Inspection on 17/10/08 for Weston House

This inspection was carried out on 17th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Weston House 17/11/06

Weston House 25/11/05

Weston House 18/05/05

Weston House 01/12/04

Weston House 22/09/04

Weston House 03/03/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Weston House 344 Weston Road Weston Coyney Stoke-on-Trent Staffordshire ST3 6HD     The quality rating for this care home is:   two star good 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: Peter Dawson     Date: 1 7 1 0 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 30 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 30 Information about the care home Name of care home: Address: Weston House 344 Weston Road Weston Coyney Stoke-on-Trent Staffordshire ST3 6HD 01782343818 01782322588 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Groundstyle Limited Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 12 MD - 5 may be under 55 years Date of last inspection Brief description of the care home Weston House is a large detached property situated on a bus route near to Meir and Longton town centres. It provides accommodation presently for up to 28 adults. The home was acquired by the present owners 5 years ago and considerable improvements have been made to the environment since that time with extensive upgrading both internally and externally. This work continues. At this time plans being submitted to add conservatory, reception/office area and additional bedrooms. The home have moved sensitively from care for the elderly towards care of younger with mental health needs. Presently there are only 4 people over the age of 65 years. The home continues Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 6 9 28 0 Brief description of the care home to provide care for older people who are accommodated on ground floor area. Access to a range of primary health care services is provided for all residents. Specialist health care staff are involved in care provision e.g. Psychiatrists, Psychologists, CPNs. Two full-time Activity Workers are employed over 7 days to promote access to the community and provide a wide range of internal and external activities on an individual or small group basis for all residents. This is very successful, has been extended over the past 4 years and provides an excellent facility for this resident group. Care Homes for Adults (18-65 years) Page 5 of 30 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: two star good 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: This unannounced key inspection was carried out on one day from 08:30 - 17:30 by one inspector. The National Minimum Standards for Younger Adults was used as the crieteria for inspection. An AQAA (Annual Quality Assurance Assessment) was provided by the service prior to the inspecton. This is a legal requirement and is the providers self-assessment of the service. Some information from the AQAA is contained in this report. The inspector was assisted by an Expert by Experience. This is someone with personal experience of using a similar service and trained to take part in the inspection of a service. This Expert by Experience talked with residents and staff at Weston House and Care Homes for Adults (18-65 years) Page 6 of 30 focussed upon the range of activities and the residents level of satsifaction with the service A report was provided on her findings some of which are incorporated into this report. People at Weston House were asked in group discussion as the inspection commenced for their preferred mode of address in the report. They unanimously wished to be referred to as residents as this was their home. This term has therefore been used throughout the report. There were 28 people in residence at the time of the inspection with no vacancies. The home operates consistently with 100 occupancy. The majority of people were seen and spoke with during the inspection by the inspector and Expert by Experience, giving a broad view and feedback about the service. People expressed positive comments about the operation of the home and the way they were supported by staff. Five residents provided written feedback directly to us prior to the inspection. Comments from residents included: Staff are very good, they are always here and its a very happy place. Good care staff always willing to help. Comments about activities were numerous and included Outings are good, I always enjoy them, we have good times. We always go out for Sunday lunch together. I enjoy the board games, shopping and bingo, we also go on holiday. Weston House is a very happy place, I am please to be here. Five staff members also provided written feedback directly to us prior to the inspection and made positive comments about training, staff numbers, information and support from managers. Comments made directly to the Expert by Experience included: staff are very helpful and brilliant and a resident coming from a long-term hospital said I wouldnt still be here without this home. There was an inspection of the environment including a small sample of bedrooms. Records relating the inspection process seen included care plans, riks assessments, staffing records, medication and other documents. Residents in this home are always keen to be involved in the inspection process, to express their views both individually and in small groups which they did throughout the day. Staff on duty were also spoken with. The weekly fees charged at Weston House can be obtained directly from the service. What the care home does well: What has improved since the last inspection? What they could do better: Recruitment procedures must be improved to ensure that a POVA (Protection of Vulnerable Adults or CRB Criminal Records Bureau) check is obtained prior to the employment of all staff. This will ensure the protection of service users. Care plans must be established for people with epilepsy who have seizures so that staff Care Homes for Adults (18-65 years) Page 8 of 30 are clear about what action they need to take to ensure the safety and well-being of the person when seizures occur. It is also important to keep a chronological record of seizures and their outcomes as a means of monitoring the well-being of the person. It is recommended that staff have training from a healthcare professional in the symptoms and control of epilepsy. Where there are changes in a persons physical health this must be reported immediately to the GP or the Healthcare professional involved in the persons care. This relates to a deterioration in the wound management of a resident. All prescribed creams must be recorded on MAR (medication administration records) sheets and signed when administered. It is important to record minutes of staff meetings to ensure those present/not present are aware of the discussions and decisions made. 