Inspection on 18/07/08 for Willes Road

This inspection was carried out on 18th July 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Willes Road 19/11/07

Willes Road 04/07/07

Willes Road 11/07/06

Willes Road 29/11/05

Willes Road 19/05/05

Willes Road 26/10/04

Willes Road 14/05/04

Willes Road 03/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/11/2008.

CARE HOME ADULTS 18-65 Willes Road 26 Willes Road Leamington Spa Warwickshire CV31 1BN Lead Inspector Martin Brown Unannounced Inspection 18th July 2008 08:30 Willes Road DS0000058002.V368197.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 Willes Road DS0000058002.V368197.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. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Willes Road Address 26 Willes Road Leamington Spa Warwickshire CV31 1BN 01926 336437 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.turning-point.co.uk Turning Point Manager post vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered manager must sucessfully copmlete the Registered managers Award and NVQ level 4 by 1st November 2006. 19th November 2007 Date of last inspection Brief Description of the Service: This house is home to five young people who have significant learning difficulties, impaired communication skills and complex behaviours. All are able bodied. The service offers 24-hour staffing and high levels of intensive support and personal care. 26 Willes Road is a Georgian detached house that has been divided into two separate, self-contained dwellings. The top two floors provide three bedrooms (one with en-suite), two lounges, one dining room, kitchen, laundry, one bathroom and separate toilet and staff office, all for three people with severe learning difficulties. The basement provides accommodation for two young men with learning disabilities. There is a rear entrance, two bedrooms, one bathroom, a small lounge and a small kitchen. There is a storage space that has been converted into an office-come-laundry. Owing to the overall unsuitability of the environment, and of the difficulties of meeting the differing needs of five people with challenging behaviours all together in such an environment, the service is negotiating with the local commissioning authority towards a planned closure. This would only be once suitable alternatives have been agreed for individual residents. The fees currently range from £1,430 to £2,501. There are additional charges for transport; a £400 allowance is made towards an annual holiday. Willes Road DS0000058002.V368197.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. This report has been made using evidence that has been accumulated by the Commission for Social Care Inspection. The inspection visit was unannounced and took place on 18 July, between 8.30am and 3.30pm. All service users were seen over the course of the inspection. They have a variety of communication needs, and responded to queries in a variety of verbal and non-verbal ways. Indications of well-being or otherwise came from direct responses, direct observations, recordings, and the comments of others. Staff on both morning and afternoon shifts were spoken with, and the manager was contacted by phone during and after the inspection. Two relatives were spoken with during the inspection, and an outside professional involved in working with the service was spoken with by phone. A tour of the premises was made, relevant documentation was looked at, and observations of the interactions between residents, staff and their environment were made. Policies and procedures, and care records were examined, and three service users were ‘case tracked’, that is, their experience of the service provided by the home was looked at in detail. Specific elements of other service users’ care were also looked at in detail. The Annual Quality Assurance Assessment, completed by the manager, also informed the inspection. Staff were welcoming and helpful throughout the inspection. What the service does well: Relatives spoken with were full of praise for the small group of permanent staff, using words like ‘brilliant’ and ‘really good’. Interactions between staff and residents were positive, and residents gave generally positive indications of well-being throughout. The service continues to support service users on a one-to-one basis, allowing for individual activities to take place. Staff work hard to ensure people are able to go out to a variety of activities throughout the day, and support contacts with relatives. Although there is a high use of agency staff, the staff seen on the day of the inspection had worked with the residence previously and had knowledge and skills to meet their needs. Where challenging behaviour Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 6 occurred, staff responses were calm and helped to de-escalate situations, whilst not rewarding unacceptable behaviour. Staff in the home showed themselves to be hard-working, positive, and committed to the well-being of the service users. What has improved since the last inspection? What they could do better: Notwithstanding improvements in the deployment of agency staff, more permanent staff are needed to ensure consistent, safe, and knowledgeable practice. Speeding up the process from recruitment to appointment and starting, without compromising safety, would help this. A greater proportion of staff able to dispense medication should ensure residents’ continue to receive medication correctly. Continued improvement to individual care plans and guidelines are needed to guide and reflect long-term consistent practice. All staff must be thoroughly aware of basics, and practice them, such as locking cupboards with potentially hazardous substances in. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 7 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. Willes Road DS0000058002.V368197.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 Willes Road DS0000058002.V368197.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been no admissions to this service for several years, and any future admissions to the service in its present configuration is unlikely. Documentation from the organisation indicates that, in the unlikely event of a proposed admission, a prospective service user may be confident that their aspirations and needs would be suitably assessed. EVIDENCE: There have been no new admissions since the last inspection, and no further admissions are anticipated. Turning Point has a referral assessment policy in place, with comprehensive risk assessments, as detailed in the Annual Quality Assurance Assessment returned by the service. This had noted that “We have a service user guide and statement of purpose that the service user would be given identifying his rights and expected behaviour of all who live at the service. We support the service users to lead their own lives through Person-Centred Care Planning (PCP), making their own choices, creating opportunities to experience wishes and dreams as well as new opportunities, including choice of home. We support our staff by providing a comprehensive training and development package, regular Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 10 supervision and appraisal in which is discussed PCA, Protection of Vulnerable Adults (POVA) and reflective practice.” Willes Road DS0000058002.V368197.