Care Home: 16, Curtis Road

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What the care home does well Professionals, relatives and staff all feel that the people living at the home are getting a good service, are happy and have their needs met. The staff work really well with others to make sure they meet people`s needs in the best way. People living at the home are supported to stay healthy. The staff said that the training they have is very good. What has improved since the last inspection? A new person has moved to the home. Some new staff and a new Manager have started work. People have been supported to go on holiday. People have tried new activities. What the care home could do better: Some of the records which tell staff about individual people need to be improved and organised better so that they are clearer and accurate. The staff need to make sure the always respect people`s choices and rights. The staff need to make sure they always follow guidelines and do their best to keep people safe. Some of the staff need training so that they can support people properly. CARE HOME ADULTS 18-65 16, Curtis Road Whitton Middlesex TW4 5PT Lead Inspector Sandy Patrick Unannounced Inspection 4 September 2008 10:45 th 16, Curtis Road DS0000017361.V364723.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 16, Curtis Road DS0000017361.V364723.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. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 16, Curtis Road Address Whitton Middlesex TW4 5PT 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) 020 8898 6026 F/P 020 8898 6026 curtis.road@unitedresponse.org.uk None United Response Lucia Marquez Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 4 6th July 2006 Date of last inspection Brief Description of the Service: 16 Curtis Road is a care home providing personal care and support to four adults with a learning disability. The service is managed by United Response and the building owned by Thames Valley Housing Association. The home is purpose-built and wheelchair accessible throughout with a large well-maintained garden to the rear of the property. It is situated in a quiet residential area close to public transport, shops and other local amenities. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We visited Curtis Road on 4th September 2008, the visit was unannounced. We met people who live at the home and staff on duty. The Manager was on holiday at the time of our visit. We looked at the records used, at the environment and observed the way staff supported people. We spoke to the Manager on the telephone when she returned from her holiday, and she gave us some of the information for this inspection. We wrote to the Manager and asked her to complete a quality self assessment. We wrote to people who live at the home, staff and visitors and asked them to complete surveys about their experiences of the service. 3 relatives of people living at the home, 4 health professionals and 2 members of staff returned surveys to us. We looked at all the other information that we have received about the home since the last key inspection. This includes records of quality checks by the organisation’s senior managers, and notifications of accidents and incidents. The people who live at the home cannot communicate verbally, however they appeared relaxed and happy during our visit. Other people told us that they thought the service was well run and that people’s needs were met. Some of the things people said about Curtis Road were: ‘I am perfectly satisfied with the care my relative receives and see no room for improvement. They do everything well.’ ‘I am completely satisfied with the excellent services at Curtis Road.’ ‘They do their best within the many constraints to give variety to my relative’s life.’ ‘There is a welcoming environment.’ ‘I really enjoy working with the staff at Curtis Road, I am confident that the team has the ability to care for the people living at the home.’ ‘The staff are caring and respectful to people.’ What the service does well: 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 6 Professionals, relatives and staff all feel that the people living at the home are getting a good service, are happy and have their needs met. The staff work really well with others to make sure they meet people’s needs in the best way. People living at the home are supported to stay healthy. The staff said that the training they have is very good. What has improved since the last inspection? What they could do better: 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. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 7 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 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have their needs assessed to make sure these needs can be met by the service. EVIDENCE: A new person has moved to the home since the last inspection. The staff told us that they had settled in well. The Manager told us that their bedroom was assessed for suitability. We saw records to show that their needs had been assessed by the staff and by other professionals to make sure the home was suitable. We saw that they and their family had visited the home before they decided to move there. And we saw that the staff had got lots of information from the place they used to live to help them get to know about this person. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The people living at the home have their needs recorded but records have to improve so that there is clear information for staff at all times. People have limited communication and are not always able to express choices. The staff do not always support people to do the things that they have chosen. EVIDENCE: The Manager told us that she was in the process of updating records about people who live at the home. She told us about some new support plans which she said were important guidelines and pictures that help the staff understand how to meet individual needs. The staff on duty did not tell us about these plans so unfortunately we did not see them. We asked the staff on duty to show us any records that new staff would need to look at for each person. If these support plans are the main care plans for people then the Manager 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 10 needs to make sure all the staff know this and that they are used regularly and for new staff. The records we saw about people were a bit muddled in places and some information was not clear. Some guidelines had been changed by hand and there was a mixture of old and new information, sometimes this conflicted. We only saw a clear care plan which told staff how to meet needs for one person. We did not see care plans like this for anyone else. The Manager must prioritise the updating of records to make sure all information is clear, current and tells staff what they need to do to meet all individual needs. Some records were misleading and information was inaccurate. For example different records, including guidelines, health care plans, medication records and assessments for one person gave different information about that person’s allergies. Therefore we were unable to tell exactly what this person’s allergies were. Inconsistent recording such as this can put people at risk and the Manager must make sure all information is clear and accurate. Some records were not dated or signed and should be. We saw some risk assessments for people but we could not find recorded assessments for some of the risks which staff had told us about. The Manager said that there are recorded assessments however these were not easily located during the visit and staff could not find them when we asked to see them. The Manager must make sure that there are recorded assessments for risks, that these are stored in an accessible place where staff can use them and that they are regularly reviewed. The Manager told us that people’s relatives and other professionals were consulted and involved in decision making. The people living at the home cannot communicate verbally and have difficulty expressing some choices. Therefore it is really important that other people are involved so that everybody can work together to help each individual meet their needs. The Manager said that she was hoping that this work and the support of advocates would get even better in the future. The Manager told us, ‘as far as possible the service group seem very happy in their own home. Although communication is difficult with this client group, the staff are convinced that they understand them when they are speaking to the user group and therefore everything is explained to the user group as it is taking place.’ She told us that the staff were going to find out more about communication and have more training so that they could support people even better. She said that they planned to access different resources to help them communicate with people. One professional told us, ‘the staff work extremely hard to establish what the residents wishes might be, they combine their knowledge, the person’s 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 11 behaviour and responses and discussion with families and professionals to establish what people’s wishes are. They also monitor people’s reactions closely’. One person told us that they believed the staff always, ‘focused on people’s best interests’. We saw one person being supported to walk into the lounge. They indicated that they wanted to go into another room and the staff acknowledged this by saying that this was what the person wanted. However, the staff then made the person sit in a chair and did not allow them to go where they wanted. The person appeared frustrated and upset by this. The staff did not react and left the person in the chair. The people living at the home have limited opportunities to express their choices and wishes. The staff must not ignore or disregard choices when people are clearly making them. This was discussed with the Manager. She said that this was not normal practice and could not understand why the staff had behaved like this during our visit. Some of the people living at the home can move themselves around in their wheelchairs. We saw one person doing this. However, we saw that on several occasions when they tried to get somewhere a member of staff moved their wheelchair back to the original position and applied the brakes. This practice is unacceptable and restricts people’s choice and freedom. We told the Manager about this and she agreed that this was wrong. She said that it was not normal practice at the home and that staff were told this. She agreed to remind the staff that they must allow people to make their own choices and be free to move where they want if they are able to. One professional told us that they thought the staff were good at respecting people’s individuality and rights. They said, ‘the staff have an excellent attitude towards the residents and are warm, friendly and have appropriate boundaries’. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 12 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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported to use the local community and to try different activities and social events. The staff need to make sure they offer emotional, social and leisure support for people at all times. EVIDENCE: One member of staff told us, ‘the service looks after people very well, providing holidays and trips to the parks, restaurants, shops and the cinema and holidays. People always have healthy food and good clothes.’ The staff plan a number of outings and activities and some people use the local resource centres. The staff told us that people had an activity outside of the home most days. The recording of this was periodic. An aromatherapist visits the home weekly to offer support to each person. A party was recently held at the home. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 13 Some of the people living at the home had been on holiday shortly before our visit. The staff and Manager told us about these holidays. The staff had worked hard to plan and support people to have varied and interesting experiences while on holiday. We saw that there were thorough records which showed how people were supported and the risks which they faced on holiday. Because of people’s health and personal needs the staff had to work extra hard to support people when they were staying in a different environment on holiday. People are supported to attend church where this is known to be their wish. There is a minibus at the home. Some people who contacted us said that there was not always a driver on duty and that this sometimes meant the people living at the home could not go out. The Manager told us that the staff were being trained by other professionals to help them understand how to support people to make choices and to be involved in the daily lives at the home. She told us that one person was supported to help make the lunch each day. We did not see examples of this when we visited. The Manager said that she would remind and encourage staff to be more proactive in always supporting people as agreed. When we visited we felt that the staff did not spend as much time with the people living at the home as they could have done. We saw that they met their care needs well but they did not spend time supporting them to take part in any activities at the home. In the afternoon people went out with staff, but for long periods in the morning most people were seated in the lounge area with the TV on and none of the staff on duty spoke to them or spent time with them except when supporting them with care or at lunch. We spoke to the Manager about this. She said that it was normal practice for staff to spend more time with people and to talk with them and support activities during the day. The Manager said that she did not know why the staff had not done this on the day we visited. The Manager told us that she was looking at ways for staff to give people more support at home doing a variety of activities. She told us that day services in the area were changing and that people would be spending more time supported by the staff at the home. The Manager should look at additional resources such as sensory equipment, different therapies and different leisure equipment which the staff could use when supporting people. Relatives of people who live at the home told us that they were always welcomed there, that they were consulted and involved in care and support and that they thought people’s needs were well met at the home. One person told us that the staff helped their relative to visit them. One person told us 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 14 that they felt sometimes communication could be improved so that they were informed of changes more promptly. Each person is assigned a keyworker who offers special support and makes sure they have the things they need on a daily basis. There is a four week menu which is varied. There is information on people’s likes and dislikes. There was a variety of fresh food in the kitchen. However, some food was not stored appropriately. For example raw chicken was stored in an open container in the fridge. Cooked meet was not properly wrapped or labelled with the date of opening. There was container of cooked rice and casserole and this was not labelled. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to stay healthy and have their personal care needs met. EVIDENCE: One member of staff told us, ‘we do our best to make sure people are always healthy’. People who live at the home have complex health needs and also need a lot of physical support. The Manager told us that the staff work hard to meet these needs and to make sure people stay healthy and well cared for. We saw that the staff on duty had a good awareness of people’s health and personal needs. They showed that they were committed to meeting these and took time and were careful when offering people personal support. We saw that there were good records which helped staff to monitor people’s health, wellbeing and personal care. The staff work closely with other professionals to make sure people have the medical support they need. One professional told us, ‘the staff know how to 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 16 deal with issues and when to get extra support and advice, they always make appropriate requests for support and follow our guidelines’. One professional told us, ‘the residents all have complex needs, limited communication skills and require a lot of support with personal care, the staff are always professional and respectful’. Another professional told us that the staff always followed their advice saying, ‘the staff try hard to meet the needs of all the people’. During our visit we saw staff supporting three people with their lunch. We also looked at the guidelines for supporting one person at mealtimes. We saw that the staff supporting this person did not follow the guidelines and therefore put the person at risk. We also saw that the staff did not speak to anyone while they were supporting them at mealtimes, they did not tell them what they were having for a meal, encourage them or make an effort to make the mealtime a pleasurable experience. We felt that the staff were very task focused and did not appear to think about the needs of the individuals they were supporting. One member of staff who supported two people had not had training to do this. We spoke to the Manager about this. She said that she could not understand why the staff had supported people inappropriately. She told us that training for staff and discussion about guidelines for supporting people would take place in the near future. There is a medication procedure and staff are trained. Medication is stored appropriately, however on our arrival at the home the keys were left in the medication cabinet and it was unlocked. The medication cabinet is appropriately organised and records were mostly accurate and well maintained. There are certificates of staff training, including administration of certain intrusive medicines. There were no guidelines for the administration of ‘as required’ medication and there needs to be. Receipt of medication was recorded but there was no record of medicines which were carried forward from the previous month. Some of the guidelines were old and needed to be archived. Some people’s medication administration records were muddled up with each others. There was no photograph of one person in the medication administration folder. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are appropriate procedures to help keep people safe. EVIDENCE: There is a complaints procedure and this has been recorded in a pictorial format. Visitors who contacted us told us that they knew how to make a complaint. Records of complaints and concerns showed how these had been investigated. There is a copy of the London Borough of Richmond protection of vulnerable adult procedure at the home. United Response have procedures for this and whistle blowing. The majority of staff have had training in safeguarding people. However new staff and one relief member of staff who regularly works at the home need to have this training. The staff support people with their money. There are good systems for recording expenditure and these are regularly audited and checked by staff and the Manager. We looked at records of some people’s money and these were accurate. However, where money had been spent on recent holidays the staff had not audited this or recorded expenditure and receipts. There was also a record of money which had been taken to the resource centre 9 days before our visit and no record of what had happened with this. The Manager 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 18 should make sure people record all expenditure in a timely fashion and records are kept up to date. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a safe and well maintained environment. EVIDENCE: The home is nicely decorated and arranged. Bedrooms have been personalised and reflect individual tastes. There is some sensory equipment in bedrooms and communal rooms. The corridors are wide and there is specialist equipment throughout the home to meet then physical needs of people living there. There is evidence that equipment is maintained and regularly serviced. The garden is nicely kept and has areas for people to relax and spend time in. Pathways have been created so that people using wheelchairs can access all areas of the garden. There are attractive flower beds and ornaments and the staff maintain these. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 20 The home was clean and odour free throughout our visit and there are good systems for laundering clothes and managing odours within the home. There were a small number of minor repairs which should be attended to. These include a damaged kitchen cabinet, a loose tap in the staff WC, a broken lampshade and some dusty extractor vents. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported by well trained and supervised staff. EVIDENCE: There are always at least three members of staff on duty and one person is the allocated shift leader. They are responsible for making sure everything is done and that everyone’s needs are met. There are good records and systems to help organise staff roles and responsibilities. The staff told us that they worked well as a team and supported each other. One member of staff told us that there was not always allocated time for a handover of information when the staff changed over. On the day of our visit, one member of staff had to stay later than the hours they had been assigned to make sure the oncoming staff had a handover. The staff on duty during our visit had a good knowledge of each of the people living at the home and the things they needed to do to support them. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 22 Two new members of staff have recently started work at the home. One person told us, ‘there is a rapid turn over of staff and frequently new staff, but Curtis Road seems to make sure new people are trained as necessary, however it would be nice if there was more continuity’. Two of the care staff have achieved NVQ Level 2 or above and five of the team are working towards this qualification. The new staff will be supported to undertake the qualification when they have completed their induction training. One professional told us that the Manager was good at arranging training for staff if they did not have the right skills to support people with particular needs. She gave an example where one person needed additional support when eating, saying that the staff were all trained and given guidelines to make sure the person had the right support. One member of staff told us, ‘the training provided by United Response is usually very good’. There is a record of staff training. This includes when staff are due for updates and refreshers. The staff need to have more regular updates in manual handling techniques to make sure people are not put at risk. One member of staff said that they had been trained in many areas as part of their induction before they started work with people at the home. The new staff had not had any training when we visited. They told us about some training events which were due to take place shortly after our visit. However, we were concerned that they were working with people when they had not been trained. In particular new staff were helping to move people and using equipment before they have been properly trained and assessed. This puts people at risk. On the day of our visit a new member of staff prepared food for lunch, however they had not had food hygiene training. They also supported people at mealtimes and had not had training in this area. The staff we spoke to said that they were well supported and had the training they needed to do their jobs. One member of staff told us, ‘this is a very nice place to work’. One member of staff said that they felt supervision meetings were not always as supportive as they would like and they did not always have the opportunity to say what they felt and their opinions. There are good systems for staff to communicate with one another. Regular team meetings are recorded and staff have planned individual meetings with the Manager. There is a recorded schedule of planned meetings. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 23 We could not look at staff recruitment files because access to these is through the Manager. However, the staff on duty described recruitment procedures. They said that reference and criminal record checks had been made and that they had attended the home for a formal interview and to meet the people living there. 16, Curtis Road DS0000017361.V364723.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): 37, 38, 39, 40, 41 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported by a service which is well managed. EVIDENCE: The Manager was registered earlier in the year. She is currently undertaking a management qualification. One person told us, ‘the new manager is very enthusiastic’. Another person told us they felt the service had improved since the Manager started work there. Another person told us, ‘the manager responds well to advice and concerns raised’, they also said, ‘the manager does an excellent job in enabling the staff to provide a good service’. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 25 One member of staff told us, ‘this is a lovely working environment and a nice team of staff’. Another member of staff told us, ‘the manager is very supportive and we work well as a team, there are good systems in place’. One member of staff told us that they were concerned that the home had had lots of different managers in a short time and that they felt this could sometimes effect the information they were given. They said that each new manager had introduced changes and that they did not always think these were the best things for the people living at the home. The Manager was very positive about the staff team. She said that she believed they worked hard and were dedicated to meeting people’s needs to the best of their ability. Senior managers from the organisation visit the home each month and undertake a quality inspection. The organisation writes to families and other professionals each year to get written feedback on the service. They work closely with all stakeholders and the housing association throughout the year to monitor the quality of the service. We saw that there were a variety of policies and procedures and these were available for staff. There are clear records for monitoring and checks made by staff supporting people and making sure the house is safe. There a regular recorded checks on health and safety, including fire safety, water temperatures, electrical safety, equipment and the house vehicle. We saw examples of these and evidence that action was taken if anything was found to be wrong. 16, Curtis Road DS0000017361.V364723.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 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 4 2 X 3 3 3 3 3 3 X 16, Curtis Road DS0000017361.V364723.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. 1. Standard YA6 Regulation 15(2) Timescale for action The Registered Persons must 31/10/08 make sure records about people living at the home are clear, up to date, accurate and tell the staff what they need to do to meet all individual needs. Records must be signed and dated. The Registered Persons must make sure that there are recorded assessments for risks, that these are stored in an accessible place where staff can use them and that they are regularly reviewed. The Registered Persons must make sure the staff always respect people’s choices and do not restrict their freedom or rights. The Registered Persons must make sure food is stored appropriately, safely and labelled to minimise risks to people. The Registered Person must make sure the staff always follow guidelines for supporting people at mealtimes. Staff must be trained in this area. DS0000017361.V364723.R01.S.doc Requirement 2. YA9 13 21/10/08 3. YA7 12 30/09/08 4. YA17 13 30/09/08 5. YA18 12 30/09/08 16, Curtis Road Version 5.2 Page 28 6. YA20 13 7. 8. YA23 YA35 13 18 9. YA35 18 The Registered Person must make sure medication records are accurate, up to date and clear. The Registered Person must make sure all staff are trained in safeguarding vulnerable people. The Registered Person must make sure new staff have training in manual handling, food hygiene, supporting people with eating and drinking, fire safety, first aid and administration of medication, including intrusive medicines. The Registered Person must make sure all staff have regular refresher training for manual handling. 30/09/08 31/12/08 31/12/08 30/11/08 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. 6. Refer to Standard YA7 YA6 YA12 YA13 YA11 YA16 Good Practice Recommendations The staff should find out more about communication and resources and have more training so that they can support people even better. The Manager needs to make sure all the staff know about the new support plans and access these regularly. The Manager should make sure staff always record activities and outings. The Manager should consider employing more people who can drive the minibus. The Manager should make sure the staff always offer the person who helps prepare lunch the opportunity to do this. The Manager should make sure the staff always take time to talk to people and support them with their interests and social needs not just when they are performing a care task with them. The Manager should look at additional resources such as sensory equipment, different therapies and different leisure equipment which the staff could use when DS0000017361.V364723.R01.S.doc Version 5.2 Page 29 7. YA14 16, Curtis Road 8. 9. 10. 11. 12. YA15 YA23 YA24 YA32 YA36 supporting people. The Manager should make sure relatives are always informed of changes promptly. The Manager should make sure staff record all expenditure in a timely fashion and records are kept up to date. The Manager should make sure the minor environmental repairs are attended to. The Manager should make sure staff have enough allocated time to handover information at the end of each shift. The Manager needs to make sure all staff have the opportunity to voice their opinions through supervision meetings. 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 16, Curtis Road DS0000017361.V364723.R01.S.doc Version 5.2 Page 31 - 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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