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 30 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 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre admission procedures ensure that needs can be met and placements are successful. Evidence: There is adequate information in the Statement of Purpose/Service Users Guide for people to make an informed choice about the suitability of the home. Pre-admission assessments are carried out prior to admission by the homes staff. Information from multi-disciplinary sources are also sought. Visits to the home prior to admission allow the person to test the suitability of the service for themselves. Following assessment written confirmation is sent to the person confirming that needs can be met following assessment. The home has a good record of successful placement of people from other settings where placements had not been successful. There were several examples seen on this Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: visit. A person recently admitted confirmed with the Expert by Experience that she had settled well following a long-standing unsuccessful placement in another home. Suitability of placements is reviewed in all instances after 6 weeks residence, allowing people to express their own views about the suitability of placement and raise any matters of concern or where improvements can be made. Care Homes for Adults (18-65 years) Page 12 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual needs and choices are met by involving residents in care planning, reviews and direct input into the daily running of the home. Evidence: Care plans for 5 people were sampled and contained good information, although there were shortfalls in some areas of information. The plans contained adequate information to identify the needs of people and how they should be met by staff. A person who has serious seizures and has sustained some injuries as a result is supported well by staff, although there is no care plan/risk assessment in relation to this. The person ultimately refuses to attend hospital when paramedics are called, making it difficult to ensure that his health and wellbeing is ensured. There have been 4 seizures in past months, it is important that incidents are recorded chronologically to identify the pattern and outcomes. It is more important to establish a detailed care plan and include triggers, timing, actions required by staff, recovery and the point at Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: which paramedics are called. Care plans contained some good information relating to social and medical history and daily notes provide adequate information to confirm the care and support given. Residents are involved in care planning and reviews that take place monthly. There was evidence of their involvement and care plans had been appropriately signed. Additionally some are subject to statutory aftercare under the Mental Health Act and reviewed as required 6 monthly. Residents are able to express their views and wishes freely. There was an open dialogue/discussion with residents and staff in the communal areas during the inspection clearly indicating a good rapport with residents who made both positive and negative comments as they wished. A person told the Expert by Experience that staff were very helpful and brilliant. Regular monthly residents meetings are held (minutes seen) and all residents encouraged to express their views about the service and make plans for the ongoing programme of social and recreational events. The independent Advocacy Service is used to ensure the protection of peoples rights and appropriate support where decision making is crucial. Two examples of Advocacy involvement were seen. The service have introduced a rehabilitation rating scoring as part of a life skills development programme. This enables individual hopes, preferences and objectives to be established as a social model of care. This encourages independence, social inclusion and ensures that people able to make their own decisions and improve their personal development and quality of life. Care Homes for Adults (18-65 years) Page 14 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual lifestyles are known and met. Opportunities for person and social development are excellent with ongoing daily activities that enhance quality of life. Evidence: Opportunities for personal development are provided to enable people to maintain and develop social emotional, communication and independent living skills. This is done by the assessment of the recently introduced life skills development assessment process, setting objectives to maximise social skills with experience in the community to develope social and recreational skills increasing independence and improving quality of life. The home has a good record of activity provision having employed a full-time Activities Coordinator for the past 2-3 years. This has now been further increased , there are Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: now 2 full-time Activity Coordinators who work 8am - 8pm providing a service 7 days per week. This is integrated into the Deputy Managers role of designing and overseeing the homes lifestyle activities programme. Activities were seen to continue throughout the day of the inspection. Residents spoke with enthusiasm about the internal and external activities available to them recalling visits to local and other places of interest. Photographs in the home capture the lifestyle experience of residents in the local community and holidays/trips to places including Turkey, Blackpool and Wales. A mini-bus is provided for external transport and is free to all residents. Some go out daily on their own, using public transport and enjoy their chosen interests and lifestyle. A strong residents committe has been established who input into how the home is run and the activities they wish to participate in. This is a well established and constantly developing programme to meet the individual and group needs of all residents and has vastly improved quality of life for people. There is a well-used kitchen facility where residents can make drinks, prepare snacks and develop their skills and independence. This area has been further equipped allowing residents to develope their skills and independence. Community links, recreation and social inclusion are at the core of the care provided. In written feedback residents stated that they were satisfied with food provision and there is resident input into menu planning. One person made a written complaint some months ago about the type of food provided. The Manager was asked to deal with this by way of discussion and written reply. The person seen during this inspection said that the matter had been resolved to his satisfaction and he would raise