Inspection on 24/09/08 for Wellington Road (51)

This inspection was carried out on 24th September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wellington Road (51) 22/06/06

Wellington Road (51) 08/02/06

Wellington Road (51) 20/09/05

Wellington Road (51) 10/03/05

Wellington Road (51) 24/09/04

Wellington Road (51) 27/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Wellington Road (51) 51 Wellington Road New Brighton Wallasey Wirral CH45 2ND     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Daniel Hamilton     Date: 2 4 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Wellington Road (51) 51 Wellington Road New Brighton Wallasey Wirral CH45 2ND 01516395685 Telephone number: Fax number: Email address: Provider web address: dmilligan@btinternet.com Name of registered provider(s): Name of registered manager (if applicable) Darryl Lindsay Milligan Type of registration: Number of places registered: Mrs Patricia Pauline Milligan care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 Date of last inspection Brief description of the care home 51, Wellington Road provides accommodation and personal care for 8 service users with a learning disability. The service has two large sitting rooms and a dining area on the ground floor. There are single and shared bedrooms on the upper floors. The service is provided in a large semi-detached house in the New Brighton area of Wallasey. The property is located within a short walking distance of the promenade and a local bus service, train station and shops. A statement of purpose and service user guide has been developed to provide information on the service and copies are available in the office area for reference. Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 8 Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The Quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection took place over one day and lasted approximately 8 hours. Eight people were being accommodated in the home at the time of the visit. A partial tour of the premises took place and observations were made. A sample of two care records were case tracked (this involves looking at the support a service user gets from the manager and staff including their care plans and medication) and a selection of staff and service records were viewed. The registered manager, deputy manager, two support staff and all the people using the service were spoken with during the Care Homes for Adults (18-65 years) Page 6 of 32 visit. Prior to the inspection, survey forms were distributed to a number of staff and service users to obtain additional information about the service. The manager also completed an Annual Quality Assurance Assessment to provide general information on the service. All the key standards were assessed and action taken in response to the previous requirements and recommendations from the last key inspection in June 2006 was reviewed. The Care Home Fees for this service were 366.17 to 381.17 pounds per week at the time of the visit. What the care home does well: What has improved since the last inspection? What they could do better: The Service user guide should be produced in alternative formats geared towards the needs of people with a learning disability. This will help prospective and current service users to understand the information more easily. An holistic pre admission assessment of needs should be undertaken by the service, to ensure the diverse needs of people considering moving into 51, Wellington Road are fully assessed prior to admission. Care Homes for Adults (18-65 years) Page 8 of 32 Service user plans must be updated and detail how service needs are to be met. This will help new and existing staff to deliver person centred care in response to the changing needs and personal goals of the people using the service. Furthermore, risks to the health or safety of service users must be assessed and appropriately managed, to ensure the independence and wellbeing of the people using the service is safeguarded. A record of the meals served to each service user should be maintained, to provide information on dietary intake and individual meal choices. All staff should be supported to complete a certified medication training course and undergo an assessment of competency. Furthermore, a service user identification system should be established, to ensure best practice. A record of the date that each medication is received into 51, Wellington Road should also be recorded on Medication Administration Charts, to provide a clear audit trail. Staff must not commence employment at 51, Wellington Road until two satisfactory references and a Protection of Vulnerable Adult or Criminal Record Bureau certificate have been received. This will help to protect the welfare of vulnerable adults. A training programme should be established for the home and all staff should complete training and refresher training periodically in Safe Working Practice training i.e. Fire Awareness, Basic Food Hygiene, First Aid, Infection Control, Moving and Handling. This will help to promote safe working practices and to safeguard the welfare of staff and the people using the service. Records should also be maintained to provide evidence that staff have completed induction training that is compliant with the Skills for Care Common Induction Standards. This will help to provide evidence that staff are appropriately inducted, competent and safe to leave. The manager should complete refresher training in Safe Working Practice topics and complete a level 4 National Vocational Qualification in Care or equivalent, to ensure he has the necessary qualifications for his role. Records should be established, to provide evidence that the emergency lighting, hot water temperatures and fire extinguishers are tested or visually inspected on a monthly basis, to promote and safeguard health and safety. