Inspection on 25/07/06 for WCS - Newlands

This inspection was carried out on 25th July 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

WCS - Newlands 24/06/07

WCS - Newlands 23/11/05

WCS - Newlands 14/06/05

WCS - Newlands 24/01/05

WCS - Newlands 20/05/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 WCS - Newlands Whites Row Kenilworth Warwickshire CV8 1HW Lead Inspector Kevin Ward Key Unannounced Inspection 25th July 2006 07:40 WCS - Newlands DS0000004267.V305473.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 WCS - Newlands DS0000004267.V305473.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. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service WCS - Newlands Address Whites Row Kenilworth Warwickshire CV8 1HW 01926 859600 01926 864240 admin@wcsnewlands.f9.co.uk 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) Warwickshire Care Services Limited Ms Wendy Bridge Care Home 26 Category(ies) of Learning disability (4), Physical disability (18), registration, with number Physical disability over 65 years of age (4) of places WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Admissions No further service users with both a physical disability and/or learning disability must be admitted. The registration category of physical disability and learning disability (4) relates to the four named service users only. 23rd November 2005 Date of last inspection Brief Description of the Service: The home provides care for 26 adults with a physical disability, aged between 16 and 65 years. The home offers short term and respite care. Newlands was built in 1976 for people with a disability. However over the years there has been a significant change in the nature of disability of residents, from that originally conceived. As a result Newlands has been partially redesigned and re-furbished. The residential and nursing home occupies a single storey building with some unusual roof elevations. An attached two-storey section is used for the head office accommodation of the parent company. There are also attached facilities used by the WRVS meals service. There is a large car parking area at the front of the home. The premises are separated into three living units each having a corridor with bedrooms off, a kitchenette, and adjacent dining and lounge area. There is also a large communal dining room, entrance hall with a waiting/meeting area, two enclosed courtyards/gardens and large grassed and planted areas surrounding the building. All areas are wheelchair accessible and there are automatic doors and ramps for access. The current placement fees for the home (25/7/06) range between £830 - £960 per week. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. No requirements were made at the last inspection of the home, 23/11/05. This inspection focused on assessing the main key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file at the Commission, such as notifications of accidents and incidents. A pre inspection questionnaire was also sent to the manager to complete to provide more information about the home. The inspection included a site visit at the home and included seeing the people who live at the home for their opinions, although it was not possible to talk with some people due to their high communication needs. The inspection also involved talking with the staff on duty. The manager was on holiday at the time of the inspection site visit. The inspection was ably facilitated by the deputy manager (care manager). A number of records, such as care plans, risk assessments, staff training certificates and fire safety records were also sampled for information as part of this inspection. Questionnaires were sent to the home for service users and visitors to complete. Prior to the service visit three service users and one visitor had completed and returned questionnaires. What the service does well: People’s needs are being assessed properly before they move into the home and they are supported to visit and stay overnight before as part of the admission process. Everyone at the home has a care plan, which contains helpful information about people’s preferred routines, to enable staff to support them in the way they like. Overall the home provides a satisfactory range of activities for the people living at the home. One person returning from a shopping trip said, “We go everywhere”. No unnecessary restrictions are being placed on people venturing out into the community independently where they are able to do so. Several people were seen in Kenilworth high street shopping and a number of people went out for a meal at a local pub on the day of the inspection site visit. The care manager explained plans to introduce a timetable for people to have dedicated one to one time with staff. This is particularly necessary to demonstrate that people with high communication needs, who cannot readily seek social contact, receive the support and attention they require. One person keeps caged birds at the home and another person has a small pet dog that he looks after with some support from staff. This indicates that the home tries to be flexible and support people’s choices where it is practicable to do so. A choice menu is in place at the home and people have access to snack foods between meals. People’s likes and dislikes are recorded in their care plans. This WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 6 is particularly important to enable staff to support people with high communication needs. Overall the home provides good wheelchair access and people have been supported to personalise their bedrooms to their own liking. The home is well equipped with walk in showers, specialist baths, specialist beds and hoisting equipment so that people’s needs can be met safely. People are encouraged to complain if they are unhappy and suitable procedures are in place for investigating people’s complaints properly. Staff are trained to recognise and report any suspicions of abuse so that people are properly protected. Staff are provided with a good range of training courses to promote good care and safe practices in the home. This includes Fostering Equality training, to raise staff awareness of issues of inequalities that can impact on the lives of people living at the home. Person Centred Planning training is also being provided for staff. This training promotes people’s greater involvement in the care planning process. Suitable arrangements are in place for monitoring quality in the home, including monthly consultation questionnaires and a range of audits. Fire safety equipment is being properly tested and serviced and staff are provided with fire safety training to support a safe living environment for people. What has improved since the last inspection? What they could do better: Overall care planning in the home is improving but there is a need to ensure that changes in people’s care requirements are consistently noted in their care plans, as sometimes this does not happen. There is also a requirement to ensure that a clear protocol is devised for triggering closer monitoring of people’s needs where there are concerns about deteriorating health, such as recording poor nutrition, turning records or fluid intake charts. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 7 This is necessary to ensure that all the necessary records and charts are completed to demonstrate a clear picture of the persons changing needs and of the care provided. Whilst overall the home is comfortable there is a requirement to clean a number of carpets that are badly stained and it is recommended that additional pictures / ornaments are purchased to make the communal areas more homely. Some people have raised concerns that their clothes are not pressed to a suitable standard on occasions. There is a requirement to monitor this matter to ensure that improvements to the quality of the ironing are improved and sustained. 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. WCS - Newlands DS0000004267.V305473.R01.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 WCS - Newlands DS0000004267.V305473.R01.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 The judgement for this outcome group is good. This judgement has been made using available evidence including a visit to this service. People’s needs are properly assessed and they are sensitively supported to move into the home. EVIDENCE: Social work assessments were seen on people’s files indicating that the home seeks proper information about people’s needs as part of the admission process. Before people move in, the home carries out a further assessment to gather more details about the person’s needs, to feed into the care plan and to confirm that the service is able to meet their assessed needs appropriately. Comments by people confirmed that they had been invited to visit the home before moving in. The care manager explained that the admission procedure typically includes an opportunity to visit and take lunch at the home before arranging any overnight or weekend stays. WCS - Newlands DS0000004267.V305473.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 and 9 The judgement for this outcome group is adequate. This judgement has been made using available evidence including a visit to this service. Care planning within the home is improving so that people’s needs are met in a safe manner, in the way they prefer. Changes in people’s needs are not always reflected in their care plans as promptly as they should be. EVIDENCE: A sample of care plans were examined and the care manager was able to demonstrate how these documents have improved over the last year and are in an ongoing state of development. Overall the care plans examined contained a satisfactory range of information about people’s personal care, health care and social care needs to guide staff so that they can support people correctly. However some gaps were identified where changes to people’s care had been agreed and not fully recorded in the main care plan. Care plans also contain helpful information about people’s preferred routines throughout the day to help staff to provide more person centred support to people so that their care is provided in the way they prefer. Good information was also seen detailing the communication needs of a person who is unable to speak, to enable staff to understand her body language and non-verbal cues. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 11 Risk assessments were seen, containing advice on reducing key hazards such as risk of falls, skin care, mobility and nutrition. Comments by the people living at the home and entries in their records confirm that they are encouraged to take part in regular reviews of their care plans with support from relatives where possible. The people living at the home confirmed that they are provided with opportunities to express their opinion about life at the home and to make everyday choices. People are given a question from the quality assurance questionnaire to complete each month so that eventually they comment on a range of issues over a 12-month period. The care manager explained that meetings were not being well attended by the people in the home and consequently the manager now provides regular opportunities for people to meet with her on a 1:1 basis to discuss issues in the home. The people living at the home confirmed that they are supported to go shopping to choose their own clothes and other personal items and some people were recently involved in choosing the tiles for two walk in showers in the home. WCS - Newlands DS0000004267.V305473.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): 12,13,15,16 and 17 The judgement for this outcome group is good. This judgement has been made using available evidence including a visit to this service. Overall people are provided with a satisfactory range of activities and opportunities to use the local community and provided with the food they like. This will be improved when dedicated one to one time is made available to people with high communication needs. EVIDENCE: Comments made by the people living at the home indicate that they are supported to gain regular access to the local community for leisure and recreational purposes. The home employs an activities co-ordinator to arrange outings and activities within the home. The people living at the home confirmed that they are consulted for their ideas regarding activities. A photo board was seen on display in the central dining area containing a photographic record of many of the activities and outings enjoyed by the people at the home. Examples of activities provided include Bingo, trips to parks and town centres, parties, film nights, fishing, farm, theatre and arts and crafts. Some people also make use of day services and college courses. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 13 On the day of the inspection site visit a number of people went out to the pub for a meal and to do shopping with staff. Comments by staff and the people living at the home confirmed that proper efforts are made to celebrate birthdays, which may commonly include a celebration at the home or going out with friends. Discussions with the people living at the home confirmed that where they are able to do so no unnecessary restrictions are placed on people going out independently into the local community. The care manager explained that there are plans to agree a timetable of one to one time for people to have dedicated time spent with staff. This is particularly important for people with significant communication needs where they are not readily able to say what they would like to do and so their wishes could be neglected. The care manager also stated that there were plans to set up a living skills group by September which would provide more opportunities for people to cook and shop, as well as improve money handling and other household skills. One person is allowed to keep caged birds in his room and another person is supported to keep a small dog at the home. The care manager confirmed that people are allowed to keep pets so long as they do not present problems for others in the home. Two sets of relatives were seen visiting and there are no unnecessary restrictions placed on visiting times. Comments by the people visiting on the day indicated that the home receives them in a friendly manner. Entries in people’s review notes confirm that their relatives are encouraged to attend and offer support at their care reviews. The care manager stated that there has been no recent sexuality and personal relationship training for staff at the home. This type of training is positive means of raising staff awareness to equip them to provide appropriate support and guidance to people where necessary. People were seen to rise in a relaxed manner and to choose what they wanted to eat for breakfast. Comments by the people living at the home indicated a good level of satisfaction with the food provided from the choice menu and confirmed that alternatives are provided where people request it. Comments by the care manager and entries in a person’s care records confirmed that the home was adopting a flexible approach, beyond the choice menu, to increasing the nutritional intake for one person with a very poor appetite. Entries in people’s records also indicate that appropriate use is made of the dietician and speech therapy service where there are concerns about people’s diet or eating difficulties. Entries in the complaints records indicate that that there were problems regarding access to snack foods earlier in the year as the main kitchen cupboards were locked up in the evening. The care manager explained that this is no longer the case and comments by people living at the home indicated that this matter has now been resolved. WCS - Newlands DS0000004267.V305473.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 and 20 The judgement for this outcome group is adequate. This judgement has been made using available evidence including a visit to this service. Overall people’s personal care and health needs are being addressed. The rating for this group of Standards is compromised by shortfalls in record keeping and the need for clear criteria for triggering closer healthcare monitoring when risks to people’s health and welfare are heightened. EVIDENCE: People were supported to rise in an unhurried fashion and to take breakfast in keeping with their own preferences. People’s routines are recorded in their care plans to help staff to assist people sensitively and to carry out their care support in the way they like it provided. Staff were seen to knock on people’s bedroom doors before entering, indicating that they respect people’s privacy. On the morning of the site visit personal care tasks took place behind closed doors indicating a suitable regard for people’s dignity. Comments made by the people living at the home indicated that overall they like the staff that support them and generally find them to be helpful. A support worker was seen to very sensitively and patiently assist a person to take their food supplement drink in a relaxed and unhurried manner. The people living at the home were seen to be well groomed and dressed in age appropriate, clean clothing. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 15 People at the home have recently expressed some concerns that their clothes are not always pressed to an acceptable standard. The care manager explained that this had been addressed with staff and that improvements would be monitored in order that they are sustained. Discussions with people who were able to communicate verbally indicate that they had been offered drinks at regular intervals. The care manager explained that in order to improve the service to people with no verbal communication, who cannot ask for attention, there are plans for a timetable of 1:1 sessions with staff so that their needs are not neglected. This is a positive and necessary development to help the home to demonstrate that they are meeting social people’s needs on a consistent basis. There is currently no protocol for automatically triggering more intensive observations, based on a risk-assessed approach, when there are concerns about deteriorations in people’s physical condition. This would be beneficial in ensuring that there is a consistent approach across the staff team and that appropriate monitoring records are always maintained where concerns about people’s health and welfare is heightened. Observation charts were in place to monitor the condition of a person recently discharged home from hospital. However there were two recent gaps in recording where the persons’ fluid intake had not been recorded and where their turning chart had not been completed. Two people’s relatives who were visiting the home spoke very positively about the service provided, indicating they were happy with the quality of the care that is given and confirming that they had been kept involved in changes in their relatives care. Skin care assessments are in place on people’s files and information provided by the care manager confirmed that staff are provided with skin care training. A PEG tube care regime was seen to be in place on one persons file and the care manager confirmed that staff are provided with training in this area of practice. Protocols are also in place for managing people’s epilepsy and for administering medication where necessary. The care manager explained that a further range of protocols are currently being developed to support good practice at the home. Entries in people’s records indicate that the home supports people to gain access to local healthcare services, such as GP, dentist and opticians and there is evidence to indicate that people’s needs are being monitored with the involvement of consultants and specialists where necessary. The care manager has referred 9 people for a physiotherapy assessment but has received a letter stating that this service is not available. Consequently the care manager explained that the home is supporting people to identify a private physiotherapy service. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 16 The care manager agreed to seek clarification for the reason the service is not available from the National Health Service and to support people to challenge the decision where appropriate. Each person living at the home has lockable storage cupboards in their bedrooms for the safe storage of medication. Discussions with staff report that medication is recorded into the home on people’s medication sheets. This was seen to be the case on a sample examination of people’s medication sheets. Comments by staff confirmed that only the unit leaders as the nursing staff are allowed to administer medication. A team leader and the care manager also confirmed that staff are only allowed to give out medication after they have completed Boots medication training, distance learning training and been assessed on 3 occasions by the manager. An auditing tool has also recently been introduced in order that the care manager can monitor medication practices in the home to ensure that safe practices are maintained. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 17 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 The judgement for this outcome group is good. This judgement has been made using available evidence including a visit to this service. Suitable procedures are in place for investigating complaints and reporting suspicions of abuse so that people are protected and their concerns are dealt with. EVIDENCE: Comments made by people indicated that they have been informed how to complain. Complaints books are present in each of the three living units to enable the people living at the home and visitors to make their concerns known. The information contained in the complaints books indicates that complaints are followed up by the home and action is taken to address people’s concerns. As previously noted the manager has recently started to provide times for people to meet with her personally as another way for people to raise any specific issues they may have with the home. Two recent complaints were discussed with the care manager and some records were sampled, the findings of which indicate that the complaints have been properly investigated by the home and followed up appropriately with the complainants. Comments made by one complainant confirmed a strong satisfaction with the way in which the home had responded to her concerns, which had led to greater confidence in the management of the home. Information was recently brought to the attention of the Commission for Social Care Inspection, indicating shortfalls in personal care support. However there was no evidence to support this on the day of the site visit; people were seen to be clean and well groomed. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 18 Procedures are in place at the home to help staff to respond appropriately to suspicions of abuse and to report any concerns they might hold about the running of the home. Comments made by staff confirmed that they have seen the procedures and several staff said that they had recently had vulnerable adult abuse training. There have been no formal vulnerable Adult Abuse Investigations at the home. The home has sought the support and involvement of the Social Services Department to consider the most appropriate course of action to take where they were concerned for the well being of someone living at the home. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 19 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 The judgement for this outcome group is adequate. This judgement has been made using available evidence including a visit to this service. Overall the home is comfortable and well equipped to meet the needs of the people living there. Improvements are necessary to improve the cleaning of carpets and there is scope for making the communal areas more homely. EVIDENCE: The home is split into 3 separate living units, each with it’s own bathrooms and dining areas. The home is all at ground floor level and overall the home provides satisfactory wheelchair access and sufficient space for people with disabilities. Overall the home is reasonably decorated and provides comfortable accommodation for people. However there is scope for increasing the number of pictures and ornaments in the lounges and communal areas, which would make it more homely. Thirteen of the bedrooms have an en-suite facility consisting of a toilet and wash hand basin. People’s bedrooms are comfortable and there is ample evidence to indicate that people have been supported to personalise their bedrooms to their own liking. The home is well equipped with specialist beds and mattresses and moving and handling equipment. Recent work has taken place to re-fit two shower rooms so that they provide walk in shower facilities for people. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 20 Specialist baths are also available for people at the home. Many of the carpets are stained and would benefit from cleaning or replacement. Documentation was seen confirming that an ill fitted carpet was to be replaced. Overall the home was seen to be reasonably clean, although as noted above many of the carpets require cleaning where they are badly stained. Protective clothing and gloves were seen in various areas of the home for staff to use when carrying out care tasks. Comments by staff indicated that suitable arrangements are in place for managing soiled laundry, including dissolvable red bags for safely carrying incontinent laundry to the laundry room. A suitable clinical waste contract is in place at the home. The home has fitted new modern washing machines with washing programmes suitable for managing continence laundry, during the last year. Staff training records confirm that infection control is provided to staff at the home. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 21 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 The judgement for this outcome group is adequate. This judgement has been made using available evidence including a visit to this service. The rating for this group of Standards is compromised by shortfalls in some aspects of training necessary to ensure safe practices at the home. EVIDENCE: A sample of recent duty rotas were submitted to the Commission for Social Care Inspection as part of the inspection process. Discussions with the care manager confirmed that typically there are three staff in each unit and a nurse on duty during the day. This can reduce to two staff on duty in each unit during the evening. The home also employs a housekeeper an activities coordinator, cleaners and cooks. The home currently employs three Asian staff and four Black staff, which helps to make the home more accessible to people from the same cultural backgrounds. On the morning of the site visit staff were seen to assist people to rise and take breakfast in an unhurried fashion and to assist a number of people to go shopping and eat lunch out during the day. Training information provided by the care manager indicates that staff at the home are provides with a wide range of care courses to support good practice in the home, such as Learning Disability Award Framework training, communication, pressure area care, PEG training, eating and drinking, care planning, nutritional needs and person centred planning. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 22 Fostering equality training is also provided to raise staff awareness of equality and diversity issues that can impact on the lives of people living at the home. The home is appropriately supporting people to train for NVQ qualifications. 58 of staff have either completed or are in the process of completing NVQ training courses, with 6 more care staff due to start NVQ training courses in August 06. Staff training information records and comments by staff indicate that staff are provided with training in Health and Safety related practices, such as fire safety, food hygiene, first aid and moving and handling. The manager and the care manager (deputy) both hold qualifications that enable them to train others in safe moving and handling practices. Positive action has taken to train the majority of staff in the prevention of adult abuse and safe handling of medication. Staff recruitment files were checked at a previous inspection, 14/6/05 and found to contain evidence to confirm that correct vetting procedures are being carried out when new staff are recruited, to ensure that they are suitable to work at the home. Staff recruitment files were locked away at the time of the inspection site visit. Since then the care manager has forwarded information to the inspector to confirm that relevant checks are still carried out by the home, including copies of evidence that people’s identification has been checked and that Criminal Record Bureau checks have been carried out. WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 23 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): The judgement for this outcome group is good. This judgement has been made using available evidence including a visit to this service. Satisfactory systems are in place for maintaining quality in the home and for ensuring a safe environment. EVIDENCE: The Registered manager holds the Registered Managers Award and is a qualified nurse with 20 years experience of Residential / Nursing Care. Various Quality Assurance arrangements are in place at the home. A quality assurance questionnaire is in place that people fill in across the course of the year by answering one question a month. The care manager explained that these consultations have recently led to action being taken to address people’s concerns about the quality of the laundry service (i.e. poor quality ironing). The care manager confirmed that a senior manager carries out monthly monitoring visits and that actions identified at these visits are reviewed the following month to ensure they have been appropriately addressed. The home WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 24 has also established a system for auditing various areas of practice, including, medication, food, and Health and Safety. Periodic audits of people’s finances are carried out to check that monies are managed correctly. A recently employed member of staff explained how the manager also observes his practice and provides constructive feedback as part of his development. Records of staff meetings and unit meetings confirm that staff are provided with opportunities to discuss care practices and a range of other matters that are pertinent to running the home effectively. Information provided by the manager as part of the inspection process indicates that all essential Health and Safety maintenance checks are being carried out at the home. The fire safety log was sampled and contained evidence to confirm that fire alarms and lights are tested at the correct frequency and fire equipment being properly serviced. Suitable clinical waste arrangements are in place at the home. WCS - Newlands DS0000004267.V305473.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 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 2 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 2 2 3 x 3 x 3 x x 3 x WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA18 Regulation 16 (2) (e) 24 (3) Timescale for action Monitor people’s satisfaction with 30/08/06 the quality of the laundry service at the home; in particular ensure that clothes are consistently ironed well. Devise a clear protocol for 21/08/06 triggering closer monitoring of people’s needs where there are concerns about deteriorating health, such as poor nutrition or fluid intake. The manager must monitor people’s health observation charts to ensure that they are being routinely completed by staff and that there are no gaps in the recording that undermine health monitoring in the home. Seek clarification from the Health 21/08/06 Authority regarding the reasons that a physiotherapy service is not being made available to the people living at the home and support people to challenge this decision where they are deemed to have an entitlement to a service. Clean the carpets where they are 30/08/06 stained and replace carpets where necessary. DS0000004267.V305473.R01.S.doc Version 5.2 Page 27 Requirement 2 YA19 12 3 YA19 12 4 YA30 23 (2) (d) WCS - Newlands 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 YA14 Good Practice Recommendations It is recommended that the manager proceed with plans to provide people with dedicated, time tabled one to one time. This is particularly important for demonstrating that the people with high communication needs receive the social support they require. It is recommended that staff are provided with sexuality training to raise staff awareness regarding sexuality and personal relationship issues and to understand the need for appropriate professional boundaries. 2 YA15 WCS - Newlands DS0000004267.V305473.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 WCS - Newlands DS0000004267.V305473.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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