Inspection on 18/04/06 for Winston Lodge

This inspection was carried out on 18th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Winston Lodge 24/04/07

Winston Lodge 11/11/05

Winston Lodge 01/07/05

Winston Lodge 07/01/05

Winston Lodge 15/10/04

Winston Lodge 06/04/04

Winston Lodge 29/09/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Winston Lodge 362 London Road Waterlooville Hampshire PO7 7SR Lead Inspector Marilyn Lewis Unannounced Inspection 18th April 2006 10:00 Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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 Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Winston Lodge Address 362 London Road Waterlooville Hampshire PO7 7SR 023 9264 7895 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.caremanagementgroup.com Care Management Group Limited To Be Confirmed Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th November 2005 Brief Description of the Service: Winston Lodge is a care home registered to accommodate up to thirteen people in the category of learning disability. The home is owned by the Care Management Group who are based in Wimbledon. The group owns two other houses close to Winston Lodge. The home is situated within walking distance of Waterlooville town centre and is close to a range of amenities. The Responsible Individual for the home is Mr Michael Buckingham. The manager of the home is applying for registration with the commission. The manager of the home stated one the 5th April 2006 that the current fees were £600 to £1200 per week. No written confirmation of services available at additional costs, such as hairdressing, was available at the time of the inspection. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 18th April 2006. The manager said that although the home is registered for thirteen service users, currently only twelve people can be accommodated due to the changes in use of rooms. The inspector met with six of the twelve service users and also spoke with a support worker and the home’s manager. Care plans for four service users were assessed and records were seen for medication, finance, fire safety training, drills, checks on fire equipment and utilities such as electric and gas, staff training and staff recruitment. The home’s Statement of Purpose and Service User Guide were also seen. The inspector toured the home and this included time being shown around by one of the service users. This was the first inspection for the year 2006/2007 and all the key standards were assessed. What the service does well: The home had a friendly atmosphere and service users looked happy and relaxed. Service users commented on the friendliness of staff and said that they liked living at the home. A staff member spoken with also commented on the happy atmosphere at the home and said that she received good support from the manager and colleagues and enjoyed working at Winston Lodge. It was evident during the inspection that service users were able to make their own decisions about daily living and leisure activities and staff were seen to encourage decision making. Service users’ opinions and ideas were listened to and acted upon, illustrated by the change of use of one of the communal rooms from a general room to an activities room. Staff had acted appropriately when a service user said that she would like to play basketball by sourcing a venue and a teacher and forming a basketball team so that the service user could play the game. The service user said that she really enjoyed playing and staff are now looking to get other service users in the locality interested in making up teams. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Contracts seen, providing service users with the terms and conditions for living at the home, gave details of services included in the fees but they did not inform of services and facilities available at an additional cost. Full needs assessments seen had been completed when the service user was admitted to the home which was at least a number of years ago and did not give a clear picture of their current needs and abilities. A review of the needs assessments for service users would enable staff to review the care plans as those seen did not reflect the current needs of the service user and the actions required by staff to meet those needs. Care plans did not contain risk assessments for daily living activities or leisure activities such as going into town for shopping or bowling. A requirement for a full audit of risk assessments was made at the last inspection in November 2005 and this is still outstanding. Further staff training is required to ensure they have the training required to do their jobs. Training required includes moving and handling, learning disabilities awareness, food hygiene and key working. Fire Records seen had not been kept up to date and indicated that not all staff had attended fire drills. At the last inspection a requirement was made for the bathroom on the ground floor to be kept clean. On this occasion the bathroom was clean but required redecorating as paint was flaking off the tiles and a service user remarked that the room was not very nice. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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 Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. The home provides information on the services and facilities available at Winston Lodge, however service users contracts need to include the additional costs that may be incurred while living at the home. Service users care needs assessments need to be reviewed to ensure the service users current care needs are met. EVIDENCE: The home has a Statement of Purpose that gives details of the organisation that owns and runs the home and the structure of staffing which includes the experience and qualifications of the manager. The document also provides information on the admission process and an overview of life at the home. The Service User Guide gives additional information on life at the home. At present it is provided in a written and symbol format. A service user who came to speak with the Inspector, understood the information provided in the Guide. The manager said that a new copy was being produced that would be in an even easier format for all the service users to understand. All the service users have been at the home for a number of years and so there were no recent pre admission needs assessments available. However the needs assessments seen for four service users required complete updating to Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 10 ensure care plans are developed that provide information on all their care needs. A copy of each service user’s contract, giving the terms and conditions for living at the home, were in the four service user records seen during the inspection. Although the documents state what services are included in the fees they do not give details of services provided at an additional cost such as hairdressing or the purchase of toiletries. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users are able to make their own decisions and are consulted on all aspects of life in the home. However the lack of care planning and risk assessments could result in the service users not receiving the support required to meet their needs. EVIDENCE: The manager said that the care plans for service users were under review and new files were being commenced. These did not hold any information at the time of the inspection but there was evidence that the new files and a format for recording the information were being set up. Care plans seen for four service users were not up to date and paperwork was not kept in order so that it was difficult to follow the information in the files. An outline of the service user had been written as a ‘pen portrait’ but two seen had not been dated so it was not possible to say that these were up to date. They were also not signed. A care plan for medication was dated 2003. Care plans for the weekly activities for one service user were also out of date. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 12 Key workers had completed a monthly review for two of the service users and the reviews had been signed by the service users and the key worker. The two service users confirmed that they discussed their care with their key worker. A daily record was kept for each service user and records seen for four service users provided clear information on their daily lives including their participation in leisure activities. An entry was made in the record for each shift, including the night shift where staff recorded which service users were asleep and who and what time a service user was up and about. Staff observed supporting service users appeared to know the service users well and were aware of the support required for them to participate in daily living activities such as getting dressed and going to the kitchen for drinks. It was evident during the inspection that service users were able to make decisions about their daily living activities. Care plans for one service user clearly documented the wishes of the service user about visits to the family home. While at the home a service user came to talk with staff about concerns regarding attendance at a day centre. The manager suggested they went to talk to her key worker and asked if the service user would mind if they spoke to the day centre staff to try to provide activities there that the service user would prefer. The conversation was undertaken with sensitivity for the service user and provided a practical solution to alleviate the concerns of the service user. Another service user asked if it was possible to go shopping the next day and staff made arrangements for this to happen and then confirmed with the service user that the shopping trip was planned. Service users were also seen to make decisions over whether they wished to participate in leisure activities and which area of the home they wished to be in, with some spending time in the lounge and dining room and others in their own rooms. Staff were observed interacting well with service users and were encouraging them to make their decisions about all aspects of daily living including what they would prefer for lunch. The manager said that monthly meetings were held to give service users the opportunity to discuss all aspects of life at the home. Records of meetings seen indicated that service users discussed issues such as future leisure activities and gave feedback on events that had taken place. Discussions also included issues such as menus and new staff members. At the last inspection a requirement was made for an audit and review to be undertaken for all risk assessments. This has not been completed. Some risk assessments seen in the care plans were out of date and showed no evidence of being reviewed. Risk assessments were not available for all the activities service users were involved in such as going shopping or using transport. The Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 13 manager said that service users were able to go into the kitchen to get themselves drinks and snacks however no risk assessments were seen for the four service users case tracked during the inspection. The manager of the home said that risk assessments for staff members had been commenced and records were seen to confirm this. A requirement was made at the last inspection for staff to receive training and guidance in maintaining the dignity of service users. The manager said that the issue had been dealt with through staff supervision and a member of staff confirmed that this had been included in their supervision programme. During the inspection staff were observed to talk with service users respectfully and five service users spoken with said that staff were friendly and caring. The home has a policy on confidentiality and a staff member spoken with confirmed that it was understood all information regarding service users was kept confidential. A service user said that any thing discussed with a staff member would be between them but understood that it may be necessary for the staff member to share that information if it was a cause for concern, such as suspected abuse. During the inspection when the service user spoke with the manager about her worries regarding going to the day centre, the manager asked the service user if it was possible to share this information with the key worker and the day centre staff before going on to talk to them. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users in the home have good support to participate in a wide range of activities and feel part of the local community. Service users enjoy the food provided at the home and they feel they are treated with respect at all times. EVIDENCE: One service user works in the local community and six of the service users attend day centres. Day centre attendance varied according to the wishes of the service users. As previously noted staff discussed any service user concerns regarding day centre activities with the service user and attempts were made to encourage service users to try other activity options that they might prefer while at the centres. Service users observed talking with staff about their concerns seemed at ease to do so and there was a good rapport between staff and service users. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 15 Some service users attend services at local churches and attend a social gathering at a church group in the week. The manager said that some of the service users are assisted to attend by family member. The manager said that currently there were no service users from different ethnic groups living at the home but that every effort would be made to ensure their cultural needs were met should someone from an ethnic minority reside at the home in the future. Records seen indicated that service users accessed establishments in the community, such as the bowling complex, shops and restaurants. It was evident during the inspection that staff made every effort to comply with service users wishes for trips into the community such as visiting the shops. The manager said that during a service user meeting a service user had asked for the opportunity to play basketball. The possibility was investigated but there were no basketball groups in the area. Staff arranged to hire a basketball hall and a tutor and set up their own basketball group. The manager said that they hope to expand this for other homes in the area to be able to participate. The service user who wished to start playing basketball was spoken with and indicated that it was a great pleasure being able to play. At the time of the last inspection some service users indicated that they did not have enough activities to do while in the home. On this occasion service users said that they were satisfied with the activities on offer and one said that she had been very busy the day before colouring and knitting. During the inspection service users were seen knitting, playing board games, watching television and tidying their rooms. Activities programmes seen for two service users were not up to date. However staff and the service users were aware of the changes to the programmes. Visitors are welcome at the home at any time and their visits were recorded in the service user’s daily records. The home encourages family and friends to attend social events with the service users. Recent events had been a Mothers Day get together and Easter celebrations. The manager said that events were usually planned monthly following discussions with service users and included discos and barbeques. The home’s policies and procedures indicate that the rights of the service users are to be upheld. Staff were observed to knock on doors and wait before entering rooms. Service users have a locked container in their room to store personal items and may have a key to their room if they wish. A service user said that they had been asked if they would like a key to their room but had refused the offer. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 16 Service users were assisted by staff using pictures of food items to produce the menu for the week. Menus seen offered choice and it was evident during lunch on the day of the inspection that choice was encouraged. Six service users in the dining room at lunchtime said that they enjoyed their meals and were able to ask for more if they wished it. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive the personal and healthcare support they require and are safeguarded by the home’s clear procedures for dealing with medicines. EVIDENCE: Service users are able to choose how and when to participate in daily living activities such as what time they get up and go to bed and which clothes they would like to wear. Staff were observed assisting service users in a friendly, respectful manner. A service user said that she received assistance with personal care from a female support worker, which was her preference. Although service users were satisfied with the way they received care, the lack of clear information in the care plans could result in service users not receiving care in the manner they would wish. Care plans seen indicated that service users received attention from GPs and other health professionals including speech therapists and the community psychiatric team as required. Visits were also recorded from the dentist, chiropodist and optician. Two service users said that they were able to visit the GP on request. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 18 Medication records seen were up to date and medicines were stored appropriately. Information on the adverse affects of medicines prescribed was available and reasons for giving medicines prescribed as required were recorded. The home has a clear system for recording medicines brought into the home and on disposal. At the last inspection a requirement was made for staff to receive training from a suitably qualified person. The manager has arranged for all staff to receive training by a suitably qualified person later in April. Confirmation of the arrangements for the training session was seen by the inspector. The manager said that no service users at the home were responsible for their own medication. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users felt their views and concerns were listened to and acted upon and they were protected by staff awareness of abuse issues. EVIDENCE: The home has a complaints procedure in place that indicates who will investigate the complaint and gives timescales for the process. A service user spoken with felt that any complaints raised would be investigated and acted upon. A complaint report was seen in one service user file and it indicated that staff had acted quickly to resolve the issue. The manager was unable to locate the complaints logbook during the inspection visit. Records seen indicated that since the last inspection all staff have received training in abuse awareness. This was a requirement of the last inspection report. Two staff members spoken with were aware of the procedures to be followed should abuse be suspected. It was not possible on this occasion to fully inspect the procedures for handling service users money. Due to robbery at the home last autumn all the bank accounts were closed and new individual accounts for each service user have recently been opened. Currently the home does not hold any money for service users. While waiting for the new accounts to be set up the home has forwarded money to the service users for purchases such as toiletries. Records have been kept of all service users expenses and the home was in the process of totalling the amounts up and arranging to make the payments from service users accounts. The manager said that when service users money was held at the Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 20 home it was kept individually, in twelve containers and records we are kept of all money coming in and going out. Receipts were kept for all transactions and these were seen during the inspection. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home looked clean and homely and service users liked their rooms and the communal areas and felt that they met their needs. However one bathroom required attention as this room, in its’ present condition, was not liked by service users. EVIDENCE: At the time of the inspection the home looked clean and homely. Service users are accommodated in ten single rooms and one double room. There is also a lounge and dining room. A room alongside the dining room was being made into an activities room. Service users decided the use for the room during one of their meetings. The inspector toured the home at one time accompanied by a service user who was eager to show her room and some other areas of the home. Three service users in their rooms at the time indicated that they were pleased with their rooms and said that they were able to choose the bed linen and curtains and colours for their rooms. Service users spoken were also satisfied with the communal rooms and one said they had ‘everything they wanted.’ Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 22 One room had en-suite facilities and all the others were provided with a wash hand basin. The home has two bathrooms, three showers and three separate toilets. Although the bathroom on the ground floor was clean it looked in need of refurbishment as paint was peeling off tiles. A service user said that the bathroom ‘did not look very nice. New flooring had been provided in the dining room and the kitchen and five of the bedrooms had been redecorated. At the time of the last inspection the banister on the stairs was wobbly and the stair carpet looked as if it required repair. Since then stabilisers have been fitted to the banisters so that they are now firm when held and the stair carpet has been attended to so that there are no loose or frayed areas. The garden area to the rear and side of the home is enclosed and two service users spoke of holding barbecues there. To the front of the property there is room for car parking. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 23 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s recruitment procedures. However although improvements have been seen in staff training, some staff have not received all the training required to do their jobs and this could result in the service users needs not being met. EVIDENCE: Since the last inspection a deputy manager has been recruited to assist the manager in the running of the home. A senior member of the support staff is a team leader and there are eleven support workers. Two of the staff team hold National Vocational Qualifications (NVQ) level 2 or above, three staff members are in the process of studying for the qualifications and two are about to start the course. The manager is aware of the requirement for fifty per cent of the care staff to hold or be in the process of obtaining NVQ level 2 or above and is working towards this. Recruitment records were seen for three staff members. Two of the files contained all the information required including proof of identity, two references and Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks. The third file did not contain any references and Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 24 indicated that a POVA check had been completed but the CRB had not yet been received. The manager said that the references had been obtained but were still with the organisation’s Human Resource team. The manager said he would arrange for the references to be forwarded to the home and stated that the member of staff waiting, for the CRB check to be completed, was working at the home under supervision. Since the last inspection there has been an improvement in staff training, however there are still some areas requiring attention. Training records were seen for the staff team. All new staff members are required to complete an induction and foundation course that includes sessions on all aspects of care provision. Records for one staff member indicated that the courses had been completed. A requirement was made at the last inspection for staff to receive training in abuse and records seen confirmed that this had taken place. Ten staff members have attended first aid training and five have completed food hygiene sessions, with the remainder of the staff team booked for the course in the coming months. On this occasion the records indicated that only four staff members had received training in moving and handling and other than two staff members who had attended sessions on Autism, there was no indication that staff had completed training in learning disabilities. Also some key workers had not received any training in the role and responsibilities of their position. Requirements have been made at this inspection for staff to receive training in moving and handling, learning disabilities and key working for those in the role, who have not yet attended. At the time of the last inspection a requirement was made for staff to receive regular supervision. Since then supervision meetings have been arranged for each member of staff and supervision records seen confirmed that supervision was taking place. A staff member spoken with also confirmed that supervision sessions were arranged on a regular basis and added that the meetings were very helpful. The manager and three senior staff members undertake supervision sessions. All have received training in providing supervision to care staff. The manager receives supervision from an area manager of the organisation. Service users spoken with said that they felt enough staff were on duty, as they did not have to wait if they asked for assistance. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 25 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users and staff benefit from the management approach of the home and they are confident their views are listened to with regard to the quality of care provided there. Lack of staff training in health and safety practices such as moving and handling and attendance at fire drills could put the health and safety of service users at risk. EVIDENCE: A requirement was made at the last inspection for the manager to apply for registration with the commission. The manager has completed the application and has submitted it to the commission. The manager holds a Diploma in Health and Social Care and is currently studying for the Registered Managers Award. He has experience in providing care for people with learning disabilities and was the acting manager of the home for a year before taking up the post Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 26 of manager six months ago. Since the last inspection a deputy manager has recently been appointed, providing assistance for the manager. The manager also supervises two other small homes in the locality. He stated that at present this only requires approximately three hours per home per week. During the inspection the manager indicated that he was keen to improve the quality of care provided at the home in particular staff training and care planning. A staff member spoken with commented on the support and encouragement received from the manager. Four service users also said that the manager was easy to talk to and this was evident during the inspection when service users were observed speaking with the manager in a relaxed and friendly manner. Since the last inspection new quality assurance procedures have been put in place to improve the methods for obtaining opinions and giving feedback. The manager said that feedback was given to service users at one to one meetings with their key workers and in monthly group meetings. Service users also attended an annual quality assurance forum held in London by the organisation. Records seen indicated that feedback was being given to service users. A service user said that it was easy to comment on the quality of care provided at the home. As stated in standard 28,service users are able to make decisions about life at the home, as illustrated in the change of use for a room to an activities room. Staff opinions are obtained through supervision and group meetings, which are held on a regular basis. The manager operates an open door style of management and service users, staff and visitors are able to speak to him at any time. As mentioned in standard 35, although staff training has improved there are still areas requiring attention including health and safety, food hygiene and moving and handling. Fire records seen indicated that staff had received fire safety training but it was not possible to identify which staff members had attended fire drills as the records were not kept up to date. The records seen indicated that only five staff members had attended a fire drill in the last year. A requirement has been made that all staff attend fire drills and records are to be kept up to date. The manager said that he would arrange fire drills so that all staff would have attended in the next few weeks. Regular checks had been made on the fire safety equipment. The kitchen looked clean and in good order and food was stored appropriately. The temperature of the fridges and freezers were being monitored and recorded. While looking at the records for the monitoring of the hot water temperature from bath taps it was noted that when a reading had been higher than the required level the situation had been rectified quickly. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 27 Up to date certificates were seen for electricity checks including portable appliances and gas. Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 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 3 2 2 3 x 4 x 5 2 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 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 3 3 x x 1 x Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 29 Yes 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 YA9 Regulation 13 (4) (c) Requirement A full audit of all risk assessments must take place and all risk assessments must be kept under regular review. This is an outstanding requirement of the inspection dated 11/11/05 Care plans must be kept under review to reflect the current needs of the service user and the actions required to meet the identified needs. Service user contracts must indicate services available at an additional cost to the fees. All outstanding staff training needs must be addressed, including moving and handling, learning disabilities awareness, food hygiene and key worker systems. This is an outstanding requirement of the inspection dated 11/11/06. All staff must attend fire drills and records of attendance must be kept up to date. The bathroom on the ground floor must be redecorated. DS0000011672.V287811.R01.S.doc Timescale for action 31/05/06 2. YA6 15 (2)(b) 31/05/06 3. 4. YA5 YA35 17 (1)(a) 18 (c) (i) 30/06/06 30/06/06 5. 6. YA42 YA27 23 (4)(e) 23 (2)(d) 16/05/06 30/06/06 Winston Lodge Version 5.1 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. Refer to Standard Good Practice Recommendations Winston Lodge DS0000011672.V287811.R01.S.doc Version 5.1 Page 31 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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. 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