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service information and assessment processes are in need of ongoing development, to ensure the service is able to meet the diverse needs of prospective and current service users. Evidence: A Statement of Purpose and Service User Guide had been developed in standard format to provide information on the service provided at 51, Wellington Road. The manager was recommended to also produce the documents in alternative formats, as some people using the service reported that they experienced difficulty or were unable to read. Examination of the documentation confirmed the Statement of Purpose had been updated to include information on the qualifications of the staff team as recommended at the last visit. The manager was also advised to update the Service User Guide to include the correct contact details of the Commission for Social Care Inspection, a summary of the complaints procedure and a standard form of contract. Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: The Annual Quality Assurance Assessment detailed that policies were in place for referral and admission and the manager confirmed that people would not be admitted to the home before an assessment of needs had been undertaken. No service users had moved into 51, Wellington Road since the last visit. Examination of two personal files belonging to the people using the service revealed different standards of assessment practice undertaken by the service. The first assessment viewed was satisfactory and included background and general information on the personal, health and social care needs of the service user. The second assessment viewed was not dated or signed and contained limited information on the needs of the service user. Some sections of the assessment form were also incomplete. A copy of an assessment completed by a social worker was also available on file, which had been obtained prior to the person being admitted to the home. Although shortfalls were noted in assessment practice, staff spoken with were able to demonstrate knowledge and understanding of the needs and support requirements of the people living in the home. Furthermore, staff were observed to interact with service users in a respectful and positive manner and all the people using the service complimented the standard of care provided. Comments included I like living here, They look after us all well and The staff are nice. Personal files viewed during the inspection contained a signed copy of a Residents Contract or Statement of Terms and Conditions. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The assessed and changing needs of the people using the service are not appropriately planned for, to promote and safeguard independence and wellbeing. Evidence: The Annual Quality Assurance Assessment for the service detailed that policies and procedures had been developed for Individual Planning and Review. The files of two people living in the home were viewed during the visit. Each file contained a Service Users Plan of Care, Assessment, Objectives and Review form. Care plans viewed did not clearly outline or describe how the assessed, changing needs and personal goals of the people using the service were to be met. Furthermore, some of the care plan records viewed were not dated and some information recorded was not up to date. Report books were used to record information on the welfare of the people using the service. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: Only one file contained information to confirm that potential hazards and risks had been assessed and no records were in place to confirm the assessment had been kept under review. The other file did not contain a risk assessment to confirm that potential risks had been assessed or evidence to confirm that appropriate action had been taken to minimise hazards. Similar issues of concern were noted at the last visit when a requirement was made to improve practice. These issues must be addressed to confirm the welfare of the people using the service is fully safeguarded. The issues were discussed with the Manager during the visit and advice was given on how care planning and risk assessment processes could be further improved. Despite the absence of key information, the manager and staff team demonstrated an awareness of the needs and support requirements of the people living in the home. The people using the service appeared relaxed in their home environment and confirmed they were encouraged to make decisions about their lives with assistance from staff when required. For example, a service user reported I can go to bed when I want. Likewise, another person living in the home stated I can choose what I want to wear and do each day. Care Homes for Adults (18-65 years) Page 14 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Meals, activities and routines are flexible and varied to enable service users to follow their preferred lifestyle. Evidence: 51, Wellington Road presented as a warm, relaxed and caring atmosphere. The manager and staff team were observed to be friendly and approachable towards the people using the service who appeared happy and content in their home environment. The people living at 51, Wellington Road were supported to follow their preferred lifestyle and to engage in a range of activities to maintain and develop their social, communication and independent living skills. For example, some service users attended day centres or colleges whilst others preferred to visit relatives or stay at home, to assist in day to day household tasks such as cleaning and shopping. Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: Service users spoken with confirmed they could follow their preferred daily routines and spend time in the lounge areas or in the privacy of their own room as seen on the day of inspection. The people using the service were assisted by staff to socialise and participate in a range of leisure, social or recreational activities subject to individual need. The usual home entertainment was available in the home such as videos, DVD, music and a football game table. A holiday away from 51, Wellington Road is also included in the weekly fee and service users choose where to go each year. The last holiday was in August when service users decided to visit Blackpool for five days with the support of staff. Service users confirmed they were able to maintain contact with family and friends and there were no restrictions around visitors coming to the house. One person reported I visit my mum every day except Sunday. Some people also attended the Dolphin and Saturday club, where they were able to socialise and maintain contact with other friends. A menu planning system had not been developed as the people using the service wanted the flexibility to vary