Inspection on 30/04/07 for Weir End House

This inspection was carried out on 30th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Weir End House 28/11/05

Weir End House 30/06/05

Weir End House 19/10/04

Weir End House 28/05/04

Weir End House 04/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Weir End House Weir End House Glewstone Ross-on-Wye Herefordshire HR9 6AL Lead Inspector Christina Lavelle Key Unannounced Inspection 30th April 2007 12.40- Weir End House DS0000024745.V337946.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 Weir End House DS0000024745.V337946.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. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Weir End House Address Weir End House Glewstone Ross-on-Wye Herefordshire HR9 6AL 01989 567711 01989 767077 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) www.craegmoor.co.uk Parkcare Homes Limited Mrs Ann Fletcher Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three service users with a mental disorder in addition to their learning disability can be accommodated. 28th November 2005 Date of last inspection Brief Description of the Service: Weir End House first became a care home in 1989. Its management was taken over by Parkcare Homes Limited over nine years ago. Parkcare is part of a much larger organisation called Craegmoor Healthcare, which runs many care services throughout the country. Craegmoor’s head office and the Responsible Individual for this home are based at Craegmoor House, John Comyn Drive, Perdiswell Park, Worcester, Worcestershire WR3 7NW. The registered manager of Weir End House and of a separate care home that is located within the same grounds (Woodpecker Lodge) is Mrs Ann Fletcher. This home provides accommodation and personal care for thirteen adults aged up to sixty-five who must require care due to learning disabilities. Three of the service users may also have a stable mental health disorder and could use behaviours that are challenging. The home has no vacancies currently. Most service users have lived there for years and they are all aged at least thirty. The property comprises of a large period house, which is situated about a mile from the market town of Ross-on-Wye. There is an annexe next to the main house in which three of the service users have their bedrooms. The property is set in extensive and lovely grounds, which include a walled vegetable garden and a woodland area and are also home to a donkey and chickens. There are two double and nine single bedrooms for service users, two of which have ensuite facilities. The home has one very large and another sizeable sitting room, a separate dining room and a conservatory for everyone to use. There are also shared toilets and bathrooms, a laundry, kitchen and office. Information about the home is provided in a statement of purpose and service users’ guide. The guide can be obtained from the home or from Craegmoor Healthcare and is available in suitable format for possible service users. The current fee for the service ranges from £590.94 up to £1008.38 per week. Additional charges include for chiropody, toiletries, magazines, swimming, gym and other recreational activities such as the cinema, pubs and clubs. The home pays up to £200 annually for each service towards the cost of a holiday. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a key inspection of Weir End House. This means all the Standards that can be most important for adults who live in care homes were checked. This visit to the home was made without telling staff and service users beforehand. Time was spent with service users, talking with some in private about their life at the home. Eight of them had also sent in survey forms showing their views. The manager discussed how the home is run, staffing, service users and any changes or developments since the last inspection. One support worker was spoken with alone about his training, experience, support received and service users’ care and lifestyles. Seven service users’ relatives and seven health or social care professionals who are involved with the home had sent in comment cards about the home. All the feedback received is referred to in this report. Various records kept by the home and the premises were looked at. There was also helpful information in a questionnaire the manager had completed before this visit. All information received by the Commission about the home since the last inspection is also considered. This includes the reports made by a representative of Craegmoor following their required monthly visits to check how the home is being run. There had not been any complaints made about the home or issues raised in respect of vulnerable adults. What the service does well: The home would only offer care to a new service user if it could meet all their needs. Possible residents always visit and try out the home before moving in. Service users each have a care plan that they help to make. Plans ensure staff know all their needs and goals and how they can offer support to meet them. Service users all have busy lives and can go out when they want to. They are supported with activities they choose and encouraged to be as independent as they can. One relative says “They enable even the most disabled to achieve their full potential, giving them a chance to make decisions and achieve”. It feels relaxed and friendly in the home and service users’ families are made welcome. One relative comments “The home has a very welcoming and happy atmosphere and our son has made amazing progress during his time there”. Relatives all think the care the home provides is very good. One says “Staff are always looking for new ways to keep residents stimulated and happy”. Staff respect service users’ individual rights and privacy and support them to have good personal and health care. They also manage their medicines safely. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 6 Weir End House is in a lovely setting with large grounds. The home is homely and comfortable and service users help staff to keep it fresh, clean and tidy. There is a stable staff team so staff and service users know each other well. There are enough staff and they receive a lot of training. This means they can understand service users’ needs and know how to support and keep them safe. The home is very well run by a manager with the right skills and experience. Staff receive good support and work well together. The team is committed to ensuring that service users have a nice home, good care and interesting lives. 