Care Home: 12 Florence Street

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 12 Florence Street 12 Florence Street St Budeaux Plymouth Devon PL5 1QL     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: Antonia Reynolds     Date: 0 5 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 12 Florence Street 12 Florence Street St Budeaux Plymouth Devon PL5 1QL 01752298425 NOFAX KSolt@michaelbattfoundation.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Michael Batt Foundation (Valued Life Projects) Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 0 0 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Age 18-60 yrs 3 3 Learning disabled adults some of whom may have a mental disorder Date of last inspection Brief description of the care home 12 Florence Street is a care home providing personal care (if required) and accommodation for three people, aged 18 to 60, with learning disabilities, who may also have mental health needs. It is owned by the Michael Batt Foundation (Valued Life Projects) which is a not for profit organisation providing services for people with a range of needs who required support and care to live in the community. The home was opened in 2000 and is an end of terrace, two storey property, located in the residential area of St Budeaux in Plymouth. All the homes bedrooms are single and are on the 1st Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home floor. None of these have en suite facilities. There is a bathroom and toilet on each floor. Each person living in the home has their own lounge room on the ground floor. They share a dining room and the kitchen. There is a garden at the rear of the property. All areas are accessible to the people who live in the home. The average fees are 1700 pounds per week for 24 hour 1:1 support but are based on individual assessment and need. Information relating to the services provided by the Michael Batt Foundation can be obtained from their Head Office at Third Floor, Poseidon House, Neptune Business Park, Cattedown, Plymouth, PL4 OSJ, telephone number 01752 310531. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection was carried out by one inspector and consisted of an unannounced visit to the home between 1.25pm and 5.10pm on Thursday, 5th February 2009, and a visit to the organisations Head Office on 25th February 2009. We last inspected this service on the 7th February 2007. Throughout this report, the term we will be used as the report is written on behalf of the Commission for Social Care Inspection. An Annual Quality Assurance Assessment (AQAA) was completed by the home prior to the inspection. The AQAA is a self-assessment that focusses on how well outcomes are met for the people who live in the home. All the people living in the home completed surveys before the inspection took place and both people were spoken with during the visit. One survey was received from a Care Homes for Adults (18-65 years) Page 6 of 32 relative. One staff member on duty was spoken with and four survey forms were returned from other staff members. The manager sent surveys to two health/social care professionals but neither of these were returned. A tour of the premises took place and records relating to the care of the people who live in the home, the staff, and the home were inspected. The manager was available for consultation and discussion during the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: A copy of the Service User Guide should be available in the home so that people have clear and accessible information about the services and facilities they should be receiving. Each person should also be provided with a copy of this in a format that they can understand. If people are expected to contribute towards the cost of fuel for staff cars when going out, a proper monitoring system needs to be in place to ensure that peoples financial interests are protected. Care Homes for Adults (18-65 years) Page 8 of 32 The manager should arrange for portable electrical appliances and the electrical wiring to be checked by a competent person to make sure people are kept safe. The staff in the home receive instruction on what to do in the event of a fire. However the names of people who attend fire safety training and fire drills should be written down so that the management of the home know who has completed this training. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who choose to live in the home can be confident that their support needs are assessed prior to admission and they will have opportunities to visit the home to meet the other people who live there and the staff team. Evidence: There were two men living in the home at the time of this inspection, both of whom have been there for a few years. One of them told us that someone else had come to live at the home for a short while since the last inspection but did not stay. Both people living in the home said they had visited before they came to live there. The organisation has procedures in place to ensure that any people who are thinking about coming to live in the home are assessed prior to admission so that their needs are clearly identified. This process is also to ensure that the staff team have the skills and competence to meet those needs. Discussion with the manager confirmed that this includes meeting and consulting with the person concerned, their relatives or representatives and any other professionals involved in the persons care, such as social and learning disability services. The organisations Quality Assurance officer, Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: who was present for part of the inspection, confirmed that there is a Service User Guide for the home but a copy was not available in the home at the time of inspection. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are actively involved in devising their own support and care plans and are enabled to participate in, and make decisions about, all aspects of their lives. Evidence: Discussions with the people who live in the home showed that the running of the home, and all routines and activities, are organised around the wishes, choices and needs of the people who live there. The staff team encourage, enable and support people to make their own decisions, choices and be as independent as possible. Two people described their activities during the week and one person said the staff listen to me and listen to what I want to do. Each person has a written plan that details the type of support and help they need on a day to day basis. This has been devised with the person concerned and, as well as providing information about daily support needs, it also includes wishes and aspirations. Activities that people participate in are assessed for possible risks, to make sure that they are kept safe from harm. Any Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: restrictions on choice or freedom have been agreed with the person concerned, as well as other professionals involved in the persons care. These restrictions were made to protect peoples health and safety and recognise responsibilities towards others. Discussions with the people living in the home confirmed that they were aware of these agreements and knew why they were in place. The people who live in the home said that the staff team are aware of the way in which their learning disability and mental health needs affect them and take these into account when supporting them to make decisions and choices. The plan also contains information about what staff must do to keep people safe, based on risk assessments that are regularly reviewed. Discussions with the people who live in the home, as well as the manager, confirmed that staff are fully aware of the needs of each person. The people who live in the home said that they participate in all aspects of the day to day running of the home such as cleaning, shopping, cooking and laundry, and staff support and assist where required. Discussion with the manager, as well as documentation, confirmed that people are encouraged to look after their own money, including managing bank accounts and budgeting. Staff will assist if necessary. In addition to people receiving their own personal monies, the organisation provides the home with additional money for each person so that they can participate in more leisure activities and buy any clothing they need. The people living in the home were expected to pay for personal items, for example toiletries and hairdressing and public transport including bus fares for staff when they are escorted away from the home on a 1:1 basis with staff. People are expected to make a contribution of 30 pence per mile towards the cost of fuel if staff cars are used. However there was no monitoring of this process in place as one persons records showed that a staff member had taken an amount for fuel that did not correspond with 30 pence per mile and the manager confirmed that it was to go to an activity where the person usually catches a bus. A discussion took place with the manager about ensuring that the personal monies of people living in the home are not used for any purpose other than their own personal use. Care Homes for Adults (18-65 years) Page 14 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are supported to lead active lives, learn life skills and attend work placements. They participate in community and leisure activities, choose their own daily routines and maintain regular contact with their families. Evidence: Discussions with the people who live in the home, and the manager, as well as documentation, showed that people are enabled to live as full a life as they wish to. One survey from a staff member said that the home provides a homely environment for the residents, allowing them the experience of having their own home, thus providing them with invaluable skills ... to go on to independent living. People have opportunities for personal development, risk taking and decision making. The ethos of the home is based on promoting individual opportunities to broaden experiences, support people to develop socially and emotionally and to understand responsible risk Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: taking. One person said that he was being supported to live more independently so that he can eventually move out of the care home and into his own home. People are encouraged to participate in all the domestic activities in the home and to take part in leisure activities of their choice. As the home supports young adults, the staff team assist people to find and keep paid or voluntary employment, and participate in educational opportunities, in the local community. Both people in the home said they attend the local college doing different courses. One person is doing a course about learning to live independently and the other person is doing an arts and crafts course. People also have opportunities to attend day services specifically for people with learning disabilities and mental health needs, such as art therapy, if required. It was evident from observation and discussion that the people who live in the home go out on most days to places of their choice or pre-arranged day services or jobs. Participating in various leisure activities is also enhanced by the additional money that the organisation provides for leisure and clothing. People have opportunities to go on holiday either with family, friends or staff. The manager confirmed that, where a holiday is organised by the staff, the costs will be shared between the people who live in the home and the organisation. The home does not provide transport, although staff cars may be used occasionally, as people are encouraged to use public