Care Home: 178 Wylds Lane

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What the care home does well Detailed information about the home is provided for prospective residents and their relatives, in an appropriate format, if necessary, and it is reviewed regularly, to enable the right decisions to be made about future care arrangements. The procedures relating to the assessment and admission of people who may want to live at the home are in place, to ensure that the needs of prospective residents are identified, and to enable staff to determine if they can be cared for appropriately at the home. Care planning procedures have been reviewed, and the ongoing development of the person centred approach to the provision of care, is helping to ensure that a good quality of life is achieved for each person. The care that is provided at the home revolves around the people who live there, and their complex needs are understood and met in an appropriate way. The families of each resident, or their representative are also supported and their involvement with the home is encouraged. The home has a vehicle to provide transport for residents, which enables them to go into town, to undertake various activities in the community, and to visit their friends and family, and also places of interest. A high standard of personal and health care is provided for each person living at the home, and good working relationships have been developed with other professionals and agencies with obvious benefit to residents. The policies and procedures relating to the administration of medication and the training provided for the staff help to ensure that residents are protected. The complaints procedure is produced in picture format and circulated to everyone involved with the home, to enable any concerns to be expressed. A record is also maintained of all the comments made about the home, which helps to give a balanced view of the service that is being provided. The policies and procedures regarding the protection of vulnerable people from abuse, and the training provided for staff, ensure that the people who live at the home are safeguarded. Residents live in a homely, comfortable, safe and clean environment, where their privacy is respected, and with their personal possessions around them. The building is nicely decorated and the equipment is generally well maintained, and provides a pleasant facility in which to live and work.The Organisation follows satisfactory recruitment and selection procedures, and is clear about the support, training and development for the staff it employs. Staff confirmed that they have good training opportunities. The quality of the service provided at the home is checked to make sure that the home achieves what it says it will for the people it supports, and to enable them to say how they would like the service to develop. The records and documents at the home are maintained to a high standard, and kept safely, which should ensure a well-organised service. What has improved since the last inspection? There is an ongoing commitment from the organisation and also the management of the home, to the further development of the service, and to putting the people who live at the home at the centre of everything. A review of the Statement of Purpose and the Service Users Guide has been undertaken, but will need to be reviewed and updated again to reflect the new care management arrangements at the home. The arrangements for the storage of medication have been reviewed, and the new metal cabinet has provided more appropriate storage facilities. A record is now maintained of the comments and compliments made about the home, which will help to give a balanced view of the service that is being provided for residents. The review undertaken by the Community Physiotherapist has resulted in the provision of various items of equipment, which have improved the quality of life of the people living at the home. Facilities are being improved for the people who live and work in the home by the ongoing maintenance and upkeep of the premises and gardens, and the replacement of dysfunctional equipment, although the need for further attention to some parts of the premises was identified. The provision of an ongoing training programme for staff demonstrates the commitment of the organisation to having a competent work force, and to providing of a high standard of care for the people they support. What the care home could do better: CARE HOME ADULTS 18-65 Wylds Lane, 178 178 Wylds Lane Worcester Worcestershire WR5 1DN Lead Inspector Rachel McGorman Key Unannounced Inspection 13th November 2007 10:00 Wylds Lane, 178 DS0000018704.V354598.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 Wylds Lane, 178 DS0000018704.V354598.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. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wylds Lane, 178 Address 178 Wylds Lane Worcester Worcestershire WR5 1DN 01905 764201 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.dimensions-uk.org Dimensions (UK) Ltd Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Home is primarily for people with a learning disability who are under 65 years of age. The Home may also accommodate people with an additional physical disabiity and those who are over 65 years of age. 18th December 2006 Date of last inspection Brief Description of the Service: 178, Wylds Lane is registered to provide residential care for up to 4 adults who experience a learning disability, and who may have additional health needs. The range of fees varies between £1,100 and £1,250 per week. The premises is a large, detached, purpose-built bungalow, situated close to the centre of the City of Worcester, with easy access to public transport and a range of amenities and facilities. The home is owned and run by Dimensions (UK) Ltd., and is part of the New Dimensions Group, which, as the parent company provides strategic direction and a range of functional support services. The stated purpose of the organisation is, to work with people with learning difficulties, supporting them to make choices, and to exercise control over their lives, and the main aim of the home is, to deliver a person-centred response to the needs and aspirations of the people we support. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this routine key inspection, was to monitor the care provided at the home, to assess how well the service meets the needs of the people who live there, in relation to the stated aims and objectives, and to follow up previous requirements and recommendations. Preparation for the inspection included looking at previous reports, analysing the information and outstanding matters, and considering the monthly Regulation 26 reports together with the various contacts made with the home since the last inspection. The visit to the service was unannounced and took a total of 3 hours. The inspector spent some time with the people living at the home, although they are unable to communicate their views verbally, but staff are able to understand their needs and interpret them appropriately. Observation of the interactions of the residents with the people who support them was very positive, and the relationships were seen at all times to be very kind and considerate, supportive and respectful. During conversations with staff, comments were made about what it is like to work for the company, how the home is organised and how they support the people who live at the home. In addition the opportunities for training and the supervision they are given in doing their work was also discussed. The care plan of one resident was inspected in detail for case tracking purposes, and was found to contain extensive records relating to every aspect of their life. The contents were discussed with the acting manager, and also the way in which the plan was being implemented. A tour of the house was undertaken, and the records kept in respect of the maintenance of equipment, and safe working practices were also seen, including the fire log and the accident book. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 6 What the service does well: Detailed information about the home is provided for prospective residents and their relatives, in an appropriate format, if necessary, and it is reviewed regularly, to enable the right decisions to be made about future care arrangements. The procedures relating to the assessment and admission of people who may want to live at the home are in place, to ensure that the needs of prospective residents are identified, and to enable staff to determine if they can be cared for appropriately at the home. Care planning procedures have been reviewed, and the ongoing development of the person centred approach to the provision of care, is helping to ensure that a good quality of life is achieved for each person. The care that is provided at the home revolves around the people who live there, and their complex needs are understood and met in an appropriate way. The families of each resident, or their representative are also supported and their involvement with the home is encouraged. The home has a vehicle to provide transport for residents, which enables them to go into town, to undertake various activities in the community, and to visit their friends and family, and also places of interest. A high standard of personal and health care is provided for each person living at the home, and good working relationships have been developed with other professionals and agencies with obvious benefit to residents. The policies and procedures relating to the administration of medication and the training provided for the staff help to ensure that residents are protected. The complaints procedure is produced in picture format and circulated to everyone involved with the home, to enable any concerns to be expressed. A record is also maintained of all the comments made about the home, which helps to give a balanced view of the service that is being provided. The policies and procedures regarding the protection of vulnerable people from abuse, and the training provided for staff, ensure that the people who live at the home are safeguarded. Residents live in a homely, comfortable, safe and clean environment, where their privacy is respected, and with their personal possessions around them. The building is nicely decorated and the equipment is generally well maintained, and provides a pleasant facility in which to live and work. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 7 The Organisation follows satisfactory recruitment and selection procedures, and is clear about the support, training and development for the staff it employs. Staff confirmed that they have good training opportunities. The quality of the service provided at the home is checked to make sure that the home achieves what it says it will for the people it supports, and to enable them to say how they would like the service to develop. The records and documents at the home are maintained to a high standard, and kept safely, which should ensure a well-organised service. What has improved since the last inspection? There is an ongoing commitment from the organisation and also the management of the home, to the further development of the service, and to putting the people who live at the home at the centre of everything. A review of the Statement of Purpose and the Service Users Guide has been undertaken, but will need to be reviewed and updated again to reflect the new care management arrangements at the home. The arrangements for the storage of medication have been reviewed, and the new metal cabinet has provided more appropriate storage facilities. A record is now maintained of the comments and compliments made about the home, which will help to give a balanced view of the service that is being provided for residents. The review undertaken by the Community Physiotherapist has resulted in the provision of various items of equipment, which have improved the quality of life of the people living at the home. Facilities are being improved for the people who live and work in the home by the ongoing maintenance and upkeep of the premises and gardens, and the replacement of dysfunctional equipment, although the need for further attention to some parts of the premises was identified. The provision of an ongoing training programme for staff demonstrates the commitment of the organisation to having a competent work force, and to providing of a high standard of care for the people they support. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 8 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. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 9 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 Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 10 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): 1,2 & 4 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate documentation is in place to enable prospective residents and their family to make an informed decision about their future care needs, but these will need to be reviewed, in due course, to reflect the new care management arrangements. The assessment and admission procedures are both detailed and thorough, to ensure that the home is able to provide the care that is needed, and also to help everyone to know if the home will be suitable. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 11 EVIDENCE: The Statement of Purpose and the Service Users Guide, provide detailed information for residents and their families, about the services and facilities available at the home. The previous manager had reviewed these documents, which were produced in an appropriate format, although they will need to be to be updated to reflect the new care management arrangements in due course. The people who live at the home keep the information that is recorded about them, unless they have made other arrangements with staff. Their personal file is reviewed regularly, to ensure that it accurately reflects all the aspects of the care that can be provided. The tenancy agreements for each person living at the home have all been reviewed and updated recently. The admission procedure is detailed and thorough and includes assessment by staff from the home, and also a Community Care Assessment undertaken by the social worker. There has been a recent admission to the home, and the acting manger confirmed that these procedures were followed. A gradual introduction to the home was made following the initial referral, and several visits were arranged for the prospective resident, prior to a decision being made about the suitability of the placement. Admission is agreed on a trial basis initially, to give everyone the opportunity to decide if the right decision has been made. The resident has obviously settled in very well, and has made himself very much at home. He was of considerable assistance during the inspection, and helped to make coffee for the inspector, whom he had welcomed very warmly on arrival. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 12 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 People who use the 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 service users plan of care is based on the initial assessment, which clearly identifies their assessed needs, and how these will be met. The way in which the person centred approach to the care of each resident is implemented helps to ensure that all the decisions made revolve round the people who live there. The key-worker system ensures that residents living at the home are supported in making choices in all areas of their lives. Residents are helped to take part safely in the various activities of daily living and to enjoy new opportunities. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 13 EVIDENCE: The needs and individual preferences of every person living at 178 Wylds Lane, are identified, and their participation in the daily life of the home, is constantly encouraged as far as they are able. Staff demonstrated an understanding of the needs and wishes of the people they support, and who may be unable to express these verbally. An individual plan of care is produced for each person based on the initial assessment undertaken during the admission process. There was evidence in the care plans, of person centred care being delivered, and the positive interactions observed between staff and the people they support were pleasing to observe. The person centred approach to care planning is being implemented, and the involvement of each resident in making decisions about their daily life in the home is encouraged by staff. All the details recorded about each service user are discussed with them and their family, or a representative. One care plan was checked in detail during the inspection and the information gave a clear picture of the resident, and showed that people who live at the home are central to everything that happens there. Several documents combine to form the plan of care and include the following: • A Support folder details daily routines, basic communication needs and behavioural issues, likes and dislikes, hobbies and interests, risk assessments, feeding requirements, and specific guidelines for staff to follow in relation to all the areas in which care and support are needed. A medical folder contains information relating to medication including side effects and allergies, homely remedies, correspondence relating to health care and medical needs, and the support needed for the resident in taking their medicines together with risk assessment. A financial folder listing bank and building society details, benefits and expenditure, audits, statements and invoices, receipts, risk assessment and details about financial decisions in respect of the resident. • • Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 14 Each resident has a key worker who has responsibility for ensuring that appropriate care is provided. Monthly meetings are held with each person, and any changes are monitored and recorded. The special communication needs of the individual are identified, and understood by staff. Residents living at the home are not all able to communicate verbally, although everyone can make themselves understood in different ways. Staff are able to identify the individual wishes and needs of each person by interpreting their reactions to every situation. Risk assessments are completed, in relation to the premises, to the activities undertaken, and any restrictions imposed, and also in respect of every aspect of the life of each person living at the home. There is also evidence in the care plans of the ongoing review of risk assessments. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14, 15,16 & 17 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The involvement of each resident in choosing their activities, both within and outside the home, and in helping to plan their lives, will ensure that their rights are respected, and enable a good quality of life to be maintained The opportunities made available to everyone living at the home, and their regular contact with family and friends, enables them to live a full and satisfying life as far as possible. There is a flexible approach to the provision of a healthy diet, and service users are encouraged to decide what to eat and when. A planned review of the arrangements should mean greater flexibility and choice for them. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 16 EVIDENCE: The residents at the home are encouraged to follow an ‘ordinary’ life style as far as possible, by using the same facilities as other people, and being involved in a range of leisure activities. The home has a vehicle for transporting residents to attend activities, go into town or visit family. Limited communication skills experienced by all the residents preclude involvement in paid employment or educational opportunities. The people who live at the home are supported by staff in various activities, although these have been rather limited recently, due to staff changes. One resident enjoys a trip into town for shopping, and likes to go bowling, or to a disco, or out for a meal. She also went to Cornwall for a holiday earlier in the year. Another person has been unwell and is therefore unable to attend any planned activities at present, and staff also said that a programme of activities is being planned for the resident recently admitted to the home. The activities that residents are involved with are supported by risk assessment, to promote their safety and enable them to have greater independence. Discussions with the acting manager identified the need for the opportunities available to each individual to be reviewed, for greater involvement with the local community to be developed, and each person enabled to do the things they enjoy. A Weekly Planner is being introduced for each resident, to enable a more structured approach to the way they spend their day. Links with family and friends are promoted, with support provided by staff, to the family of each resident, who are encouraged to be involved with the home. The support of volunteers or an advocate is sought if needed, although everyone living at the home has regular contact with their family. The arrangements regarding the provision of food reflect the individual likes and dislikes of each service user, and these are recorded in the care plan. General food stocks for the home are purchased each week, sometimes with the assistance of residents who are encouraged to choose what they would like to eat. The acting manager acknowledged the need to review arrangements in respect of food provision at the home. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, 20 & 21 People who use the 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 care that is provided at the home revolves around the people who live there, and their complex needs are understood and met in an appropriate way. The manner in which support is provided by staff helps to ensure that the dignity and rights of the people they support are respected, when meeting their personal and health care needs. The health of each person is promoted and they are protected, by the regular medication reviews, and by the high standards maintained when giving medication. Bereavement training for all staff will enable them to more appropriately manage the death of a person they support. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 18 EVIDENCE: The personal and healthcare needs of residents are well documented, and there is evidence to show how staff understand and respond to them in an appropriate way. The individual needs of each person are identified and recorded in their plan of care, which is detailed and informative. Reviews are undertaken regularly with each resident to ensure that any change in their needs is identified. Staff confirmed that personal care is provided to each resident in privacy, by the carer of their choice, whenever possible. The independence and dignity of everyone living at the home is promoted, and a relaxed and flexible approach maintained, which was evident during the inspection. The healthcare of residents is closely monitored, and additional specialist support and advice is sought from the primary health care team, and other health professionals, when necessary. Health Action Plans have been implemented for everyone living at the home, and those seen had been completed to a good standard. Routine eye care, podiatry and dental treatment are also arranged. Specialist dental care is provided for one resident at the Queen Elizabeth Hospital in Birmingham, and an eating and drinking skills assessment has been undertaken for two people living at the home. Following the involvement of the Community Physiotherapist, the need for several items of equipment was identified. One resident has had a new wheelchair, and another person was provided with a new bed and a chair, although further assessment is now needed for one person. The previous issues with the supply of continence equipment for one person, now appear to have been resolved, the acting manager said. Medication arrangements at the home are now satisfactory, and a new storage cabinet has been provided. The Medication Administration Records were checked and had been completed appropriately, and a detailed profile is also recorded for each resident. A review of the procedures relating to the administration of medication has been undertaken recently as part of quality monitoring by the organization. The local Pharmacist undertakes a regular check to ensure that the correct procedures are being followed, and staff confirmed that training has also been provided for them. The recent death of a resident who had lived at the home for many years was discussed with staff, and the need for bereavement training to be made available for all staff was identified, although everyone confirmed that they had all been well supported by the organisation. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their family can express any concerns, through a clear and effective complaints procedure. The comments made about the service are also recorded to ensure that a balanced view is maintained. The awareness of the management and the training provided for staff, ensures the protection of the people who live at the home, from all forms of abuse. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 20 EVIDENCE: A procedure for the investigation of complaints has been produced and this indicates that any issues are dealt with immediately, to prevent them from developing into a larger problem. The document has been produced in a format that is clear to residents, and it was also recorded that it has been discussed with them and their families. The acting manager confirmed that there have been no complaints made about the service since the previous inspection, but comments are now being recorded to give a more balanced view of the service. Several compliments had been noted from people visiting the home about, ‘how well the residents are looked after by staff’, and on the ‘lovely family atmosphere that is always evident’. The family of a resident who died quite recently at the home were, ‘very appreciative of the care given to their relative’, and another family wrote to express how thankful they were to staff for, ‘caring for their relative so well over the years’. An additional comment from a professional visitor to the home was very complimentary about ‘the way in which staff had cared for a resident, and the hard work that they had done in caring for this person’. An appropriate procedure is in place relating to the many aspects of abuse and the protection of vulnerable adults, and all staff are given training as part of their induction process, the acting manager explained. Staff are able to show they have a clear understanding of the issues, during discussions with them at the time of the visit, and also to their individual role as an advocate for service users. They confirmed that training on abuse and the protection of vulnerable adults has been provided. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 29 & 30 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for their purpose. They are comfortable and clean, and ensure as far as possible that the safety and wellbeing of service users is promoted. The location is convenient to local services and facilities, and the layout provides adequate communal space for the needs of each individual. The overall standard of the accommodation is satisfactory, although some areas require attention. The décor, and furnishings, with the exception of the bathroom, and provide residents with an pleasant and homely place to live. The maintenance programme and the ongoing development of the premises and facilities helps to enhance the quality of life for the people who live there, although work is outstanding in some parts of the house. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 22 EVIDENCE: The premises at 178, Wylds Lane is a large detached, purpose built bungalow, that provides a safe and well-maintained environment for the people who live there, and is suitable for its purpose. The communal areas of the home are spacious and airy, nicely decorated and comfortably furnished, with the exception of the bathroom, which requires attention. There are three communal rooms, offering choice for service users. These consist of a spacious lounge, a large kitchen/dining room, and a further sitting room. The gardens are accessible to service users, and have benefited from further attention during the summer months. There is also a patio that can be accessed through a French window from the lounge. There are four single occupancy bedrooms for service users, which all comply with space and furnishing requirements, and protective covers are provided for the bed rails on the beds of the people who require them. The rooms are furnished to reflect the personality of their occupants, and some have sensory equipment, specific to their needs. Appropriate aids and adaptations are provided, and these are well maintained. An ongoing maintenance programme is followed, and contracts are in place for the servicing of equipment at the home. The extractor fan in the bathroom is now functional, an area of damp on the ceiling has been dealt with, a broken blind has been replaced and window locks fitted to improve security at the home. Redecoration of several areas of the home has been undertaken, and residents are involved in helping to choose colour schemes for their bedrooms, and some items of furniture and equipment have been replaced, although the following remain outstanding: • • The need for a new carpet to be fitted in the main lounge was identified previously, as it is rather worn in places, but this has yet to be replaced. Attention is needed to the equipment in the bathroom and also to the décor. The floor under the bath has lifted, and staff explained that a constant pool of water lies there, and although this does not present a hazard, it is unsightly, and requires attention. The heating boiler has been dysfunctional for sometime, although it is adequate except in very cold weather, the acting manager said, therefore this should be reviewed and repaired or replaced, to ensure the comfort and safety of the people who live at the home. There is an area flooring between the corridor and bathroom that presents a tripping hazard, as the levels vary, therefore this is affecting the independence of a resident admitted recently, who is rather unsteady when walking. • • Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 23 The home is clean and fresh and provides a pleasant environment for the people who live there. Staff confirmed they are familiar with the procedures regarding to the control of infection, and that they have been given training in health and safety matters, which helps them in maintaining satisfactory standards within the home. The home has not received a recent visit from the Environmental Health Officer, and the acting manager confirmed that there are no outstanding requirements from the previous visit. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35 & 36 People who use the 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 home has an experienced and competent team of staff, who are able to ensure that the needs of the people living at the home can be effectively met. Appropriate recruitment procedures ensure that residents are supported and protected by the people who are employed to care for them. The supervision provided and the training programme available to staff ensures that they are effective in their work, and therefore able to provide appropriate care and support to residents. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 25 EVIDENCE: Dimensions provides relevant information for staff on joining the organisation, and also keeps them updated on new developments and any changes that take place. Each member of staff is given a Welcome Pack that contains details about the organisation, and its aims and objectives, an Employee Handbook that provides information about terms and conditions of employment and policies and procedures, and an Induction Checklist covering the first three months of employment. Residents and staff benefit from the thorough recruitment and selection procedures that are implemented by the organisation, which include a commitment to equal opportunities. Criminal Record Bureau checks are completed prior to an appointment being confirmed, and verbal and written references are also obtained. There have been some changes in the staff team in the last twelve months, although a core of experienced staff is retained, and this enables some continuity of care for the people they support. Agency staff are not used at present, but relief staff, who know the residents in all the local homes run by Dimensions, are employed by the organisation to cover some shifts. Staffing is maintained at a level that is adequate for the needs of the people who live at the home, although the recent disruption in the team temporarily limited the opportunities available for residents to do the things they enjoy, and to follow their activity programmes. The situation is now resolved, the acting manager said. A training programme is in place at the home, and staff who spoke with the inspector confirmed the training courses they have recently attended, and said they are given ‘good training opportunities.’ A record is maintained in respect of the training received by each member of staff, and their individual training needs are regularly reviewed. All staff undertake mandatory training, and care-related training is also available to staff, and covers various specialist areas including abuse awareness, the person centred approach, communication and managing epilepsy. Medication training, which all staff have to attend has been further developed, the inspector was told, and is now in three parts, and also includes competency testing. The NVQ (National Vocational Qualification) training Levels 2 & 3 in Care is provided, which all staff are expected to undertake, to ensure that they have the competence and skills to do their work. Formal supervision is arranged for all care staff, to ensure that they are supported in their work, and that residents benefit from a well-supervised team. A record of the content of the discussion is maintained in their file. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use the 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 new care management arrangements should provide appropriate leadership for staff, and ensure that the needs of residents are met. The quality of the service provided at the home is monitored to make sure that it achieves what it says it will for the people who live there. The policies, procedures and records maintained at the home, comply with legislative requirements and therefore help to safeguard the rights of the people who live there. The health, safety and welfare of service users is promoted and protected in respect of all safe working practices Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 27 EVIDENCE: The home has been without a registered manager, in recent months, following the resignation of the previous manager. The acting manager who now has the responsibility for the day-to-day running of the home, is Ms Wendy Lewis. She is a Registered Nurse in Learning Disability, with many years experience working with people with learning difficulties. An application for registration is to be submitted to the Commission in the near future. There is evidence of effective person centred care being delivered by the staff team at the home, who are obviously very committed to their work, and whose interactions with the people they support were pleasing to observe. The new management arrangements should be of benefit to the service and also to the people who live and work at the home. An annual development plan is produced which involves the whole Home, and forms part of the quality assurance programme of the Organisation. Known as PATH (Planning Alternative Tomorrows with Hope), it has identified where the team is at, and where they would want to be in 12 months time, who they will need to help them to get there, and who will do what and how. The Quality Monitoring Officer visits the home regularly, to do an audit of the various areas which inform the process. Reviews take place every 3 months, to determine what has been achieved, and what still has to be done. The outcomes are measured, the results collated, and an annual report is produced. A comprehensive health and safety policy has been produced, risk assessments are completed, and staff trained in relation to all safe working practices. The Organisation employs an officer to advise on health and safety matters, and the home has a Health and Safety representative, with delegated responsibility for ensuring that risk assessments are reviewed regularly and implemented. The acting manager said that the COSHH (Control of Substances Hazardous to Health) folder had been updated recently. Routine maintenance and servicing of equipment is done, and temperature checks are recorded. The policies and procedures produced by the Organisation are circulated, and staff confirmed they are familiar with the content. The records checked during the inspection were completed to a satisfactory standard, and they are securely kept. Regulation 26 reports are submitted to the Commission on a regular basis. The accident book was seen and appeared to be in order. Notifications are made under Regulation 37, which requires reports to be sent to the Commission of death, illness or other events in the home, although there had been a recent omission relating to an injury to a resident from a fall. The home has not received a recent visit from the Fire Safety Officer. The Fire Log Book was seen, and the appropriate checks have been undertaken with the required frequency. The Fire Risk assessment has been reviewed recently. Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 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 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 2 X 3 X X 2 X Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 6 Refer to Standard YA1 YA14 YA17 YA21 YA24 YA24 Good Practice Recommendations Further review of the Statement of Purpose and Service User Guide should be undertaken to reflect the management changes at the home Opportunities for involvement in more activities in the local community for residents who wish will further increase their enjoyment of life. A review of the arrangements for the provision of food should be completed and the proposals implemented to enable greater choice for residents Training should be provided for all staff on death and bereavement to ensure their understanding of the issues, and enable them to respond to the situation effectively Consideration should be given to the replacement of the lounge carpet to improve facilities for residents Attention should be given the uneven floor levels to eliminate the tripping hazard and promote the safety of residents DS0000018704.V354598.R01.S.doc Version 5.2 Page 30 Wylds Lane, 178 7 8 9 10 YA27 YA29 YA37 YA42 The bathroom should be upgraded to improve the facilities available to residents Improvements should be made to the heating at the home to ensure that it is adequate at all times to meet the needs of residents To ensure that residents benefit from a well run home the acting manager should apply for registration without further delay Notifications should be made to the Commission regarding any event that may adversely affects the well being or safety of a resident Wylds Lane, 178 DS0000018704.V354598.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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. 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