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. The summary of this inspection report can be made available in other formats on request. Weir End House DS0000024745.V337946.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 Weir End House DS0000024745.V337946.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Suitable information is available to help prospective service users decide if they might like to live at Weir End House and if the home could meet their needs. Thorough assessment and admission procedures are in place to make sure the home would be able to meet the needs, wishes and goals of new service users. EVIDENCE: Appropriate information documents are provided for the home, including a statement of purpose, service users guide and terms & conditions of residence. Relevant documents are produced in a format with symbols and photographs so they should be easier for people with learning disabilities to understand. Service users say they have been given a copy of the service users’ guide. Although there have not been any new service users for a while it is reaffirmed with the manager that the assessment and admission process for prospective service users would be carefully managed. Staff from the home would always meet them to fully assess their needs, having received a copy of a community care assessment made by a social worker from their funding authority. Visits to the home, overnight stays and a trial stay would be arranged to ensure they fit in with existing service users and their needs can be met. A review meeting would be held after the trial period, involving the home, service user and their representatives to decide if the placement is suitable and so if they stay there. Weir End House DS0000024745.V337946.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. Service users’ plans show all their current care needs, preferences and goals. This helps to ensure they receive the support they would like and need to meet their needs and are enabled to make choices and decisions about their lives. Relevant risks are also assessed so that the home can support service users to take reasonable risks to enhance their lives, whilst any possible risks to their safety and welfare are minimised. EVIDENCE: One service user’s care records were looked at in detail and another’s briefly. They include background information, their photograph, pen picture and a map showing all the people who are important to them. Each service user has a detailed care plan that is drawn up in an appropriately “person centred” way. Plans therefore show their likes & dislikes, preferred daily routines, skills (and how to develop them) and goals as well as their needs. They cover relevant areas, such as mental health & behaviours, communication and independence, Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 10 and appropriately specify the action and support needed to meet any goals identified. Progress is also evaluated regularly, with any outcomes described. Craegmoor had recently introduced a more “person centred” care plan format and there are detailed instructions for staff relating to setting them up and for subsequent reviews, with the full involvement of service users. They include personal assessments, service users’ consent to share confidential information, personal details, their life story, everyday care plans; additional care plans, risk assessments and dated evaluations. Pictures, symbols and photographs of significant people, life events etc are used in the plans so that service users can understand them better and they are signed and owned by them. The home has started to revise the existing plans and risk assessments in line with this new format with the service users. One service user confirmed he had helping to draw up his own plan and already has a copy. Detailed daily reports are made by care staff about service users showing any events in their lives, their behaviours, moods, health, activities etc. Records are also kept of visits to and from health & social care professionals and of contact and communication with relatives, friends and advocates. They provide very useful information about service users’ ongoing lives and their health, welfare and progress and also demonstrate that their plans are being followed. Service users are allocated particular staff as their keyworker. They spend some individual time with them and so make the support they receive be more personal. The staff member interviewed said he is able to offer some one to one support and to arrange and go on outings the service user he keyworks wants. He also helps him keep his room tidy, check and buy new clothes etc and arrange and attend necessary health care checks. Keyworkers also review their allocated service users’ plans with them monthly as well as participate in their annual placement reviews. All the service users spoken with know their keyworker and clearly get on well with them and appreciate their input. Relevant risk assessments are carried out which appropriately focus on service users’ rights to independence and to leading a normal lifestyle. They include them managing their own personal allowance, going out and having their own bedroom keys. Some people also have a health and keeping safe plan so that action is taken to minimise any possible risks to their health, safety & welfare. Weir End House DS0000024745.V337946.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Service users take part in a range of activities they enjoy and that help them to develop their social and life skills and integrate within the community. Service users’ rights and individuality are respected and they are encouraged to make choices and decisions in their daily lives to the extent they are able to. They are also supported to maintain links with their families and friends. The home provides varied and wholesome meals that service users like. EVIDENCE: Service users’ plans include a list of their social interests and needs; a daily activity planner and a timetable named “What I do during the week”. Plans show that some people go to college or to a work related day service to develop their life skills. One service user says he goes into Ross shopping, to the cinema and on day trips with his keyworker and that he can out as often as he. However he spends all his time in the garden and views this as his job, Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 12 alongside the home’s gardener and has chosen not to attend day services or