transport wherever possible. Discussions with the people who lived in the home, as well as information received from a relative confirmed that contact with, and visits to, relatives and friends is encouraged and promoted. The staff will escort someone to another part of the country to visit relatives if this is needed. Discussions with the people who live in the home, as well as documentation, showed that people choose their own menus, do the shopping and are supported to prepare and cook individual meals at a time of their choice. The manager said that each person receives 35 pounds per week to do their own food shopping and they each have a cupboard, refrigerator and freezer space in the kitchen to keep their own food items. This demonstrates excellent practice as it enables people to learn about managing a housekeeping budget, which is a key skill when living independently. Privacy is respected, bathroom and bedroom doors have locks and the people who live in the home have keys to their own bedrooms and the front door. One person said he had removed the lock from his bedroom door, leaving a hole in the door, but he was not bothered about the hole and had not yet decided whether he wanted the lock back or not. Both people who lived in the home said they had no particular faith or religion and did not wish to attend a church or any other place of worship. The manager confirmed that, if people wished to attend a church or other place of worship, this would be facilitated by the staff team. Care Homes for Adults (18-65 years) Page 16 of 32 Care Homes for Adults (18-65 years) Page 17 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home can be confident that personal support is provided in the way, and at the time, that they want and need. Health care needs are addressed as soon as they are identified. Evidence: Discussions with the people who live in the home confirmed that they receive personal support in the way they prefer and require. Each person has a support plan that provides information about personal, social, emotional and health care needs. These plans were written clearly and described peoples goals and aspirations and how staff should support them to achieve these aims. People said they have contact with representatives from Social Services, learning disability services, doctors, dentists and various other healthcare professionals and consultants. Information contained within personal files, as well as discussion with the manager confirmed that external professional advice and guidance is sought when necessary from local health care professionals or social services. One of the people who lived in the home said that he had attended art therapy for a while which he said he enjoyed. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: The people who live in the home said that they decide what time they get up and go to bed, have meals, bathe and go out during the day or evening. Through discussion and observation it was clear that timings are flexible and the choice of the people who live in the home. None of the people who live in the home administer their own medication because they are not safe to do so, or do not feel confident in doing so, therefore this is done by staff. People said they were in agreement with this practice as they did not want to keep medication in their rooms. Medication was locked away safely and regular medication reviews with health professionals take place. Records pertaining to the administration of medication were up to date and the practice of administering medication, described by a staff member, was found to be safe. Discussions with a staff member showed that he knew what to do in the event of someone refusing their medication and that unused or contaminated medication has to be returned to the pharmacy for safe disposal. The manager said she was in the process of arranging additional medication training for all staff from the local pharmacist. Care Homes for Adults (18-65 years) Page 19 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are protected from abuse, neglect and self-harm. People can be confident that any concerns or complaints will be listened to, taken seriously and acted upon immediately. Evidence: The people who live in the home said that they feel safe there, they trust the staff, and would tell the manager if they had a problem or concern. Information received from a relative said that, whilst they were aware of the complaints procedure, they had never had to use it. These discussions, as well as discussions with a staff member and the manager, demonstrated that the open culture of the home and the recognition of peoples rights, ensure that people are protected from harm. All staff have undertaken in-house training in safeguarding adults and discussion with the manager confirmed that she knew what action to take should she suspect that any person in the home was being abused or not treated respectfully. There was written guidance in the home for the staff to follow should they need to. This guidance was also available in a format using photographs, pictures and symbols to make it easier to understand for the people who live in the home. Information in surveys from four staff members showed that they were aware of the organisations policies and procedures on whistle blowing, safeguarding vulnerable adults and complaints and concerns. The home has a complaints procedure and discussions with the people who live there Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: showed that they know how, and to whom, to make a complaint if they wish to. One person said he had made a complaint and this was addressed immediately, and to his satisfaction, by the manager. Regular house meetings are held where any issues can be raised and dealt with immediately, although it was also clear from discussion that people may raise