Care Home: 145 -146 Goddard Avenue

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What the care home does well This is a service that ensures they can meet people`s needs before they move into the home. Care plans are in place that reflect the assessed needs and are kept under review. The home has updated information available in the form of a statement of purpose, a service user guide and a brochure. Discussion with the provider and manager confirm that the home takes the rights, dignity and diversity of the people living at the home very seriously and challenges external agencies when any form of discrimination takes place. People are encouraged to make decisions regarding how they choose to live their lives and these decisions are respected and any associated risks are assessed and minimised. This is a service that is rarely complained about and there have been no complaints since the last inspection. People using the service have the opportunity to share their views or raise concerns in one to one sessions with their key worker or within the house meetings. The experienced manager is developing new systems for behavioural management. Another area that is being further developed is building on people`s communication skills. New staff are recruited, inducted and trained properly. Potential new staff are invited into the home to have tea with the people who live there before they are offered a position to ensure they will fit in and are accepted. The staff team are committed, caring and respectful at all times, this was observed during the inspection. People are encouraged and supported to participate in age appropriate activities if they choose. The home is developing some good systems for monitoring quality assurance. At the last inspection three requirements and three good practice recommendations were set. These have all been met. The provider and the manager are both working hard to further develop this service and have already made great steps in achieving this since the previous inspection. What has improved since the last inspection? The Statement of Purpose and the Service User Guide have been updated to contain current relevant information. There is now also a service brochure to provide information. Person Centred Planning is being further developed to ensure there is full involvement from the people living at the home in the planning of their care. All risk assessments and care plans are reviewed regularly and recorded. The arrangements for the safe administration, recording and storage of medication have improved. Health Action Plans are dated when they are completed. What the care home could do better: It would be good practice to ensure that all hand written entries on medication boxes showing the start/stop dates are signed and dated. It is recommended that whilst developing the behavioural management guidelines, some consideration be given to how these will be evaluated.We discussed how the introduction of ` Circle of Support/Friends meetings may be a useful tool for obtaining/recording people`s wishes, feelings and concerns. The manager must ensure that all staff attends regular refresher training in manual handling. CARE HOME ADULTS 18-65 Goddard Avenue (145) 145 Goddard Avenue Old Town Swindon Wiltshire SN1 4HX Lead Inspector Pauline Lintern Key Unannounced Inspection 6th December 2007 10:00 Goddard Avenue (145) DS0000067326.V342793.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 Goddard Avenue (145) DS0000067326.V342793.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. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Goddard Avenue (145) Address 145 Goddard Avenue Old Town Swindon Wiltshire SN1 4HX 01793 533552 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) XLCARE LIMITED Miss Zehrida Arif Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The staffing arrangement referred to in the letter dated 4th April 2006 must be complied with for a minimum of 6 months from the date of registration. The 2 existing service users aged over 65 years (referred to in the application form dated 20th March 2006) may be accommodated at the home whilst the home can demonstrate that their needs can be met. 23rd August 2006 Date of last inspection Brief Description of the Service: 145 Goddard Avenue is a care home providing accommodation for seven people who have a learning disability. XLCare owns the home and the proprietor also has the day-day management responsibilities. The home is located in a residential area in Old Town, Swindon. It is situated within easy access to local shops and amenities and is also on the main bus route into Swindon town centre. It is a three storey terraced house, with five single bedrooms, and one shared bedroom. The garden is large and well maintained, with ready access for all residents. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over six and a half hours. The provider and the recently appointed manager were present throughout to assist with the inspection. There are currently seven people living at 145 Goddard Avenue. On the day of the visit three people using the service were at home in the morning and the remaining people were at day services. Two returned in the afternoon and were able to meet the inspector. We met with three people using the service in private and one in the dining area during lunch. Prior to the inspection the manager completes a questionnaire, which provides information about the people living at the home, staffing, fees and confirms that necessary policies and procedures are in place. We sent out survey satisfaction forms to the people using the service, relatives, staff and healthcare professionals to obtain their views on the service provision. We received four responses from healthcare professionals, two from relatives, one from staff members and one from a person using the service. We had the opportunity to meet with two staff members in private to obtain their views. We sampled various records including care plans, risk assessments, quality assurance, staff recruitment records, and health and safety. A tour of the building also took place. Since the last inspection many documents have been reviewed and updated. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: This is a service that ensures they can meet people’s needs before they move into the home. Care plans are in place that reflect the assessed needs and are kept under review. The home has updated information available in the form of a statement of purpose, a service user guide and a brochure. Discussion with the provider and manager confirm that the home takes the rights, dignity and diversity of the people living at the home very seriously and challenges external agencies when any form of discrimination takes place. People are encouraged to make decisions regarding how they choose to live their lives and these decisions are respected and any associated risks are assessed and minimised. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 6 This is a service that is rarely complained about and there have been no complaints since the last inspection. People using the service have the opportunity to share their views or raise concerns in one to one sessions with their key worker or within the house meetings. The experienced manager is developing new systems for behavioural management. Another area that is being further developed is building on people’s communication skills. New staff are recruited, inducted and trained properly. Potential new staff are invited into the home to have tea with the people who live there before they are offered a position to ensure they will fit in and are accepted. The staff team are committed, caring and respectful at all times, this was observed during the inspection. People are encouraged and supported to participate in age appropriate activities if they choose. The home is developing some good systems for monitoring quality assurance. At the last inspection three requirements and three good practice recommendations were set. These have all been met. The provider and the manager are both working hard to further develop this service and have already made great steps in achieving this since the previous inspection. What has improved since the last inspection? What they could do better: It would be good practice to ensure that all hand written entries on medication boxes showing the start/stop dates are signed and dated. It is recommended that whilst developing the behavioural management guidelines, some consideration be given to how these will be evaluated. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 7 We discussed how the introduction of ‘ Circle of Support/Friends meetings may be a useful tool for obtaining/recording people’s wishes, feelings and concerns. The manager must ensure that all staff attends regular refresher training in manual handling. 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. Goddard Avenue (145) DS0000067326.V342793.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 Goddard Avenue (145) DS0000067326.V342793.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): NMS 1,2,3 Quality in this outcome area is excellent. The home provides plenty of information to enable people to make an informed choice about where they live. Each person coming into the service has a full assessment of his or her needs carried out. The home ensure that the proposal of the service provision is clearly detailed and agreed by all relevant parties. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a Statement of Purpose that provides relatives and professionals with information about the home. They have also recently developed a brochure for the home using large text to suit the needs of some people who may access this service. Each person living at the home has a copy of the service users guide, which they keep in their bedroom. This includes information on how to raise any concerns or worries and what can be expected from the service. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 10 People told us that they received a contract and were provided with enough information about the home before they decided to move in. One person told us “I went for tea and met other residents before I moved in”. The way that the home prepares for a potential new admission is commendable. People have the opportunity to visit the home and stay meals as many times as they need. Before any agreements are made the home provides the funding authority with a proposal of the service that will be provided. This covers agreed staffing levels, activities, expectations and costing. The provider explained that this ensures that all parties are happy and in agreement with the contract. People who are planning to move into the home have a full assessment of their needs completed to ensure they can be met by the home. The last two people to move into this home were involved in the development of their individual support plans. Any conditions applied are agreed with all parties concerned such as families, the person themselves and any external agencies. Where there is a need for further assessment advice is sought from other healthcare professionals such as a clinical psychologist. Goddard Avenue (145) DS0000067326.V342793.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): NMS 6, 7,8, 9 Quality in this outcome area is excellent. Care plans reflect persons assessed needs. People are encouraged and empowered to make decisions about their lives and participate in all aspects of life within the home. Strategies are in place to identify potential risks and measures put in place to minimise them where possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person living at the home has a plan of care and recorded information about their needs. This includes the development of person centred plans. There is information for people using the service ‘about my plan’, which explains how the plans works and suggests that individuals may wish to make a tape or video of their plan. The manager showed us the template letter, Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 12 which will be sent out inviting people to join an individuals ‘circle of support’. A guide explaining the role will also be included. The home appears to have an excellent grasp of person centred planning. There is evidence to show that people living at the home have been involved in the development of their plans and setting their short and long term goals and actions needed to fulfil them. One person living at the home has designed a ‘letter head’ for the home’s correspondence. The home ensures there are good communication links between themselves and external agencies. This includes involvement of advocates for life changing decisions and day services