Inspection on 19/03/08 for Wells Road Care Home

This inspection was carried out on 19th March 2008.

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

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

Wells Road Care Home 15/02/09

Wells Road Care Home 05/09/07

Wells Road Care Home 11/04/07

Wells Road Care Home 20/04/06

Wells Road Care Home 15/02/06

Wells Road Care Home 21/03/05

Wells Road Care Home 29/03/04

Wells Road Care Home 10/11/03

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Wells Road Care Home 280-282 Wells Road St Anns Nottingham NG3 3AA Lead Inspector Susan Lewis Unannounced Inspection 19th March 2008 10:00 Wells Road Care Home DS0000002259.V361208.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 Wells Road Care Home DS0000002259.V361208.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. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wells Road Care Home Address 280-282 Wells Road St Anns Nottingham NG3 3AA 0115 844 3732 0115 950 2066 mvickis@ncha.org.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) Nottingham Community Housing Association Carmel Hopkinson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users shall be within category LD Date of last inspection 5th September 2007 Brief Description of the Service: Wells Road Care Home is situated in the residential area of St Ann’s, close to shops and amenities and is registered to provide accommodation and support for up to six adults with a learning disability. The home itself is comprised of a pair of semi-detached houses joined together and the accommodation consists of communal lounge, dining room and kitchen on the ground floor and six single bedrooms with shared bathing facilities on the upper floor. There is currently one vacancy. The home has enclosed front and rear gardens accessible to service users. The registered provider is Nottingham Community Housing Association. The current fees are £342 per week; this does not include personal purchase, clothing, magazines and hairdressing. This information is included in the Statement of Purpose, which is made available to prospective service users along with other relevant information about the service upon request. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection involved one inspector; it was unannounced and took place over 6.5 hours, including an evening meal. The main method of inspection used was called ‘case tracking’ which involved selecting two residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We were unable to effectively understand and communicate with some of the people living at the home, therefore some judgements in this report are drawn from our observation of staff and resident interactions. Two members of staff were spoken with as part of this inspection. Documents were read as part of this visit and medication was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken, all communal areas were seen and a sample of bedrooms to make sure that the environment is safe and homely. A review of all the information we have received about the home since the last inspection was considered in planning this visit and this helped decide what areas were looked at. The registration documents were checked to ensure that they reflected the registration status of the service and they were found to be correct. What the service does well: People who use the service are assessed prior to moving to the home and know that the trained and competent staff can meet their needs. Each person has a support plan that includes risk assessments that are detailed, and used to inform how staff should best support a person. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 6 Staff are understand the importance of consistency when supporting people and are knowledgeable about the needs of people living at the home. Staff work well with people using the service and interactive is positive and meaningful, people are treated with respect and dignity and staff are aware of how important this is. People who use the service are supported to maintain contact with family and intimate relationships are also supported whilst maintaining the persons safety. An open environment is created by the manager that encourages people to express their views on how they want to receive their care and choice is supported. People who use the service are actively involved in decision making and take part in tasks that support the running of the service. What has improved since the last inspection? The manager has taken steps to address the outstanding requirements set at the last inspection. A format has been created to provide confirmation to people who use the service in the future that the service is able to meet their needs. The person who uses the service or a representative now signs contracts. Where restrictions are placed on people due to a risk assessment this is now agreed to by the person or their representative and where possible people who use the service are involved in any decision affecting their lives. Although radiator guards have not been fitted arrangements have been made to ensure that there is no risk posed by radiators becoming too hot and burning people who use the service. Updated risk assessments have also taken place where individual risks were identified regarding a person using the stairs to ensure they remain safe. T Although a formal training course for attachment disorder has not been found the manager has taken steps to attend a conference on the subject and information has been found and passed onto staff to better inform their practice. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 7 Information relating to Criminal Records Bureau checks is now available for inspection ensuring that people who use the service are fully protected by the recruitment procedures. The fire risk assessment has now been signed by the manager as being suitable to ensure the safety of people who use the service in the event of a fire. The portable appliances and gas safety tests have been completed thereby assuring that the people who use the service live in home that is safe. 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. Wells Road Care Home DS0000002259.V361208.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 Wells Road Care Home DS0000002259.V361208.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 5 Quality in this outcome area is good Information is provided to people who use the service however it is not always in a format that is suitable to their abilities. Admissions to the service only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a Statement of Purpose and a Service User Guide. The Guide is in an easy read format and each person who uses the service has a copy in his or her bedroom except where this is indicated in his or her care plan as not appropriate. The guide includes information regarding the service with regard to what a person using the service can expect such as the staffing rotas and their training, complaints procedure, how medication is handled in the service, house rules, what is acceptable behaviour and what is not, activities, visitors and guests. There is also information about the service’s admission criteria. Two requirements were made at the last inspection. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 10 Firstly the service must provide written confirmation that they are able to meet the assessed needs of people who use the service. As no new people have been admitted to the service since the last inspection the manager showed the inspector a copy of a document that will be used in future. This shows what the service is able to do and how it intends to achieve it. Using this format in the future will meet the requirement. The second requirement was to ensure the service is accountable to the people who use it agreement to contracts must be obtained from service user or their representatives. Wells Road uses the standard Nottingham Community Housing Association licence agreement for people who use the service. This is a complicated document and is not in a format that is suitable for people who use it. However the manager is getting people who use the service or their representative to now sign them and as such the requirement is met. Information provided in pre inspection documentation showed that people who use the service have the opportunity to visit the home for tea and overnight visits to see if it meets their personal needs, choices and wants. Family and friends are encouraged to visit the home before the service user moves in. Support plans examined showed that people who use the service have an up to date Community Care Assessment. The manager will also assess the needs of individuals to ensure the service is able to support people appropriately. Staff spoken with were knowledgeable regarding the needs of people who used the service and were able to give examples of how following the support plans had been successful in defusing difficult situations. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 11 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 and 9 Quality in this outcome area is good. The philosophy of the service is to involve residents in the planning of care that affects their lifestyle and quality of life. The plan is reviewed regularly involving the resident and, where agreed, their families. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two support plans were viewed in detail with a further one sampled. Each plan was a printed copy from the computer system called SuRe. SuRe is a standardised system used throughout the NCHA organisation. According to policy and procedures each plan should be printed off as it is updated and amended. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 12 The plans viewed provided detail as to how a person’s needs are to be met. If a person has particular need relating to challenging behaviour then the plan details what staff must do to minimise distress to the person and any risk to other people using the service. Staff spoken with confirmed that they found care plans useful and did work when followed in a consistent manner. Although support plans are detailed providing key information about how people who use the service have their needs met they are not written in a format that is accessible to users. There are no easy read plans in any of the printed formats seen. In reading support plans it was clear that they are developed from Community Care Assessment and the home’s independent assessment, each plan covers the personal, social, emotional support needs of the person using the service. During the course of the inspection staff were observed and heard interacting with people asking them what they wanted to do and waiting for replies without hurrying the person, this provided evidence that people using the service are supported and assisted in making decisions about their lives in an appropriate manner. Risk assessments were detailed and provided clear information about how staff should manage any identified risks to maintain both the person using the service other users and staff safety. Risk assessments and support plans are reviewed regularly and amended to meet changing needs. Evidence was seen in files that reviews took place either with a representative or the person themselves. Where the person did not have a family representative the manager was investigating using advocates. This was in response to a recommendation made at the last inspection. There was also evidence that advocate services had been used in the past. These have been time limited and relating to an issue. Their involvement then is reliant on the staff or manager being proactive in making contact with the advocate service and there is potential that advocates may not be consulted when they need to be. Staff spoken with said that the service has a key worker system and as a key worker they knew what their responsibilities were in supporting people who use the service. Two requirements were made at the last inspection. The first was regarding where a ‘baby monitor’ is being used in a service users room to monitor their breathing at night, no consent to this practice was in place at the time of the last inspection. Consent has now been obtained from their representative and this is available on the person’s support plan. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 13 The second requirement was regarding where restrictions are in place and there was no written consent. Risk assessments viewed showed that representatives have now been consulted and agreed to these restrictions. Evidence was seen of regular resident meetings, minutes of which were provided in easy read format. The meetings provide a forum where any issue about the home is discussed, there is no set agenda and people who use the service are able to raise any issues. Risk assessments also provide very good information to ensure that people who use the service have their privacy and dignity supported and maintained. In the two plans that were looked at in detail there was clear information about what staff should do to support people who wished to express their sexuality. A person who used the service assisted the inspector during the tour of the building and showed the menu board in the kitchen. Signs and symbols are used to support people who use the service to know what meals are during the day. This person said that they were able to choose meals they liked and at the weekend they had a Chinese meal, which was had enjoyed. Staff spoken with confirmed that people who used the service were encouraged to use meals they liked whilst also being encouraged to eat healthily. People who use the service are able to take part in a variety of activities and this is recorded in a diary of activities. Those people who do not go to day service go out with staff shopping to the recycle centre and various community based activities. Staff spoken with said that people who didn’t go to day service usually went somewhere or did something most days. The activities diary confirmed this. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 14 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, 15, 16 and 17 Quality in this outcome area is good. Residents are involved in meaningful daytime activities of their own choice and according to their individual interests and capability; they have been fully involved in the planning of their lifestyle and quality of life. The menu is varied with a number of choices including a healthy option. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has recently developed a ‘listen to me books’ which people who use the service and staff use to identify anything that person particularly is interested in and it is then used to develop activities and outings. More information is now available in easy read formats and the pre inspection information states that this will continue to be developed in the next twelve months. This means people who use the service have a better access to Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 15 information that will inform their decisions. Staff spoken with were aware of areas of improvement planned for the next year. Support plans viewed contained guidance on how to support people who use the service in maintaining their dignity and privacy, staff spoken with were aware of service user rights to be treated with respect and dignity and said this had been covered in their induction. Staff were aware of the importance of knocking on bedroom doors before entering and waiting for the person to tell them to come in. Staff were observed knocking on doors before entering bedrooms. It was evident from observations and conversations heard during the inspection that staff and people who use the service have positive interactions staff were observed taking time to engage with residents with communication difficulties and using different methods of communication to ensure that both parties were understood. . Residents are involved in planning holidays and support plans indicate what staff must do to support people in choosing a holiday. Some people who use the service attend day services throughout the week whilst others have chosen not to attend one person has decided he has retired and no longer attends staff support him to take part in meaningful activities during the week. Another person attends music therapy for half a day. During the inspection this person was assisting staff with doing the health and safety assessment in the building. Staff spoken with said that usually there was enough staff available to ensure that each person had one to one time with and talked about the variety of activities that people who used the service are supported and encouraged to take part in. This included going to the pub, shopping, going to the recycle centre, rug making and preparing meals. Staff were knowledgeable about people who used the service and their family circumstances and knew who had involvement and who didn’t. Support plans and diary notes indicated when people went to stay with families and what support was needed. A resident was heard to ask staff if his mum was due to visit that weekend, staff at that point hadn’t heard anything from his mother so advised him of this. Staff said that families are also invited to social activities that the service puts on such as Christmas Parties, bonfire night and summer BBQs. Support plans also stated where there were limitations on contact with family members and why. The evening meal was seen and was pasta and a Bolognese sauce. People who use the service were asked if they were enjoying it and they said they Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 16 were. The diet record book showed what each person had eaten and also where meals were not taken and for what reason. In discussion with staff they confirmed that people who used the service were supported to choose the menu and currently work is being done on creating a menu plan that reflects people’s choices ensuring that there are two choices available each day and also support a healthy eating plan. Support plans also indicate where residents need time to eat a meal and what staff need to do to encourage people to ensure that they eat a healthy diet. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 17 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 and 20 Quality in this outcome area is adequate. People who use the service receive the support they need in the way they want and have access to health and remedial services. Medication records are generally up to date for each resident and medicines received, administered and disposed of are mostly recorded, however there is potential for people who use the service not to receive their medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The two support plans looked at showed that detailed information is obtained about the physical and emotional health needs of individual people who use the service. They are registered with their own GP, there was also evidence that other professionals involve such clinical psychologist, chiropodist, optician, and social worker. Support plans detail what support each person needs including whether the person needs to be told shortly before the appointment to minimise distress. Support plans seen show that a variety of needs are supported these include Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 18 behaviour, hygiene, medication, sexuality, social interaction and provide detailed description of what staff need to do to ensure people who use the service are fully supported, staff sign to say that they have read and understood support plans. Staff spoken with said they felt plans were very detailed and gave clear guidance when providing support to people. In discussion with staff it was clear that they had read them and were able to give examples of putting them into practice. Support plans also indicate where people may have compromised nutrition and what action is taken to monitor this. One person is at high risk of loosing weight quickly and his weight is monitored regularly. If any change is noted then a support plan indicates what action staff need to take this includes adding extra calories in his meals to ensure his weight is maintained at a healthy level. Support plans showed that this is done in consultation with his family. Daily records indicate that staff support people who use the service to access health care services and ensure that if they feel unwell they are able to see a doctor. During the course of the inspection a person who uses the service was unwell and staff