any issue at any time with the staff and management team. Care Homes for Adults (18-65 years) Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a large amount of personal space so that they can spend time on their own or with others. The standard of the environment and decor is good, providing people with an attractive and homely place to live. Evidence: The people who live in the home say that they like living there and the home is comfortable and there is plenty of room for them. In a survey received from one person living in the home, he said that the house has improved a lot since I first moved in ... I like the new dining room ... it is nicely painted and I like the colour. The home was also found to be safe, clean and well maintained, providing a homely environment for the people who live there. The house is no different from any other house in the area therefore blends into the neighbourhood because there is nothing to distinguish it as a residential home. Each person has a single bedroom on the 1st floor, none of which have en suite facilities or wash hand basins. Bedrooms are individually furnished and decorated, containing many personal possessions. Each person has their own lounge room on the ground floor which is excellent as it provides people with plenty of personal space to be on their own or entertain friends and relatives. The people who live in the home Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: said that they choose the decor and furnishings for their bedrooms and lounge rooms. Bedroom doors were fitted with appropriate locks and each person has their own key to their bedroom, as well as to the front door of the home. One person had removed his bedroom door lock, leaving a hole in the door, but he said he did not mind this and had not yet decided whether he wanted to put the lock back or not. Bathroom and toilet facilities are very good for two people. The home has a bathroom on the 1st floor consisting of a bath with a toilet and wash hand basin and a bathroom on the ground floor consisting of a bath, with a shower, toilet and wash hand basin. Hot water is not thermostatically regulated but this has been risk assessed and both people living in the home are deemed to be aware of the risks of hot water. Both people are able to modify the water temperature of the shower or bath if required. The bathroom and toilet doors are fitted with locks that afford sufficient privacy but staff can gain access in an emergency. The only shared rooms in the house are on the ground floor and consist of a dining room and kitchen. All the rooms in the house are homely, well furnished and clean. There is a sleeping in room for staff on the 1st floor. The home has a no smoking policy although people said they could smoke in the back garden. Laundry facilities are in the kitchen and people are encouraged and supported to do their own laundry. There were no concerns at this inspection about the risk of any cross infection, based on the needs of the people living in the home. Care Homes for Adults (18-65 years) Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures are robust and people who live in the home benefit from a consistent, well supported and supervised staff team. Evidence: The people who live in the home said that they liked the staff and described them as all right and fine. They said the staff are always there to help them if they need it, they always listen to them, but they also leave people alone if they want to be private. Discussion with the manager, as well as information in the AQAA and staff rotas, confirmed that there is a small staff team, most of whom are men because the home only accommodated men at the time of inspection. Surveys received from four staff members confirmed that the organisation carries out various checks and obtains written references before new staff are employed. Two staff files were inspected at the Head Office of the organisation and these contained all the required information such as written references and criminal record bureau checks. There are usually at least two staff members on duty when both people are at home, although this increases to three at times, depending on the level of support being provided. One staff member sleeps in the home at night. Discussion with the manager, surveys from four staff members, as well as documentation, confirmed that staff Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: meetings and individual 1:1 supervision sessions with staff are held regularly. These meetings address the principles and values of the organisation, staff performance and training and development needs, as well as day-to-day support issues. The organisation operates an on call system, where members of the management team are available both in and out of office hours. The organisation has a designated staff member to coordinate and arrange training and discussion with a staff member, as well as training records, showed that staff are expected to attend a variety of training relevant to their roles including qualifications in working with people with learning disabilities. These courses included a comprehensive six week induction course, including topics such as first aid, health and safety and food hygiene. Staff were also expected to undertake training in manual handling and person centred planning, human development, conflict management and awareness of epilepsy. The AQAA said that three out of six staff members have completed a nationally recognised qualification in providing care and support to people with learning disabilities. The manager said that another two staff will be starting a learning disability qualification in March 2009. A survey received from one staff member said that the training staff receive includes issues of equality and diversity such as gender, sexuality, ethnic origin and faith. Care