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): 6,7,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service encourages and supports residents to make decisions. Further development of communication guides, and continued use of them, will better enable residents to have their wishes understood. There are positive signs that information used to reflect and guide the meeting of individual needs and wishes is becoming more unified. In the long term, residents will only benefit if Plans are reviewed and updated in a consistent manner. EVIDENCE: The care plans of four residents were looked at. Care plans are divided into different sections, such as health and professional notes, personal notes, ‘Who am I?’ and risk assessments and guidelines. A lot of these overlap, and some information is more recently reviewed than others. Staff advised that information is being reviewed and revised, and much information looked at showed that it had been reviewed and revised in the previous month. Some Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 12 information appeared out of date, but was then found to be available elsewhere in a more recently reviewed form. There were many good examples of clear, user-friendly information, well–illustrated with relevant photographs to reflect individual preferences and inform staff practice. Outside professionals spoke of communication guides being developed. They agreed that such guides had been developed previously, and the important thing was for staff to use these and continue using them, to ensure that information was updated and passed on, so that it was not lost. Individual daily records are now kept in the office until needed. These gave brief details of that person’s day and activities undertaken, and their general well-being. Permanent staff spoken with showed a good awareness of the needs of residents. A high percentage of staff were agency workers, who learnt from permanent staff. This posed difficulties when there is only one permanent staff member on duty. Individual risks are recorded, usually in the form of guidelines covering activities and day-to-day care. Staff spoken with were aware of specific risks, in for example, individuals going out, and how these were managed. Residents continue to be supported to make decisions about their lives, in both everyday and more long-term decisions. Person centred plans show evidence of residents’ views being sought in respect of long-term futures, although it is appreciated that this is not a straightforward procedure. More day-to-day decisions were seen to be supported, although this is compromised in some instances by there not being sufficient experienced staff to support some activities outside the home. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 13 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): 12,13,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are benefiting from improved support in enabling and encouraging them to undertake a wide variety of activities. More experienced and consistent staffing will enable this to continue and be fully available more of the time for all residents. More planning in provisions will enable healthy items such as salad to always be available. EVIDENCE: One resident enjoyed a horse riding session in the morning, and then went to the hospital later as part of an ongoing programme. Two residents were looking forward to visiting their parents’ later in the day. Staff supported one resident by driving him to his parents. It was planned for another resident to go with him, as he enjoyed the ride, followed by a meal, but staffing constraints that shift meant this was not possible. This resident had enjoyed a walk out with a staff member earlier. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 14 One resident had not gone out at all by the end of the inspection. This person may choose not to go out, as has been observed previously to be the case. Staff recognise the need to be able to offer him the opportunity, but recognise that this is not always possible, owing to staff constraints – most frequently, the constraint of not having suitably experienced staff knowledgeable and confident to meet his needs. In contrast, it was noticed that another resident had been supported to resume activities that had previously lapsed, and which were once more being enjoyed, with the help of a positive and consistent staff approach. Holidays were forthcoming for residents, supported by, in some instances, by a combination of staff and relatives. One resident has resumed a college course, helping to widen his skills and social contacts. Menus showed a variety of wholesome food being provided. Management instructions confirmed that the menu planning was to be followed. Lunch for two residents that day was sandwiches, as on the menu board. Cheese and ham sandwiches were made. Staff wished to supplement this with salad and crisps, but found none were available. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents receive support and have their health needs need met by a small, quality staff team, but this good work is compromised by having to rely on less experienced agency workers for much support. In medication, as in other aspects of health and well-being, there is a heavy reliance on the dedication and excellence of a relatively small number of permanent staff. EVIDENCE: The majority of care and support on the morning of the inspection was being provided by agency workers. These workers had worked at Willes Road, typically, four or five times previously, so had a reasonable, but by no means fully comprehensive, awareness of the support needs of individuals. One such worker was observed dealing with some challenging behaviour around mealtime by one resident, and was seen to be managing this appropriately, and in accord with agreed guidelines. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 16 Individual records showed appointments with health professionals were taking place as required. One person is having regular supported visits to a local hospital in order to ascertain and resolve visual difficulties. An external health professional with connections with the service was spoken with, and felt that staff were working well with professionals to improve the well-being and futures of individual residents. One person has a personal monitor to pick up any problems that may arise, especially at night. Staff advised that it picks up any sound, and conceded that it limited this person’s privacy. Staff advised on the improvement in one person’s well-being since they had requested a review of medication. This person is now more lively and more talkative. This was observed during the inspection. Medication was looked at. One resident was currently having eye drops. There was no dedicated fridge to store these in. Staff said this would be actioned, and were able to inform me that this had been done following the inspection. A sample of medication records were examined. these were satisfactory. Medications recorded as dispensed tallied with those remaining. The majority of medicines are dispensed from pre-packed ‘blister’ folders. These were seen to be accurate. Because of the current small number of permanent staff, there are relatively few able to dispense medication. There was only one member of staff on duty able to do this on the morning shift. On the afternoon shift, there were none, resulting in a member of staff being on call for this purpose coming in. One permanent member of staff on duty that shift advised that she had previously dispensed medication in her previous job, had completed the relevant training, and had been waiting to be checked as competent under the organisation’s procedure. She found the delay frustrating. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are protected by a service that continues to demonstrate its promptness in dealing with allegations of misconduct and potential abuse. Residents should also benefit from a service that constantly works on effectively getting, and acting upon, their views. Residents’ individual monies are now more securely managed. EVIDENCE: Residents have high communication needs and continue to be dependent to a high degree on staff interpreting their views and wishes, using their knowledge, experience, and existing communication guides. Service users are able to make their views known with a mixture of gestures, simple word responses, or, in one instance, simple communication devices. External professionals are involved in working with staff on ‘person centred’ work, to gain individual views, and on helping communications. A relative was spoken with, who had raised concerns the previous week, regarding an agency worker who had accompanied them on a horse riding trip, but had spent much of the car journey either asleep or texting, rather than engaging with the service user. The manager had promptly informed the agency, and they were not to use this person again. That apart, this person Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 18 was happy with the work of staff to encourage participation in activities and in improving confidence and well-being back towards previous levels. It was compared favourably with previous services. Other than this, concerns by relatives centred around uncertainty over the future of the service. This was evident in records of ‘family forums’. The complaints book had one compliment, from a charitable organisation who had worked in the service. The service informed us of one internal allegation, which is currently being dealt with. Relatives spoken with said they had concerns over the frequency of staff turnover, and the high use of agency staff in recent years, rather than with the quality of permanent staff, which they felt to be good. Their main concern was the use of staff unfamiliar with the needs of the people living at the home. However, they were fulsome in their praise of the core of permanent staff at the home. ‘They are brilliant.’ was one comment. Relatives commented that they were always kept in touch if there were any problems, and were told of outings or achievements. Staff were able to demonstrate the finance system that has been made more secure. A sample of monies was seen to tally with records, the only difficulty being the amount of small change made checking a very long process. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from the efforts the service has made to overcome the difficulties inherent in five people living in an old three-storey property not ideally suited to meeting the needs of five people with challenging behaviour. EVIDENCE: The environment has been noticeably improved. The communal room behind the lounge has been redecorated and is now a relaxation room, being comfortable and inviting, with a consistent colour scheme, comfortable furnishings, and solely for residents’ use, rather than as previous, a mish-mash of sitting, laundry, storage and records space. Staff advised that some residents will use this space for relaxing or for watching DVDs or listening to music away from other residents. The hallway has now been redecorated, with no ripped or discoloured wallpaper in evidence. Two lights are bare, with no lampshades. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 20 Carpets on the stairs, although not unsafe, are worn, and would now benefit from being replaced. The laundry is small, but, although suffering from ‘wear and tear’, was tidy. The garden at the rear is much tidier. Although overgrown in places, it now has no unsightly or hazardous clutter. It is evidently used by residents in good weather, with chairs and some ‘play’ equipment outside. The front of the house was much tidier and presentable, with, for the first time in a number of inspections, no fridges or similar waiting to be disposed of. The toilets were clean and tidy, and well-stocked with towels toilet rolls. There are curtains on the windows. There were no unpleasant odours apparent. The dining room was clean and tidy, with a new dining room table. The dining room walls were bare, pictures having been taken down. Staff later advised that these were in the process of being replaced, and that more photographs of residents and others were to be featured. Some photos were on display in the lounge. Basement areas, too, have been improved. There is now no noticeable remnant or smell of damp, and there have been no flood alerts since the last inspection, but the nearness of the property to the river continues to leave this as a possibility. A pest control officer visits the property regularly; owing, I was advised, primarily to its location near the river. Records of these visits, along with actions and recommendations, are kept in the home. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from the attentions of a small, dedicated staff team who understand their needs and how they can be met. This relatively small team needs expanding in order to ensure a consistent quality service all the time. The service should be able to demonstrate that all agency staff used are suitable and safe to work with the residents of the home. EVIDENCE: On the morning of the inspection, there were four staff on duty. This was one under agreed limits, owing to an agency worker not arriving, leaving no notice for a suitable replacement. One resident was out with a parent for much of the morning, allowing one-to-one staffing with the remaining residents. Of these staff, only one was a permanent Turning Point staff, the others were agency staff. The agency staff advised they had worked at Willes Road a number of times previously, and showed in interactions, a reasonable knowledge of residents’ needs and how to meet them. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 22 The permanent member of staff in the morning, the shift leader, spent a disproportionate amount of time in contact with agencies and other staff trying to ensure that forthcoming shifts were adequately covered. Staff expressed frustration at the length of time recruitment of permanent staff took. One permanent member of staff gave the example of being accepted for a post, but of not being able to start for three months. Staff and recruitment files for permanent staff were not able to be seen, in the absence of the manager. A sample of these were seen at the previous inspection, and were satisfactory. ‘Pro formas’ for agency workers were seen. These are completed from agency information, giving details principally of training and of Criminal Records Bureau checks. These were seen for two of the agency workers on duty, but not the third. A request was seen from the acting manager requesting this information in February. There are high rates of training both gained and being undertaken by the permanent staff. As they are a relatively small percentage of the total workforce at present, however, this still translates as qualifications such as National Vocational Qualification level 2, and relevant training such as managing challenging behaviour, being achieved by less than 50 of current staff. Staff advised that all permanent staff have, or are undertaking, National Vocational Qualification level 2 or similar qualification. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ are benefiting from improvements brought about by the leadership provided by a manager who has been brought in from a nearby service. Residents’ health and safety is compromised if cupboards that are meant to be locked are left unlocked. EVIDENCE: The person now given management responsibilities for Willes Road has started to make improvements. This person is an experienced manager at another, nearby, Turning Point service. Staff commented that they now felt they were being given clear leadership and direction. One commented that ‘things were much improved, and there was less stress’. Material improvements in the Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 24 home have already been noted. The office is far more ordered, and staff were able to locate files and information far more readily than previously. Records showed family forums taking place regularly, along with staff meetings, and service user meetings. Records of service users meetings showed the limitations of responses obtained regarding issues that affected residents’ lives, with views ranging from key phrases, to smiles and gestures. The principal concern of family forums has been the future of the service, and of individual residents. Person centred plans are ongoing with residents, to try and gauge what individuals may wish for their own future. One staff noted improvements in activities for one service user in particular, feeling that this was down to a renewed commitment to ensuring opportunities were provided and followed through. Health and safety practices were observed, with hazardous implements such as knives being locked away, and with no evidence of ‘clutter’ impeding residents or staff. One unfortunate, and major, exception to this was the fact that the cupboard above the kitchen sink, containing potentially harmful substances, was found to be unlocked. It was promptly locked when this was pointed out. The shift leader was suitably distressed by this occurrence, as was the project leader, who advised that it would be raised at the forthcoming staff meeting. A notice on this cupboard stated it should be kept locked, but this warning was diluted by the fact that there was a similar notice on the cupboard under the sink, which was open, and empty, with a broken lock. This notice was then removed. A panic button has recently been installed, enabling a quick alert to be given to and from different floors, including the basement, if needed. Staff on duty who were asked were not clear on how this worked. This was to be discussed at the staff meeting. Evidence was seen of regular fire tests and drills, and a recently reviewed fire risk assessment was in evidence. In the basement, one door, from the lounge allows access to the back garden, and was open. There is an emergency key next to it, for exit in the event of a fire or similar emergency. The hall door, which was locked, did not have such a facility. Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 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 3 x 3 x 3 x x 2 x Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? no 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 YA42 Regulation 13(4) Requirement Cupboards containing potentially hazardous materials must be locked at all times when not in use. The service must be able to show that all agency staff working in the home have clear Criminal Records Bureau checks. Timescale for action 25/07/08 2. YA34 19 25/08/09 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 2 Refer to Standard YA17 YA18 Good Practice Recommendations Healthy meal options, such as salad, should be readily available, to support residents’ well-being. Where personal monitors are used, staff should discuss with appropriate professionals arrangements for dignity and privacy, and whether there are suitable alternatives to the device being used. Procedures for approving staff as being competent to administer medication should ensure that this can be done as promptly as possible, whist still remaining safe. DS0000058002.V368197.R01.S.doc Version 5.2 Page 27 3 YA20 Willes Road 4 YA23 Less small change in individual monies will facilitate speedier checking of monies and reduce the chance of error. More permanent staff will mean consistency for residents, and a more consistent approach to meeting their needs. The advisability of improving the exit via the basement hall door should be considered, seeking advice from the Fire officer, if necessary, to maximise residents’ safety. 5 6 YA32 YA42 Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Willes Road DS0000058002.V368197.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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