any future concerns immediately with the Manager. Care Homes for Adults (18-65 years) Page 16 of 30 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. Early referral to healthcare professionals and accurate recording of medicated creams will ensure the healthcare needs of residents are totally met. Evidence: Personal support is given to ensure privacy and dignity. This was confirmed in discussions with residents. The majority are young adults requiring only oversight of personal care. A 92 year old person who has been resident for 5 years and requires considerable personal care confirmed this too. Her physical condition has deteriorated requiring 2-3 staff to assist with personal care. On the day of the inspection an Occupational Therapist made an assessment of the moving and handling needs of this lady and recommended a hoist which was being obtained and training for staff also being arranged in its use. The resident wishes to remain at Weston House and said that she was happy and carers are wonderful. Many aspects of healthcare support are good but there were some shortfalls: A District Nursing Manager was seen in the home on the day of inspection and Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: expressed concerns that a deterioration in a persons condition had not been reported to the Nursing Service. The resident has recurring cellulitis the Nursing service visiting weekly to provide wound care. There had been a deterioration in the persons condition over the previous weekend which had been reported to a Senior Carer but no action taken to inform the Nursing Service prior to their weekly visit serveral days later. The wound had deteriorated quickly. Early referral to the Nursing Service is required if there are indications of deterioration in the condition of a resident being treated. The Manager will ensure all staff are aware of this. The Nursing Manager confirmed this was not the usual practice with this home. Nurses and care staff usually worked closely together with good dialogue and joint working. Several residents have alcohol related illnesses requiring a high level of care. This is provided with support from external Healthcare professionals. The home has close and direct links to Consultant Psychiatrists. Several people have epilepsy needs, one mentioned previously in this report has severe seizures. Staff are aware what actions to take, but these need to be recorded in care plans. There has been no training from Healthcare professionals in relation to this condition and it is recommended that training is sought from pehaps a Epilepsy Nurse Specialist or similar. The medication system was inspected. Two requirements made at the last inspection in relation to medication had been addressed. The home advised us of a medication error recently when the same medication was given to one person twice on one occasion. The matter was immediately reported to the GP who confirmed there would be no ill effects. Measures have been introduced to ensure this is not repeated. Medication records seen were generally good but with one exception - Cream administered daily by staff to a resident was not recorded on the Medication Administration Record (MAR sheet). There was no entry on the current MAR sheet and therefore no record of administering the cream. Creams must be recorded on MAR sheets with all other medication and signed when administered by staff. Care Homes for Adults (18-65 years) Page 18 of 30 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. Concerns, complaints and protection procedures are followed by staff and residents ensuring the protection and best interests of residents are upheld. Evidence: There is a complaints procedure avialable to residents and visitors in the home. Residents in feedback to us said that they knew how to make a complaint and would know who to speak to if they were unhappy. One resident made a written complaint in relation to issues surrounding food. These were investigated and dealt with appropriately by the Manager. Two complaints were made by relatives relating to finance and a contract issue, both dealt with appropriately. One referral was made to the Safeguarding Adults Team, investigated by them and found to be unsubstantiated. Staff have had training in relation to the various aspects of abuse and procedures for reporting suspected or actual abuse. Referrals made under Safeguarding procedures and the complaints procedure confirm that staff and residents are aware of the correct procedures to be followed in these important areas. Care Homes for Adults (18-65 years) Page 19 of 30 Care Homes for Adults (18-65 years) Page 20 of 30 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. Continued improvements to the environment ensure a safe, comfortable setting for residents. Evidence: Two requirements were made in relation to the environment at the time of the last inspection. These related to complaints from residents about inadequate toileting and bathroom facilities and inadequate supplies of hot water. Both were addressed with the installation of a new hot water system and installation of two new shower rooms and improved toilet facilities regularly cleaned and montiored. There have been extensive improvements to all parts of the environment over the past 5 years by the present owners. An annual development plan is compiled, copy sent to us and all plans have been implemented, vastly improving the environment. In the past year all windows have been replaced with double-glazed units, shower rooms created, the nurse call system replaced with a portable system and all bedrooms have been fitted with TV aerials. The kitchen area used by residents has been upgraded with new oven/hob to further assist with the development of residents skills in food preparation. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Further improvements planned for the current year are impeded only by difficulties in obtaining planning consent from the Local Authority. A conservatory will augment the communal space available and building work to create a new reception area and office space will further improve facilities once planning consent is finalised. A sample of bedrooms seen during the inspection showed well furnished, comfortable rooms, personalised to reflect individual preferences. Many rooms have been redecorated, and new furniture and flooring provided. There was a homely feel to those rooms seen. There are no en-suite facilities in this home, although provision of these facilties is being considered for the future. There are presently 3 shared bedrooms, the new building work will reduce this number to one. A resident complained to the Expert by Experience on the day of the inspection that he wished to move bedrooms as he was unhappy with the person he shared with. The information given was not