Homes for Adults (18-65 years) Page 25 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management approach is open, inclusive and positive, providing clear leadership and guidance. Empowerment and enablement of people is the focus of the organisation. Peoples rights, health, safety and welfare are protected and promoted. Evidence: The manager has been working at the home since August 2008 and was in the process of applying to be registered with the Commission for Social Care Inspection. She said she has previous experience of working with people with learning disabilities and is working towards a relevant qualification. The people who live in the home said that they liked the manager and thought she was fine. They said they could talk to her about anything at all. In a survey received from one person, he said I like my house now we have a new house manager ... she does a good job here at Florence Street. These discussions, as well as observation, confirmed that the ethos of the home is excellent because the management approach is open and inclusive with the home being organised to meet the needs and aspirations of the people who live there. People who live in the home have access to their own records and we observed this as one of Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: the people who lived in the home read through his records during the inspection. Surveys from four staff members indicated that they also feel well supported by the manager. Feedback from one staff member said that the organisation has a very humanistic approach to support including person centredness and social role valorisation supporting people to live a valued life in the community. Information from a relative said that the staff at the home manage peoples needs very well. Lines of accountability are clear and the organisation has a management structure that enables it to cover absences when required, and provide an effective on call system to support staff. The organisation has a quality assurance system in place which includes consultation with the people who live in the home as well as their relatives and representatives. The home receives a visit once a month from the organisations Quality Assurance officer who talks to the people who live in the home, the staff and the manager as well as checking that documentation is up-to-date and finding out if the home needs any maintenance or decorative work. One of these visits took place at the same time as this inspection. Very detailed annual quality assurance reports are produced for each home, as well as one for the organisation as a whole. These contain action plans to improve the quality of care being delivered to people who live in the home. Copies of these reports can be obtained from the organisations Head Office on request. Health and safety checks, including fire equipment and gas safety are carried out regularly. There was documentation showing that portable electrical appliances had been checked at some point, but this record was not dated and had been completed by a previous manager, indicating that it may have been done some time ago. The manager could not find a record showing that the electrical wiring in the home had been inspected to make sure it was safe. Fire safety training is carried out with both staff and the people who live in the home. The fire procedure was available in a format using photographs, pictures and symbols to make it easier to understand for the people who live in the home. One person who lives in the home described what he would do in the event of a fire, that is, alert everyone else in the home that there was a fire and leave the home as quickly as possible. However the names of people who have received training in fire safety were not documented. Discussion with the manager, as well as staff training records, confirmed that all staff complete training in emergency first aid, health and safety and food hygiene. The use of hot water has been risk assessed and the manager does not consider that thermostatically controlled valves, to regulate the temperature, need to be installed. All accidents and incidents are recorded and the manager monitors these to look at the cirumstances of each incident and look for any patterns that may emerge so that the staff team can take action to prevent a recurrence. Care Homes for Adults (18-65 years) Page 27 of 32 Care Homes for Adults (18-65 years) Page 28 of 32 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 29 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 A copy of the Service User Guide should be available in the home so that people have clear and accessible information about the services and facilities they should be receiving. There should be a proper monitoring procedure in place where people who live in the home are expected to contribute towards the cost of fuel for staff cars when going out. This is to ensure that peoples financial interests are safeguarded. The names of people who attend fire safety training and fire drills should be documented. This is so that the management of the home know who has completed this training and the frequency of the training so that they can check if anyone has not completed it. The manager should arrange for portable electrical appliances to be checked by a competent person. This is to ensure that these appliances are maintained properly to help protect the safety of the people who live there. The manager should establish whether the electrical wiring in the home has been checked by a competent person. This is to ensure that the electrical system in the home is maintained properly to help protect the safety of the people who live there. Page 30 of 32 2 7 3 42 4 42 5 42 Care Homes for Adults (18-65 years) Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. 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