their choice of meals. A record of meals provided each day was in place which provided evidence of a varied and balanced diet. The manager was advised to also maintain a record of individual meals served to each service user, to provide a record of the meal choices and the dietary intake for each person. The people using the service reported that they were encouraged to participate in shopping for the home and confirmed that they were encouraged to assist in household tasks such as cleaning, washing up and tidying the kitchen. Some service users reported that they would also like the opportunity to participate in more cooking activities. For example, one person stated I would like to be able to make cakes in the kitchen again. This request was discussed with the manager who agreed to address the matter on behalf of the service users. The mealtimes at 51, Wellington Road were flexible to meet the needs of service users and the evening meal remained an opportunity for the people living in the home to socialise and exchange information about their day as part of a family unit. Comments regarding the standard of catering and food was good. For example; one person reported The food is nice and another said They ask me what I want to eat. Care Homes for Adults (18-65 years) Page 16 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service are supported to maintain their personal care and have access to healthcare services to maintain independence and general wellbeing. Evidence: The people living at 51 Wellington Road required minimal assistance with personal care and support. All of the service users were able to transfer independently and did not require any aids to promote their independence or safety. Although shortfalls in care planning processes were noted, the manager and staff spoken with were able to demonstrate knowledge and understanding of the personal care needs and support requirements of the people living in the home. Furthermore, staff were observed to interact with service users in a respectful and positive manner. Examination of health care records confirmed that the people using the service were supported to attend appointments with health practitioners. Records viewed detailed that service users had accessed the chiropodist, psychiatrist, dentist, doctor, optician or community nursing staff, subject to individual needs. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: The Annual Quality Assurance Assessment for the service detailed that staff had access to a policy on the Control, Storage, Disposal, Recording and Administration of Medicines. The manager was also recommended to obtain a copy of guidance issued by the Royal Pharmaceutical Society of Great Britain for staff to reference. Medication was stored in a medication cabinet that was fitted to a wall in the office. A sample of Medication Administration Records (MAR) were viewed during the visit and all accounted for medication administered. The manager was recommended to record the date that each medication was received into the home on individual MAR charts to provide an audit trail and to establish a service user identification system and a record of staff responsible for administering medication, together with sample signatures. Medication was dispensed in a monitored dosage system by a local pharmacist and administered by staff as the people using the service were unable to administer their own medication. The Manager reported that all staff had completed in house medication training and that himself and two of the five staff had completed training from the Community Pharmacist. Two other staff had completed training in previous roles however only one of the staff had evidence of having received medication training. The manager was recommended to ensure that all staff complete refresher training and that documentary evidence of medication training be placed on file, to ensure best practice. The manager was also recommended to undertake a written assessment of competency on all staff designated with responsibility for administering medication, to ensure best practice. Care Homes for Adults (18-65 years) Page 18 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems had been developed to listen and respond to complaints and to safeguard and protect vulnerable people from abuse. Evidence: A Complaints procedure had been developed in a standard format. At the time of the visit, the procedure was in need of review as it did not include the correct contact details of the Commission for Social Care Inspection. The manager reported that a copy of the procedure had been attached to the notice board in the dining room but this had been removed since the last visit. The manager agreed to re-display a copy of the procedure and to consider producing the policy in a format suitable for people with a learning disability. The Annual Quality Assurance Assessment (AQAA) for the service detailed that no complaints had been received since the last visit. This was checked by discussing the issue with the people living in the home and by examining the complaints record for the service. The Commission for Social Care Inspection had also received no complaints about 51, Wellington Road since the last inspection. Policies and procedures on abuse and whistle blowing had been developed by the service and a copy of the local authority safeguarding adults policy had been obtained Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: for staff to reference. The manager reported that four of the five staff had completed external training in the protection of vulnerable adults from abuse and that he had provided training in this subject to the outstanding employee as part of the induction process. Staff spoken with during the visit demonstrated a satisfactory awareness of how to recognise and respond to suspicion or evidence of abuse and the people using the service confirmed that they felt safe and had no concerns or complaints about the home. Care Homes for Adults (18-65 years) Page 20 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is pleasant and generally well maintained providing the people using the service with a safe, clean and comfortable environment in which to live. Evidence: 51, Wellington Road is a large semi detached property situated in a residential area in the New Brighton area of Wallasey. The premises is in keeping with other properties in the area and there are no outward signs that it is a care home. The home is maintained by the manager and contractors are brought in as and when required for major or specialised work. The service is currently registered to provide accommodation for 8 people. The accommodation comprises a spacious front lounge and an office, lounge dining area and domestic style kitchen to the rear of the premises. Both the lounges on the ground floor have a television and there is also an additional lounge on the first floor, which is used by service users who wish to listen to music. On the day of this visit the home was clean, well maintained and appeared safe. The garden to the rear and front of the premises was tidy and the flower beds maintained. Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: The furnishings in 51, Wellington Road are of good quality and domestic in character. Service users that are not mobile could not be accommodated in the premises as all bedrooms are on the upper floors and the home does not have a passenger or chair lift to enable service users to access the floors easily. The accommodation is provided in both single and shared bedrooms. The shared bedrooms have a privacy screen to promote service users privacy. Each bedroom is personalised and decorated and furnished according to the individual tastes of the service user. Communal bathrooms and toilets are located on each floor near to service users bedrooms. All bedrooms are equipped with a call system, which is used by service users in an emergency. A STROBE is also provided for a service user that has a hearing impairment, to enable them to respond to the fire alarm should the need arise. The laundry facility is sited away from the food preparation area and the Annual Quality Assurance Assessment for the service detailed that policies and procedures are in place to prevent infection and to manage infection control. A cleaner works four days per week and assists the people using the service to maintain and clean their bedrooms. Care Homes for Adults (18-65 years) Page 22 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment practice is not safe or robust and does not protect the welfare of the people using the service. Evidence: 51 Wellington Road had a team of 4 support staff and a registered manager. The staffing hours in the home were variable between the hours of 8.00 am to 10.00 pm in order to respond to the needs and routines of the people living in the home. Examination of rotas and discussion with staff and service users confirmed there was normally one or two staff on duty during the day and evening. During the night, one member of staff undertook sleep in duties. The manager reported that two support workers and a cleaner had commenced employment at 51, Wellington Road since the last visit. The Annual Quality Assurance Assessment (AQAA) for the service detailed that staff who had worked in the home in the past 12 months had completed satisfactory pre employment checks. The personnel files of the three staff were viewed during the visit and a number of issues were noted regarding recruitment practice and records. For example, one employee did not have an application form, health declaration or evidence of induction Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: and only one reference had been obtained which was not dated. Secondly, another application form did not provide full employment history information and the Criminal Record Bureau check on file was over 16 months old and related to a previous employer. Furthermore, one reference was approximately 2 years old and the other reference had been received approximately 5 months after the employment had commenced. There was also no evidence of induction on file. The references relating to a third staff member were not dated and there was no evidence of induction. The AQAA for the service detailed that two of the four care staff had a National Vocational Qualification in Care (NVQ) at level 2 or above. The outstanding two staff were working towards a NVQ level 3 in Care at the time of the visit. A training and development plan had not been developed for the home. Examination of individual training records revealed that some staff had completed a limited range of training during their employment at 51, Wellington Road and were in need of refresher training in Safe Working Practice topics. The manager was also advised to also obtain information on the Skills for Care Common Induction Standards, to ensure staff completed appropriate induction training. The Annual Quality Assurance Assessment for the service highlighted that training was to be updated in the next 12 months. Despite the absence of induction records, staff spoken with confirmed they had received induction training and staff spoken with demonstrated a good awareness of the principles of care and the importance of promoting independence and rights. Care Homes for Adults (18-65 years) Page 24 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of key information and records is in need of ongoing development and review, to safeguard the welfare of vulnerable adults. Evidence: 51, Wellington Road was managed by Mr Darryl Milligan who was registered with the Commission for Social Care Inspection as the manager of the service. Since the last visit, the manager had completed a level 4 National Vocational Qualification (NVQ) Registered Managers award. Advice was given regarding the need to also complete a level 4 NVQ in Health and or Social Care and to update safe working practice training. Certificates were on file to confirm the manager had completed training in the Protection of Vulnerable Adults and managing challenging behaviour. A certificate was also viewed which confirmed the manager had completed a workshop in Challenging Behaviour as recommended at the last inspection. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: The manager reported that the Registered Provider continued to visit the home on a regular basis in accordance with Regulation 26 of the Care Home Regulations, however reports were not available in the home for inspection on the day of the visit. Records showed that questionnaires were sent to the people using the service during July 2008 and copies had been retained for reference. The survey covered a range of areas including Food and Catering, Personal care and support, Daily living, Premises and Management. A summary report had been produced and the manager was advised to develop an annual development plan for the service. Minutes were available to confirm that staff meetings were coordinated periodically. Discussion with the service users and the manager confirmed that meetings were also coordinated with the people using the service. Recent minutes of the meetings were not available for inspection on the day of the visit, as they were stored on the managers computer. Prior to the inspection, the manager completed an Annual Quality Assurance Assessment for the service which provides key data and numerical information on the service. All sections of the document were completed, however there were areas were more supporting evidence would have been useful to illustrate what the service has done in the last year and how it is planning to improve. Information received via the Annual Quality Assurance Assessment confirmed policies and procedures had been developed for Health and Safety. Likewise, the dataset confirmed that equipment in the home had been serviced and or tested periodically. Fire records were viewed for the property. Records were available to confirm the fire alarm system had been tested on a regular basis and service certificates were available to confirm the fire alarm system and extinguishers had been periodically inspected and maintained. At the time of the visit there were no records to confirm the emergency lighting had been tested and the fire extinguishers visually inspected on a monthly basis. Likewise, a record had not been established to confirm the temperature of each hot water was checked and regulated to 43 degrees centigrade. A current public liability insurance certificate was displayed and previous inspection records detailed that a building risk assessment had been carried out. The manager was aware of his obligation to record any accidents and incidents and the circumstances when the Commission must be notified. Care Homes for Adults (18-65 years) Page 26 of 32 Care Homes for Adults (18-65 years) Page 27 of 32 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person must 30/08/2006 ensure that service user plans are detailed showing how service needs would be met. The plans must be reviewed at regular intervals with the service users and/or representatives wherever possible. The registered person must 15/08/2006 ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. The registered person must Obtain two written references for all staff employed at the care home. 15/08/2006 2 9 13 3 34 18 4 42 23 The registered person must 15/08/2006 ensure that the hot water at outlets used by service users is checked regularly to ensure that it close of 43 degrees centigrade. Care Homes for Adults (18-65 years) Page 28 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person must 24/11/2008 ensure that service user plans are detailed showing how service needs would be met. The plans must be reviewed at regular intervals with the service users and or representatives wherever possible. This will help new and existing staff to deliver person centred care in response to the changing needs and personal goals of the people using the service. 2 9 13 The registered person must ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. This will help to protect and safeguard the independence and wellbeing of the people using the service. 24/11/2008 Care Homes for Adults (18-65 years) Page 29 of 32 3 32 19 Staff must not commence 24/10/2008 employment at 51, Wellington Road until two satisfactory references and a Protection of Vulnerable Adult or Criminal Record Bureau certificate have been received. This will help to protect the welfare of vulnerable adults. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The Service user guide should be produced in alternative formats geared towards the needs of people with a learning disability. This will help prospective and current service users to understand the information more easily. An holistic pre admission assessment of needs should be undertaken by the service, to ensure the diverse needs of people considering moving into 51, Wellington Road are fully assessed prior to admission. A record of the meals served to each service user should be maintained, to provide information on dietary intake and individual meal choices. A record of the date that each medication is received into 51, Wellington Road should be recorded on Medication Administration Charts, to provide a clear audit trail. All staff should be supported to complete a certified medication training course and undergo an assessment of competency. Furthermore, a service user identification system should be established, to ensure best practice. Records should be maintained to provide evidence that staff have completed induction training that is compliant with the Skills for Care - Common Induction Standards. This will help to provide evidence that staff are appropriately inducted, competent and Safe to Leave. A training programme should be established for the home and all staff should complete training and refresher training periodically in Safe Working Practice training i.e. Fire Awareness, Basic Food Hygiene, First Aid, Infection Control, 2 3 3 17 4 20 5 20 6 35 7 35 Care Homes for Adults (18-65 years) Page 30 of 32 Moving and Handling. This will help to promote safe working practices and to safeguard the welfare of staff and the people using the service. 8 37 The manager should undertake refresher training in Safe Working Practice topics and complete a level 4 National Vocational Qualification in Care or equivalent, to ensure he has the necessary qualifications for his role. Copies of monthly visits undertaken by the Registered Provider should be available at 51, Wellington Road for inspection, to confirm the visits have taken place in accordance with Regulation 26 of the Care Home Regulations. Records should be established, to provide evidence that the emergency lighting, hot water temperatures and fire extinguishers are tested or visually inspected on a monthly basis, to promote and safeguard health and safety. 9 39 10 42 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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