to ensure peoples’ changing needs are identified. An example of this was the provider asking the day services staff to assist the people living at the home to complete our surveys rather than asking the care staff at the home to do it. The four surveys returned to us from healthcare professionals all confirm that the home communicates clearly and works in partnership with them. One person commented, “ Our client receives a tailor- made approach to their care. We are all pleased with the quality of care our client receives and the progress they have made”. All people using this service are encouraged to make decisions regarding they way they live their lives. The provider reported that one person had mentioned moving from the home (although this was not brought up at their review meeting). Following this the home shared the person’s request and a referral was made to an independent advocate to explore what the person required, therefore respecting their rights to make a decision. Another example was when one person became unhappy on a particular day of their day service. The home worked in partnership to explore the concerns raised and this resulted in a reduction of the day service. One person told us that although some other people at the home choose to attend a local men’s club, they prefer not to go. We met with one new person to the service who told us they were “still happy here”. Overall comments in from our surveys spoke positively about the service provision at 145 Goddard Avenue. Goddard Avenue (145) DS0000067326.V342793.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): NMS 12, 13, 15, 16, 17 Quality in this outcome area is good. People have the opportunity to participate in appropriate activities and educational opportunities if they wish. People tell us they access the local community. Links with family and friends are encouraged. The home works hard to ensure people’s rights are respected. People told us that they enjoy the meals at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use this service are involved in meaningful daytime activities of their own choice and according to their individual interests and capability. The home has developed an activities programme, which is specific to the feedback Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 14 from the satisfaction surveys provided to the people using the service. The provider reported that they are hoping to further develop the timetable for each individual to include the recording of goals and achievements. Activities identified on the timetable included; book night, jigsaw puzzles, swimming, clubs, personal shopping, darts, and park visit, pop corn/DVD evenings, budgeting for the week, sewing and knitting. On the day of the inspection one person was going Christmas shopping and to purchase new clothes for the planned Christmas dinner/party. The provider explained that they had arranged to go out for a Christmas meal and there would also be dancing to a live band for those that wished to participate. She confirmed that some people at the home did not wish to attend so they would be having a DVD night at home instead. People told us they enjoyed their summer holiday in Weymouth. One person showed us their photographs and said they enjoyed staying in a hotel and visiting the Sea Life exhibition. The provider confirmed that the holiday had been a real success and it had been good to see people really relaxing and enjoying themselves. They are already discussing plans for next years holiday. The provider told us that if there are planned activities for the weekends or evenings they ensure that extra staff is on duty to enable people to attend. People access the local community by visiting local shops, walks in the park and visits to local pubs and clubs. The manager reported that in the summer there had been a street party with a recycling theme, which the home joined in with. There was a band, races, music and bike rides. People are supported to maintain links with their families and friends. The home provides ‘tea visits’ for visitors. People using the service are supported to maintain close relationships. There is evidence to show that advice and guidance has been sought from appropriate professionals to ensure the health, safety and welfare of one person living at the home. One person living at the home told us they regularly visit their family and that they were planning to go home for Christmas. One comment we received from the relatives survey stated that they felt it would be good if each person using the service had a list of close family and friends birthdays so that staff could remind them to send cards and then people would not get forgotten, which can be upsetting. Discussion with the manager and the provider demonstrates how they ensure that people using the service have their rights and diversity respected. It appears that any form of discrimination will be challenged by the home to ensure individuals have access and equality. During the inspection one person using the service was observed opening the door to the vicar who had arrived to go out for coffee with another person Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 15 living there. It was also noted that when a letter arrived for someone, it was not opened until this could be done in private with staff support if it is needed. The menu is created weekly and identifies the person responsible for helping prepare the evening and lunchtime meal. There is a list of people’s likes and dislikes and highlights any allergies or specific dietary needs. The home promote healthy eating and all meals are either low sugar or sugar free, which means that everyone can eat the same foods without restriction. On the day of the inspection we were invited to join everyone for lunch. There was a nice relaxed and pleasant atmosphere where people chatted to each other. One person told us they had made the meatballs, which was a favourite. They proudly showed us their home made Christmas cakes. One person living at the home had made cakes to sell at the Jubilee Gardens open day. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 16 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): NMS 18, 19, 20 Quality in this outcome area is good. People are offered support with their personal care in a way they prefer. Physical and emotional health needs are met. Arrangements for the safe administration and recording of medication have improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living at the home are encouraged to be as independent as possible, however staff are there to provide support when it is needed. One staff member reported that when some people move into the service they are told they are more independent than they really are and they do not find this out until later. Where possible people using the service are able to choose who they are comfortable with providing their personal care. Each person living at the home has a health plan, which is kept under review. All visits to health care professionals are recorded and identify follow up Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 17 appointments. There is evidence to show that people have been supported to attend ‘well women’ clinics. The provider explained that one person living at the home with specific needs as been encouraged to arrange with support from the home, a support group, which would be held at 145 Goddard Avenue. The person was observed making arrangements and planning for the event. They said that they would make cups of tea and provide biscuits for everyone who attended. There is evidence to indicate that people living at the home have access to healthcare professionals including consultant psychiatrists, opticians, dentists, podiatrists and the community psychiatric nurse. Weights are recorded monthly to ensure people maintain a healthy weight. The manager explained how the home is currently developing a ‘ Behaviour Management Approach’ to support people with their emotional needs. She added that this is being done in conjunction with parents, care managers and health care professionals. We discussed the need for there to be an evaluation of what approach has been used and its success. Arrangements for managing medication at the home are good. Medication storage and administration records were accurate. All staff that administers medication have received appropriate training. All medication/creams have a start date/ when opened. It would be good practice to sign all handwritten entries. At the time of the inspection no one using the service self medicates. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 18 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): NMS 22, 23 Quality in this outcome area is good. The home continues to develop forums for people to have the opportunity to share their views. People are fully protected from any form of abuse by the home’s policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has recently developed a new recording format to capture any concerns made by people using the service. This contains detailed information such as events leading up to the complaint, which may be relevant to the reason the complaint arose. This will enable to manager to audit all complaints and concerns to see if there are any patterns or trends, which may influence any changes to practice that may be needed. Each person living at the home and their representatives have a copy of the complaints procedure. Part of the quality assurance survey asks for confirmation from relatives that they have a copy of this policy. The complaints procedure is discussed with each person living at the home. People told us they knew who to talk to if they had any concerns. There are regular one to one meetings for the people using the service and their key worker, which provides a forum for them to raise any issues. There Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 19 are also regular ‘house meetings’ where people have the opportunity to share their views. All staff receives training on safeguarding adults and have an understanding of the local protocols for reporting any suspected abuse. Staff demonstrated a good understanding of abuse issues and knew what to do if they suspected any taking place. People who use the service have their finances well managed by the home. Records checked as part of the inspection process balanced with the cash held in the tins. All monies are securely locked away and there is limited access to individual savings accounts. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 20 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): NMS 24, 30 Quality in this outcome area is good. People who live at this home benefit from a clean and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is decorated, furnished and equipped to meet the needs of the people who live there. It has a warm, homely atmosphere. We toured the building, which was found to be clean and tidy. Due to a leak one top floor shower had a ceiling where the plaster was peeling badly and had an exposed light fitting. This was discussed with the manager who confirmed that the leak had now been repaired and they were waiting for the area to completely dry out before the plaster on the ceiling could be replaced. The provider confirmed that she is currently replacing showers throughout. Bedrooms were observed as being personalised and individual to suit each person’s needs. People told us they are happy with their rooms and have everything they need. Two people showed us their room with Christmas Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 21 decorations, lights and Father Christmas’s on display. They were very pleased with their new large television. The provider has a maintenance, decoration and development plan. She hopes to extend the service soon. On the day of the inspection the home was found to be clean, tidy and fresh. The laundry area was found to be clean and hygienic. Staff are provided with protective clothing such as gloves and aprons. The manager carries out spot checks to ensure the cleanliness of the home. The home follows the ‘Essential Steps’ guidance for infection control. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 22 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): NMS 32, 34, 35, 36 Quality in this outcome area is excellent. Caring and trained staff supports people using this service. There is evidence that each person has been recruited following the correct procedure. Staff members undertake training beyond the mandatory requirements. Staff members told us they receive regular one to one formal supervision. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is currently four care staff working at the home. One new person has recently been appointed and is waiting for the return of their police check before commencing work. The manager explained that the rota is now more flexible to provide extra staff on duty during peak times. The manager and provider often provide ‘hands on’ support to the staff team. One member of staff told us “ The first thing the manager does each morning is ask if there is anything she can help us with”. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 23 The home uses a ‘hand over’ sheet to ensure that all tasks and information are carried out and handed over to the next shift. The manager reported that the staff team were involved in the development of these sheets. All current staff have a National Vocational Qualification level 3 or above. Staff receive training to help them meet the needs of the people using the service. Besides the mandatory training requirement staff are provided with training in areas specific to the needs of the home such as mental health, Epilepsy, Person Centred Planning and conflict management. The home have found an accredited training course for the safe handling of medication at Swindon College for staff to attend. In January the manager is planning to have more staff attend the four days First Aid Course and in February they are planning for staff to attend the Fire Marshall training. It was noted that one staff member was in need of refresher training for manual handling. Evidence shows that staff are recruited and inducted properly. Appropriate checks are made prior to someone working in the home, including police checks. Staff told us they completed an induction into the service and initially shadowed more experienced staff. The induction programme links with the recommended Common Induction Standards, which includes completing a three-month workbook satisfactorily. People who use the service are fully involved with the recruitment of new staff. They have the opportunity to meet them and ask them questions. The provider reports that new staff are assessed on communication and interaction with the people living at the home and not solely on qualifications alone. Potential new staff are invited for tea to meet the people living at the home. Staff members confirm that they are regularly supervised and records also indicate this. Regular team meetings take place where staff have the opportunity to share ideas and views. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is excellent. The home is run in the best interests of the people who live there. There are excellent systems to review, develop and improve the home. People’s safety and welfare are well protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The recently appointed manager is Ms Janet Painton who has vast experience in the care sector and has completed her Registered Managers Award and her NVQ level 4. She is also a qualified trainer in Autism. She has yet to submit her application to the Commission to become the Registered manager. The provider and the manager ensure that the home is run in the best interests of the people living there by empowering them to assist in reviewing, developing and improving the service. As mentioned earlier in this report Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 25 there is opportunities and forums available for people who use the service to share their views. The manager and the staff are very service user focused and this was observed throughout the inspection and has been reflected throughout this report. Staff spoke highly of the manager and the provider and said they felt wellsupported and received clear direction and leadership. One staff member told us “They are both very approachable”. The home has developed excellent systems to monitor and review the quality of care delivered to the people living at the home. This includes satisfaction surveys to relatives, outside stakeholders and the people using the service. The last questionnaires were sent out August 2007. The survey forms for the people using the service are in a format with symbols and involves ‘circling’ the picture that identifies how they feel. The fire logbook was found to be up to date and accurate. A fire risk assessment is in place. Health and safety checks are completed regularly therefore protecting the people who use the service. All toxic material is securely locked away. Although radiators are not guarded they have thermometers to ensure they remain at a safe temperature. The Commission obtains information prior to inspections. This information includes conformation that all necessary policies and procedures are in place and are up to date. These are not inspected on the day but the information is used to help form a judgement as to whether the home has the correct policies to keep the people living there and the staff team safe. In this instance policies and procedures were in place. These along with risk assessments are reviewed regularly and updated when necessary to ensure they are appropriate and reduce risks to staff and people using the service. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 26 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 4 3 3 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 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 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 4 X 4 X X 3 x Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 27 NO 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. Standard Regulation Requirement Timescale for action 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. 3. 4. 5. Refer to Standard YA20 YA6 YA7 YA42 YA6 Good Practice Recommendations Any handwritten entries on medication boxes should be signed and dated. It is recommended that the home explore the possible benefits for holding ‘circle of support’ meetings. It is recommended that the home continue to further develop aids to communication. It is recommended that all staff attend regular refresher training in manual handling skills. It is recommended that mechanisms be put in place to evaluate and record the behavioural management guidelines, which are currently being developed. Goddard Avenue (145) DS0000067326.V342793.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Goddard Avenue (145) DS0000067326.V342793.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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