording including probing of food, fridges and freezers. The cook confirmed Environmental Health Officer had visited in recently. The report seen and the chef confirmed that cleaning identified had been undertaken. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. The service users’ health and personal care needs are being met ensuring are support is given in the way they prefer. The home medication practices, policies and procedures supports and protects service users. EVIDENCE: The inspector observed the service users respond positively to staff intervention and support. The service users comfortable at the home and had a good relationship with their key workers. Staff were observed being mindful of individuals’ privacy and dignity. The staff confirmed that daily routines were flexible and were able to tell the inspector who liked to lie in and liked to stay up late. The service users spoken with confirmed this. Personal and health care records on the four care plans tracked were appropriate and included instructions on specialist medical tests such as frequency of blood checks. Other records seen included regular check ups at the doctors, consultants, opticians and dentist. The two service users spoken with explained that they go to their local health centre where they are registered for all health care checks, although the community psychiatric nurse Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 14 will visit them at the home. One service user confirmed that they have been visiting a chiropodist regularly to help with a foot complaint. The care plans and daily records showed that service users’ lives and daily routines were varied, full and flexible. The service users and staff spoken with confirmed this. Four service users showed the inspector their bedrooms and one service user stated they keep their bedroom locked. It was noted that rooms had been personalised and personal effects including make up and other toiletries, which they had chosen for themselves. One of the service user likes to buy their own cleaning products to clean their bedroom with. This has been risk assessed and the room is kept locked but it was noted that the individual had accumulated a large quantity of chemicals. This was discussed with the manager who agreed that the care plan needed to be reviewed. Two service users stated that they had no religious preference and one-service users stated that whilst they had believes they had chosen not to attended church regularly. Another service user explained that they attend their local church regularly. The staff were observed supporting service users to self-administering medication appropriately and there is a satisfactory medication policy and procedures. Staff were also observed fully involving service users in the checking and recording systems for administration of their medication though they were not self administering. Risk assessments for self-administration were available and regularly reviewed. The home uses a blister pack system form the local pharmacist. The medicines were correctly stored in an appropriate cupboard that was clean and reasonably orderly in date and in sufficient quantities. The manager confirmed that they are awaiting delivery of a new medicine cupboard that will make it easier to manager the blister pack system. There were no control medicines at the home on this visit. The records for receipt, disposal and administration were seen and found to be satisfactory. The home uses the ‘Medicine Administration Record Sheets (MARS) system for recording the administration of medication and medication received in the home. The support workers spoken with stated they had received training in the safe handling of medicines and they regularly assessed for competency by the home. Staff training records seen that confirmed this. A recent copy of the British National Formulae (BNF) book was available in the office and detailed information for each type of medication is held on file, which includes emergency procedures in the event of an overdose. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 15 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 service users, relatives and staff are confident that their complaints will be listened to, taken seriously and acted upon. Staff have a good understanding of Adult Protection issues that protects residents from potential abuse. EVIDENCE: The service users asked indicated that staff listened to their concerns. The staff spoken with confirmed this. The inspectors observed staff interacting with service users and dealing with their queries and concerns. The service users and staff were aware of the home’s complaint procedures and stated that they would support and encourage service users to have their say and voice their concerns. The home’s complaint procedure includes the various stages; the address for the Commission and complaints will be dealt within 28 days. An easy to read complaint procedure was available on the service users’ notice board and a copy was seen in one service user’s bedroom. The home has received one complaint this year, which was quickly resolved and appropriate records kept. A further complaint was received and then withdrawn, which had been appropriately dealt with and recorded. The home’s complaint log was seen and found to be satisfactory. Complaints are monitored monthly by the organisation. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 16 The service users spoken stated they felt safe at the home and the staff also confirmed this. The four staff spoken with confirmed that they were aware of abuse and had received an initial instruction on induction about abuse subsequent in house training and external training. Training records and certificates confirmed this. The staff were aware of the abuse procedure and their responsibility to report concerns immediately. They stated that there was a clear and supportive ethos towards whistle blowing. The home has been involved in one protection of vulnerable adults allegation. This has been appropriately reported to social services and the home has followed its procedure keeping appropriate records. The home has an up to date copy of the Hampshire County Council ‘Protection of Vulnerable Adults’ policy and procedure and it’s own policy and procedures reflecting the guidelines from Hampshire County council’s policy. There is a clear whistle blowing procedure and the home has encourages an open and fair ethos. The staff spoken with confirmed this. Each service user has a care plan and risk assessment on budgeting and finance. Two service users spoken with confirmed that they hold their own accounts and are supported to access financial services and money if necessary. Home does not hold money for service users, if there is an emergency then money from the home’s petty cash maybe made available and the client is invoiced for the sum. There is a fully auditable trail of records held within the home. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 17 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. The home presents as a clean, homely, comfortable and suitable environment for the service users. The standard of the décor within the home is good with evidence of on-going maintenance. EVIDENCE: The manager showed the inspector around the home, explaining that service users choose the colour schemes in their own bedroom and in the communal areas. However, four service users showed the inspector around their bedrooms. They confirmed that they liked their bedrooms and the inspector observed that they had been personalised. There is a large mature garden accessible from the kitchen with different areas, a private ‘secret garden area’, patio, mature trees, lawns and flowerbeds. One service user who is keen on gardening does most of the gardening. There is a vegetable plot where the home grows its own vegetables and fruit. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 18 The home has a maintenance service that is available to undertake repair and general maintenance as needed. Maintenance and repair logs were available on site. The home was found to be clean, tidy and reasonably maintained. However, it was noted that the hallway carpets were stained and starting to look warn in high use areas. Manager stated the carpets were due to be deep cleaned and were part of the refurbishment plan to be replaced in near future. The down stairs lounge is smoking and all the service users spoken with confirmed they were happy with this. However, following a recent risk assessment new style ashtrays that reduce the risk of fire from cigarette ends not fully extinguished have been supplied. The service users and staff explained that if they wish to they could make use of the quiet lounge on the first floor where no smoking policy is in place. One service user stated that they have used it to entertain their quest when they wanted some privacy other than their bedroom. The kitchen diner is large with recently replaced flooring and has two cookers to allow for individuals cooking and staff cooking for those who need assistance. The dining area in kitchen is personalised with a clients notice board bulging with information leaflets on local community events and other activities, fire safety information and complaint procedure, last inspection report, sun protection health information and art worker was displayed around the room. Since the last inspection, the home has replaced the freezer, washing machine and three further small fridges that are available in each bedroom. The small fridges in the bedroom were discussed who stated that he would look into a formal regularly monitoring system for bedroom fridge over and above the regular temperature checks already being done to ensure that food is appropriately stored and not out of date. One service user’s room had an unpleasant odour from poor hygiene. This had been identified as a need that the home had risk assessed and agreed a strategy for improving the individual’s personal hygiene. There were three bedrooms where the service users have chosen to smoke in. These had been appropriately risk assessed. The home has replaced two beds with double size beds allowing individuals the opportunity to express their sexuality and maintain relationships if they wish. The laundry is situated on the ground floor and compact but serviceable. There are two washing machines; one is an industrial machine that provides the appropriate sluicing cycle meeting good infection control practices and a tumble dryer. Gloves and aprons were available and the staff confirmed that they have received training on infection control. The service users and staff spoken with felt there were sufficient toilets and bathrooms. Communal toilets were clean, easily accessible with appropriate locks and liquid hand washing soap and disposal paper towels. The manager confirmed that new floor covering for all bathrooms and toilets had been ordered and they were awaiting delivery. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 19 The home’s fire extinguishers have been replaced recently with all new universal extinguishers. Various locks around the home have been replaced. Warnford House DS0000011846.V304245.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 good. This judgement has been made using available evidence including a visit to this service. The service users are supported by sufficient, competent and qualified staff that undertake regular training. There are satisfactory recruitment procedures that ensure service users are not put at risk. EVIDENCE: The inspector observed staff interacting with service user in a respectful manor. The staff were seen making themselves available, listening and interested in what the service users were doing and planning. It was noted from September 2006 staff duty rotas that there are normally two support workers on duty during the day from 09:00 to 21:00 hours when one support work is available who also covers each sleeping night duty between 23:00 to 07:00 hour. The staff and service users do the cleaning and laundry but the home employs contracted cleaners once a fortnightly for a thorough clean. Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 21 The service users felt there were sufficient staf on duty at any time to provide them with the support they required. The staff spoken with felt there are sufficient staff on duty to meet the needs of the service users. The manager explained that all new staff completes an organisation induction on starting work at the home that meets the Skills for Care Council minimum standards for induction. This induction last for up to six weeks and is recorded in a workbook that is signed by the manager and staff member. The newest member of staff spoken with confirmed this and their induction workbook was seen in the process of being completed. Three staff recruitment records and training documentation were seen and found to be satisfactory. The certificates, training records and personal development audits for each staff seen included the flowing subjects covered; Welfare assessment, induction that meet skills for care standards, National Vocational Qualification (NVQ) certificates, First Aid, Food hygiene, Diabetes, self harming, Health & Safety, safe handling of medicines, dementia, break away training, schizophrenia, infection control including MRSA and scabies and mental health conditions. The staff spoken with stated that they received regular training and had a good knowledge of each service user. Out of the five support workers, three hold a National Vocational Qualification (NVQ) level 3 in Supporting independence (which has been renamed Health and Social Care) and one is in the process of completing. The home has achieved 80 of its carers with a qualification in care. The fifth support work is new to the post and is in the process of completing their induction. They will progress onto Foundation course before starting their NVQ. The new member of staff felt supported and found the induction programme very informative. The three staff files seen held the necessary documentation including two satisfactory written references, identification, criminal record bureau and protection of vulnerable adult list checks prior to starting work. The staff and manager confirmed that each staff member had their own copy of the General Social Care Council’s Code of Practice. Signed contracts of employment including terms and conditions were seen on the file. There were regularly supervisions and annual appraisal on each file. The staff stated that they found the supervision process beneficial. Warnford House DS0000011846.V304245.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 good. This judgement has been made using available evidence including a visit to this service. The service users benefit from a home that is well run where their view are listened to and their health, safety and welfare are promoted and protected. The home has a satisfactory quality monitoring system for reviewing and developing the home’s performance. EVIDENCE: The manager has the necessary experience and skills to manage the home well. The service users and staff described the manager as approachable, fair and listened to their views and concerns. Two staff stated that he was “the best manager they had worker for”. The manager holds a National Vocational Qualification (NVQ) level 3 in supporting independence and is the process of completing his NVQ level 4 in Health and Social Care. He has also completed the first two units of the NVQ registered manager’s award and confirmed that he regularly undertakes training to maintain his skills. Recent training he has undertaken includes Food hygiene, first aid, moving and handling, COSHH, fire Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 23 safety, meds, supervision workshop, suicide awareness. He also participates in the organisation project develop and had recently attended a conference on mental health issues. The home seeks the views of the service users on a regular basis and these are recorded in the individuals’ files. Service user quality surveys are sent out by the organisation to assess quality of the service being provided. These are collated by the organisation and the area manager uses the feedback as part of the annual quality audit of the service. The inspector was able to seen the summary report for the quality audit completed in 2005. The manager confirmed that the audit for 2006 has been completed but the home is still awaiting the report. The manager completes a monthly performance monitoring report for the organisation and reviews policies and procedures annually. The area manager undertakes monthly monitoring meeting and generates a written report that meets the Care Homes regulations 2001, regulation 26 reports. The home has a Best Value file that includes all quality monitoring outcome and actions to be taken. The service users have house meetings where their opinions are actively sought. Notes from these meetings were available. Staff confirmed that they attend regular meetings that are minuted. These minutes were available in the office. Further regular meetings held at the home include health and safety and management meetings. The staff confirmed that they attend regular supervisions sessions and record seen confirmed this. The inspector was able to seen various up dated risk assessments for the environment, health and safety and fire safety. The service users stated they feel safe at the home and confirmed that the fire alarms are regularly tested. They also stated that they take part in regular evacuation and attend fire safety lecture. The inspector viewed the records for fires safety maintenance, evacuation and visual checks finding them to be satisfactory. The manager organises and undertakes ‘in house’ training on fire safety and staff also attend external fire safety training. The records seen showed that staff had received the necessary training and participated in drills. The home has a satisfactory reference file for the Control of Substances Hazardous to Health (COSHH) with information leaflets for each chemical being utilised within the home and chemicals were securely stored. The home’s records for reporting injuries and incidents were appropriate. The incident records seen matched the Care Homes Regulation, regulation 37 reports. Warnford House DS0000011846.V304245.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 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 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 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 3 X Warnford House DS0000011846.V304245.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. Standard Regulation Requirement Timescale for action 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 Warnford House DS0000011846.V304245.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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