college any more. Another service user says she goes to college and shops in Ross for her own clothes and toiletries. She knits and does jigsaws when at home, recently went to an ice show and is saving to go to Disneyland Paris. Service users are enabled to mix within the wider community. The home has three vehicles and they all regularly go out socially to pubs, cafes, Ross town and the Forest of Dean. Staff are deployed flexibly to facilitate individualised activities and provide transport. Service users’ contracts specify the provider will contribute £200 a year towards an annual holiday and the home also has a monthly budget to fund leisure activities, college fees, outings etc. It is good that staff continually seek new opportunities for service users out in the wider community which are more “mainstream”, such as an environmental project. One relative comments “X has become a very independent and knowledgeable person because of the encouragement of staff”. Service users make choices in their daily routines and their independence is encouraged. A kettle was seen in one person’s bedroom for making their own drinks and they are all expected to take responsibility for household tasks and self care i.e. their rooms and laundry to the extent they are able. Service user meetings are held monthly when they discuss menus, activities etc and issues relating to the home. One service user is chairman of the Craegmoor residents’ forum called “My Voice” and attends regional meetings at their head office monthly. He obtains other service users’ views for these meetings and says this has given him confidence to talk in public and interview people. Craegmoor also produce a newsletter for service users & their representatives. The provider and manager are aware they must ensure equality and that the diverse needs of service users are identified and met. Service users’ rights, gender and special needs are considered and being addressed appropriately. One relative says “They enable even the most disabled to achieve their full potential, giving them a chance to make decisions & achieve”. The manager had copied a recent press publication on the “Dignity Challenge” and put it on the staff notice board. She is to obtain information on the Mental Capacity Act soon to ensure the staff team are familiar with new legislation and guidance. Staff support service users to keep in touch with their families and maintain friendships. Staff and service users talked about their regular calls from the home and visits to them with their keyworkers. Families confirm they are kept informed and involved in their relatives care and made welcome in the home. Regarding food provided by the home weekly menus are drawn up and service users are involved in planning, shopping and cooking. There is a comment sheet service users can complete showing their views of meals they have had to assist in future planning. Breakfast is individual’s choice of cereals, toast, fruit juice etc. and main meals showed on menus are varied and wholesome. They include fresh vegetables, pasta, salads, rice etc. and there is always fruit Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 13 available and yoghurts. This evening’s meal was ravioli on toast or ham, new potatoes, peas & parsley sauce for those who had a snack meal for lunch, followed by jelly and ice-cream. Staff say they shop daily for fresh food and stocks seen included fruit juice, fresh fruit & vegetables, wholemeal cereal & bread, yoghurts and home made cakes. Service users say the food is nice and they can choose what they like within reason. The home has a “Fit to eat” file about health eating and have laminated cards showing healthy meals and the value of exercise etc. Staff support service users who require a special diet and one person’s plan includes that their food intake and health should be monitored. The manager is aware of one service user’s difficulty in respect of their diet and staff take appropriate steps to minimise any negative effects. Whenever necessary a nutritional assessment is carried out and service users have weight checks that are recorded monthly. Attention is also paid to maintaining good food hygiene in the home e.g. fridge & freezer temperatures are checked and recorded; the home has a food probe and stickers are used and dated of when jars etc. are opened. Weir End House DS0000024745.V337946.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Service users receive appropriate support with their personal and health care and their medicines are managed safely by the home on their behalf. EVIDENCE: Service users’ plans show the support they each need with their personal care and any individual preferences, such as receiving support from a same gender carer. Service users were observed to be well presented and appropriately dressed for their age, activities etc. and they say they are able to choose and shop for their own clothes, which most do with help from their keyworkers. Care records include information about each service user’s physical and mental health and their plans specify any issues relating to their health and details of their medication. They all have an annual general health care check from their GP and other routine & specialist health care checks are arranged and attended as and when necessary, with records kept. Staff have received instruction from relevant specialists, such as the Diabetes nurse and a Dietician, and there is also written guidance to help them support service users with special needs. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 15 One GP and other health care professionals say that the home communicates well with them; that they can see their patients in private and there is always a senior available to confer with. They feel that staff understand service users’ needs and any advice they give is incorporated in their plans. Although service users’ plans in respect of their health care already involve them to some extent e.g. one person makes their own appointments, it is good the home intends to set up Health Action Plans (HAPs) for each of them. HAPs meet with Department of Health guidance for people with learning disabilities as they help to ensure that their health is monitored; any problems identified and their good health is promoted. They also show that any special care needs are recognised and understood and they are supported to keep themselves healthy through preventative as well as routine & specialist health care input. Regarding medication the home has an assessment tool to establish if service users may be able to self-administer their medicines safely, although currently none do. Medication is being suitably stored in a locked trolley and keys held securely by senior staff and managers. Administration by staff was observed to be managed safely and records are being maintained appropriately and staff designated to administer have received relevant in-house & external training. Appropriative policies & procedures are in place for managing medicines and the home has protocols for homely remedies and for when medicines can be used as and when required. There is a reference book and patient information leaflets are kept for staff information and medication is audited regularly both internally and by Craegmoor management when an assessment is made of the home’s competence in respect of supply, storage & administration. Weir End House DS0000024745.V337946.