were seen to attend to him. Due to the needs of the people who use the service no one administers their own medication. The support plans indicate how people prefer to take their medication including where a resident likes to stand in the hallway and what to do if they refuse medication. The Nottingham Community Housing Association medication policy can be found in the main office and there is a drugs error policy in the cabinet. The temperature of the room is monitored to ensure it does not go above save limits and the medication is spoiled. The medication records of the two people whose support plan were being tracked were viewed. In one no errors were found in the second four omissions were found, three on consecutive nights. As a result the records of three other people at the service were viewed there were no errors identified. However due to the way medication is dispensed it is difficult to carry out an audit to confirm whether the medication had been administered according to the prescription. All staff have had medication training and are signed off as competent before being able to administer medication. Staff said that the practice within the service is for staff to administer in pairs to minimise the risk of errors. The Medication Administration Records sheet contain a brief synopsis of information contained in the support plan regarding how the person wants medication to Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 19 be administered and a photograph of the person. Medication administration was not observed on during this inspection. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 20 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 and 23 Quality in this outcome area is good. The service has a complaints procedure that is up to date, very clearly written, and is easy to understand The home has an open culture, which enables residents to express their views, and concerns in a safe and protected environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an up to date copy of Nottinghamshire safeguarding adult procedures located in the main office. The complaints procedure has appropriate timescales for responses and action and copies of the complaints procedures are available in easy read format throughout the service and in each persons bedroom. There have been no complaints received since the last inspection by the service or the Commission. Staff spoken with were aware of their responsibilities in safeguarding adults who use the service and said that they had received adult protection training during their induction and that this was updated regularly. Evidence to confirm this was seen in training records. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 21 Procedures for managing people who use the service monies are robust and staff spoken with were aware of the procedures to follow. This ensures that people who use the service can be assured that their money is handled safely and they are not at risk of abuse. There are regular resident meetings where people who use the service are able to express their views and feel listened too the minutes of these meetings are provided in easy read format. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 22 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 and 30 Quality in this outcome area is adequate. The home provides a physical environment that meets the specific needs of the residents who live there. Residents can personalise their rooms. The home is generally clean and tidy. Maintenance is not always actioned promptly and some practices may place people at risk of infection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A person who uses the service took the inspector on a tour of the building. The person spoken with said that she liked her bedroom and had been able to decorate in the way she liked. This was evidenced in other people’s rooms as well. One person had a bedroom with very little in it simply a bed, a chest of drawers and an in built cupboard and did not meet the National Minimum Standards. It was identified in the person’s support plan as to why this was. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 23 There was some evidence that items of furniture were being replaced, however in the dining room there was a welsh dresser with a drawer front missing. The manager said that they hoped to replace this but had to wait due to funds. The pre inspection information stated that the service had new carpets and some areas had been redecorated. This was noted during the tour. The kitchen was clean and hygienic with a new oven due to be fitted as the previous one no longer worked; the service had been without an oven for over a week. The bathrooms were clean and functional. At the last inspection it was noted that there was no soap or towels in the toilets. During this inspection although there was liquid soap available there was no facilities for people to dry their hands. This was discussed with the manager and was informed that arrangements need to be made so people can dry their hands properly to minimise the risk of spread of infection. A requirement was made at the last inspection with regard to the unguarded radiators. Risk assessments have now been put in place to minimise any risk they may present to people over radiators. A random check on these radiators showed that they were all maintained at a safe temperature. A requirement was also made to ensure that the gas safety and portable electrical test certificate is in place. Evidence was seen that this is now completed. A requirement was made to look at the risk assessment for a person who has difficulties with the stairs. The risk assessment had not been amended on the file but had been amended on the SuRe computer system the manager ensured that it was printed out before the end of the inspection and placed in the person’s support plan. The laundry was functional there was a sink that could be used for sluicing but there was no sink for washing hands. In the last report it was noted that the manager said that the sink was not used for sluicing and for hand washing. Any laundry needing sluicing would be undertaken by external laundry services. This situation must be clarified to ensure cross infection does not take place. Staff carries out maintenance checks and any repairs passed to the NCHA repairs department, staff said that on occasions this can be very slow. Staff said that over Christmas the dryer broke down and for over 2 weeks all laundry for the service had to be dried. This does not support residents’ privacy and dignity as well as being a possible challenge to people’s health. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 24 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, 34 and 35 Quality in this outcome area is good. Staff receive relevant training that is targeted and focussed on improving outcomes for people. Staff are recruited following procedures that protect people who use the service from potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff have been recruited over the last few months to replace those staff who have left. Evidence in support plans showed that extra psychological support was obtained for those people who were affected most by the changes. Staff spoken with said that they felt that there were now enough staff on duty at each shift and that staff worked together as a team and communicated better than previously. The rota was seen and showed that sufficient staff are employed to meet the needs of people using the service. Staff said that they have a good handover and that their daily tasks are set out in the jobs book so everyone knows what they have to do or if a person using the service is in need of extra support. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 25 Staff said that they were supported to attend training and all had had regular updates of statutory training. Evidence was also seen in training records that staff received regular updates. Information provided by the pre inspection report showed that there has been a high turnover of staff in the last 12 months and a large number of shifts were covered by bank or agency staff. However with the recruitment of more staff this hopefully will now stabilise and staff reported things had settled down with less agency staff being used. Pre inspection information also showed that five out of the eleven staff have their National Vocational Qualification 2 and a further two are undertaking it. A requirement at the last inspection was for information regarding Criminal Records Bureau checks to be available for inspection. Evidence was seen on staff files that this information is now kept showing start dates and when Criminal Records Bureau check were received along with POVA First checks are completed. This means that appropriate checks are completed to ensure that people who are unsuitable to work with vulnerable people are not employed. A requirement was made at the last inspection regarding staff being booked on training course for ‘attachment disorder’. In discussion with the manager she said that they had had difficulty locating this training but she had attended a workshop regarding the subject evidence for which was seen, and a member of staff had written a report on the subject and a protocol was being developed. Although not fully met, enough work was evidenced to suggest that the manager had made every reasonable attempt to meet the requirement and that the work was ongoing. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 26 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): 37,39 and 42 Quality in this outcome area is adequate. The Manager has the required qualifications and experience to run the home. Procedures have improved to ensure the monitoring of the health and safety practice within the service, however there are some gaps in reporting of incidents that take place in the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was clear from discussion with the manager that since the last inspection she has made a serious effort to raise the standard in the service. This can be seen in the pre inspection information received by the Commission and from the work carried out to meet the requirements made at the last inspection. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 27 The manager has National Vocational Qualification 4 Registered Managers Award. Staff spoken with said that the manager was supportive and worked hard to support the people who used the service. Staff felt that she organised the service to maximise the independence of people who used it. She was described as a hard worker and very open. She gave a clear indication of the standard required for people who used the service. Staff also said that the manager supported them with time for training and access to National Vocational Qualification. Staff spoken with said that they felt that people who used the service were consulted about the service through residents meetings and quality assurance systems and that they were given feed back about what was happening in the service. A requirement was made at the last inspection regarding the fire risk assessment being signed by the manager evidence was seen that this has now been done. A requirement to ensure that the overdue gas safety and portable appliance testing must be completed to ensure the safety of service users has now been completed and evidence of this was seen in the maintenance book. In looking at records and in discussion with the manager and staff it was apparent that a number of issues that should have been reported to the Commission such as the cooker breaking down had not been. This was discussed with the manager as to the importance of ensuring that the Commission was made aware of any incident that may adversely affect the well being of the people who use the service. Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 28 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 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 29 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 OP20 Regulation 13(2) Requirement Arrangements must be made to improve the auditing of medication to ensure that people who use the service receive their medication as prescribed. Where furniture is damaged it must be repaired or replaced to ensure that people who live in the service are not placed at potential harm by such damage. Arrangements must be made to ensure that people who use the service are protected from possible infection by having suitable sluicing arrangements in place for soiled laundry. Where incidents occur that adversely affect the well being of the people who use the service arrangements must be made to inform the Commission without delay to ensure the safe management of the service. Timescale for action 30/04/08 2 YA24 23 01/06/08 3 YA30 13(3) 16(2) 01/05/08 4 YA42 37 30/04/08 Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 30 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 YA5 Good Practice Recommendations The contract should be provided in a format that is more suitable to the needs of the people who use the service to support their understanding of what the service should provide. The staff group should be more proactive in seeking advocate support for people who use the service to ensure that people who use the service have their rights protected and supported. To prevent cross infection, people who use the service should have a method off drying their hands after using the toilet. 2 YA6 3 YA30 Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Wells Road Care Home DS0000002259.V361208.R01.S.doc Version 5.2 Page 32 - 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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