totally accurate, but the home are aware that he would prefer a single bedroom and it has been explained to him that this will be provided when additional rooms become available or occupancy changes. All areas of the home were bright, comfortably furnished and homely in appearance. Standards of hygiene and infection control practices are high. Residents spoken with said that they were satisfied with the environment and facilties at Weston House. Care Homes for Adults (18-65 years) Page 22 of 30 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. Competent, committed and well trained staff provide a good standard of support to residents. Recruitment procedures must become more robust to protect residents. Evidence: Staffing levels have increased. There are now 2 full-time Activity Workers, one on duty each of 7 days from 8 am - 8 pm. in addition to care staff. This ensures activities are in place throughout each day. Additionally the Manager and Deputy Manager are on duty during the week and additional to the above staffing numbers. There are 3 waking night staff on duty - residents are checked hourly or even half-hourly if there are any concerns. One member of night staff is always located on the upper floor during the night shift. There are adequate numbers of support staff including catering, domestic, laundry and maintenance. NVQ training is offered to all staff and relevant to the service type. The number of NVQ qualified staff exceeds the required 50 and training continues. Training records showed that all statutory training has been provided with updates as Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: required. The Company has a qualified in-house Trainer who works closely with SSCWP (Staffordshire Social Care Workforce Partnership) to secure quality training for all staff. The AQAA states that all staff have full induction, twice yearly appraisals and are supervised 6 times per year, this was supported by the records seen. A sample of staff files were inspected. In once instance a carer had been employed prior to the home obtaining either a POVA (Protection of Vulnerable Adults) or CRB (Criminal Records Bureau) disclosure. This is not acceptable either must be obtained prior to employment to protect the interests of residents. Recruitment procedures have been inconsistent in the past and this area must improve. There was evidence of only one staff meeting this year although the Manager said that there had been more but minutes of the meetings not written up. Other references and documentation was in place but photographs of all staff should be obtained. Care Homes for Adults (18-65 years) Page 24 of 30 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 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 well run and managed with a well trained, competent workforce committed to improvements in quality of life for residents. Evidence: Two requirements of the last inspection report relating to fire safety were swiftly actioned. Residents are now involved in fire drills and there have been trial evacuations of the premises heightening awareness of fire safety. This is particularly important in this home as a large proportion of residents smoke in the designated smoking area. The previous Registered Manager left the home last year and has been replaced by the former Registered Manager who has 8 years experience and has obtained the Registered Managers Award. She is also a registered provider of the service. The Manager takes a positive lead in the home promoting an open and inclusive atmosphere. Residents are given the opportunity to be involved in the daily running of Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: the home and decision making - an example being the choice of furnishings, colour schemes recently changed in the home. Similarly the views of staff should be sought in regular staff meetings and recorded. There is a satisfaction survey for residents and one for social workers and CPNs. The resident satsifaction surveys are to be changed to make them more user friendly. Surveys of external stakeholders could be extended to include GP, District Nurses and other visiting professionals. There is a monthly Newsletter, very well presented circulated to all residents and gives useful information about the wide range of activities at Weston House, both internal and external. This would be a useful means of informing residents about feedback obtained about the service. The Company employ a qualified Heath & Safety professional who ensures all statutory checks, risk assessments and safe working practices and procedures are up to date and reviewed as necessary. There is a well trained and committed staff group. The progress made in both standards of care and improvements to the environment over recent years is good. Staff have worked hard and are justly proud of the progress made. They are able to demonstrate many examples of residents making positive progress in dealing with their enduring mental health needs, at the same time optimising the quality of life for them also. Good engagement was evident between staff and residents throughout the inspection and positive comments made by residents to support this. There is a sound business and financial plan for the home which is reviewed annaully. A copy of the annual improvement plans are sent to us and objectives are consistently met. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Adults (18-65 years) Page 27 of 30 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 34 19 POVA or CRB clearance must 07/11/2008 be obtained for all staff prior to employment This ensures the protection of residents 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 6 A care plan should be established in relation to epilepsy needs and include detailed information of the actions to be taken by staff in the event of seizures. This will ensure greater safety for the person Specialiast training for care staff in the managment of epilepsy and seizures would improve staff knowledge and confidence in dealing with some difficult situations in this area of work and improve the service to residents. Ensure early referral to healthcare specialists where there are changes in the condition of residents to ensure ongoing wellbeing of people. All prescribed creams must be entered on MAR sheets and signed when administered. This will ensure the correct treatment is give to residents. Regular staff meetings (6 per year) should take place and be recorded and evidenced. This will ensure matters raised Page 28 of 30 2 19 3 19 4 20 5 33 Care Homes for Adults (18-65 years) by staff are known to all and can be addressed in the interests of residents. Care Homes for Adults (18-65 years) Page 29 of 30 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). 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