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Robust systems are in place to manage complaints and protect service users. Service users and their relatives know how and feel able to express their views and concerns with confidence they will be listened to and dealt with properly. EVIDENCE: The home has a written complaints procedure in a suitable format for service users. Copies of this procedure have been given to them and are available in the home. Service users say they can always talk to the manager and their keyworker and that all the staff are very nice. They also have the opportunity to raise issues in their meetings. Service users’ relatives are familiar with the procedures but have not needed to complain about the home. The Commission has also never received any complaints about the service and no issues have been raised relating to safeguarding vulnerable adults. There are policies & procedures relating to abuse and protection, including a whistle blowing procedure and a copy available of the multi-agency procedures for Protection of Vulnerable Adults (POVA). Staff receive relevant instruction as part of their induction, through LDAF & NVQ and ongoing training, including a session taken by the local POVA co-ordinator. The manager and staff know where and how to refer any concerns relating to service user’ protection. They are clearly aware of their responsibility to safeguard service users’ and would take any necessary steps to do so, although feel that the practice and climate within the home ensures that such issues would not arise. Weir End House DS0000024745.V337946.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. Weir End House provides accommodation that suitably meets service users’ needs and offers them a safe, clean, homely and comfortable home. The accommodation is decorated, furnished, equipped and kept to a high standard. EVIDENCE: Weir End House is in a lovely rural setting and is only a couple of miles from Ross-on-Wye town centre. Whilst service users are not able to walk to access local services and facilities the home has three vehicles, and staff are deployed flexibly, to provide transport whenever needed into town, college, outings etc. The home is spacious and comfortable and although a relatively large group of younger adults live at the home, three service users have their bedrooms in a separate annexe. The communal rooms are very pleasant and all areas seen were clean, tidy & fresh and well decorated, furnished & equipped. The outside of the home has recently been redecorated, with new windows fitted, and there is an ongoing programme to upgrade the property. The home also has an efficient system/maintenance worker for minor repairs and improvements. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 18 The grounds are a credit to the home. They are very well maintained with a wide variety of vegetables such as potatoes, carrots, onions, lettuce, beetroot and tomatoes in the green house. Chickens provide the home with eggs and the home has a donkey that service users help feed etc. Some people were seen to be sitting out today and freely wandering around enjoying the garden. Service users clearly view Weir End House as their own home and have well personalised their bedrooms. They use their rooms as their personal space if they wish and hold keys to lock their doors. Whilst two bedrooms are shared this has been a long-term arrangement and the occupants are happy to do so. Consideration would have to be given to this if one person moved out. Attention is clearly paid to ensure that good general health & safety and food hygiene are maintained in the home. There are policies & procedures relating to all relevant aspects and staff undertake all the mandatory training topics. Protective gloves etc. are provided; there are suitable laundry facilities and arrangements in place for the disposal of soiled waste. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. Service users continue to be supported by a stable, competent and effective staff team who know them well. Staff are appropriately trained and supervised. Thorough recruitment procedures are in place, which should help to make sure that only suitable staff work at the home, for service users’ protection. EVIDENCE: The staff team comprises of the manager, deputy manager, thirteen care staff and five ancillary staff. Rotas show at least three support staff are deployed throughout the day on weekdays and at least two weekends, plus the manager and/or deputy. Two staff sleep in on call at night. These levels are more than just adequate to meet the individual and group needs of service users. There is a very stable staff team, which is good for consistency of care and staff and service users clearly know each other and get on well. Their obvious commitment to the home and service users is commendable. One social care professional says a “Skilled care team and very caring. The home is well maintained and has high standards, which reflect the value base of the home”. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 20 Regarding recruitment it was previously confirmed that Craegmoor have robust procedures in place. Although there were no new staff recently a staff member who transferred from another of the provider’s homes since the last inspection was interviewed. He confirmed a new police check and written references had been obtained and he has completed a thorough induction. This involved time spent with senior staff going through all the home’s policies & procedures, fire safety, health & safety etc and working some shadow shifts. He has completed all core, and some care and service users’ needs related, training topics and is soon to start NVQ. Records show he fully completed an application form and all necessary checks had been taken up. Also there are copies available of the relevant, required documents e.g. photograph & driving license. The provider has implemented a comprehensive induction programme for all new care staff. Each staff member also has a training & development file, which includes all the training they must undertake during their three-month probationary period and then ongoing. They also have a Personal Performance Agreement that involves regular individual supervisions, work performance appraisals and a training & development plan. New staff are now also expected to complete the LDAF induction programme, which is accredited especially for staff working with people who have learning disabilities. The manager and records show that the whole staff team have undertaken the mandatory health & safety training with refreshers arranged as needed. Other relevant training includes managing medicines & person centred planning and sessions on mental health from a Psychologist. Since the last inspection some have attended autism awareness and report writing. Five staff already have an NVQ qualification; three are about to complete and then others will start. There is good communication within the team and they work well together, for the benefit of service users. Staff meetings are held 4-6 weekly and they say their views and any issues raised are listened to and acted upon. Support staff receive regular individual supervision from a team leader and they feel they are well supported by each other and management. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including this visit to the service. Service users benefit from a home that is being well run by an experienced and qualified manager. The management and staff team ethos and approach, and their working practices, promote service users individuality, safety and welfare. Systems are in place to monitor and review the quality of the service, resulting in a plan for its continual improvement, based on what service users want. EVIDENCE: The registered manager (Mrs Ann Fletcher) also manages Woodpecker Lodge and is supported by a deputy manager who is designated as the unit manager of Woodpecker Lodge. Mrs Fletcher has many years experience working with people who have learning disabilities. She has achieved an NVQ level 4 in care & management and continues to undertake appropriate training and update her knowledge and skills to keep abreast of current guidelines and legislation. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 22 Management arrangements for the home are appropriate and administrative and supervisory tasks and responsibilities are delegated to the deputy, two team leaders and some aspects to other staff, such as general and fire safety. This inspection provides evidence that the home continues to be very well run, and there is an open and positive management approach. The leadership style is clearly effective, and there are clear lines of accountability. The manager confirms that she and the home are also well supported by the provider. The home has implemented Craegmoor’s comprehensive Quality Assurance & Monitoring (QA) system. Part of this process includes regular unannounced external audits of various aspects of the service, such as medicines, health & safety, care planning and the premises. Also the required monthly visits to the home form a representative of the provider. Home managers have received training on this QA system and are also required to complete internal audits of all the relevant aspects of the service, which are appropriately based on the National Minimum Standards. Another important element of the QA process is a service user involvement project called “Your Voice” and there is guidance for managers that include principles for involving service users and significant other people. Monthly meetings are held at the home (with an agenda & records kept) and some service users represent the home at group meetings held at Craegmoor’s head office. Service users and their relatives, GPs etc are also sent questionnaires quarterly asking what they think is good about the service, not so good and what should change. This is good as feedback from service users and other stakeholders must be included in plans to continually develop and improve the service. Reports made by the provider and manager include actions needed to improve the service with dates that are confirmed when completed. These actions points appropriately result in an annual plan for service development. Regarding health & safety staff undertake training in all mandatory topics i.e. first aid, food hygiene, infection control, fire safety and moving & handling with regular refreshers. The pre-inspection information and records show all required safety and electrical checks are carried out; routine in-house and external maintenance and/or servicing of services and equipment are arranged and COSHH risk assessments are in place. The Fire Authority had recently inspected the home and made several requirements. The manager confirmed the home’s evacuation procedures had duly been revised and steps were in hand to do other work specified. The fire log shows all required checks and tests had been recorded as undertaken at the specified intervals, with drills arranged six monthly. All staff participate in at least one drill a year with service users are involved and fire safety is discussed in their meetings. There were no safety hazards identified during this visit and from this evidence it was apparent that staff and service users are aware of how important it is to maintain safety in the home and that their practices seek to promote safety in the home and minimise any identified risks to safeguard service users & staff. Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 3 X X 3 X Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NA STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered persons meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered provider 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 to consider carrying out. No. Refer to Standard Good Practice Recommendations Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Weir End House DS0000024745.V337946.R01.S.doc Version 5.2 Page 26 - 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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