Care Home: 180 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 individuality of everyone is recognised, and the commitment of staff to supporting and enabling them to achieve as much as they are able is commendable. The home has a vehicle to provide transport for residents, and to enable them to undertake various activities in the community. The activity programme enables them to individually do the things they enjoy and to make choices about their daily lives, which are supported by risk assessments, to promote their safety and enable them to have greater independence. 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 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 and dignity 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 Tenancy Agreement for each person living at the home has been reviewed and updated, and is now available in a format that is understandable to residents. An individual plan of care is now produced for each person based on the initial assessment undertaken during the admission process, and contains the information to enable staff to provide relevant care for residents. Training has been provided for staff on abuse and the protection of vulnerable adults, in addition to that received during induction, to ensure an in-depth understanding of the issues. Facilities continue to be 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 equipment. What the care home could do better: CARE HOME ADULTS 18-65 Wylds Lane, 180 180 Wylds Lane Worcester Worcestershire WR5 1DN Lead Inspector Rachel McGorman DRAFT: Key Unannounced Inspection 13th November 2007 10:00 Wylds Lane, 180 DS0000018705.V353338.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, 180 DS0000018705.V353338.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, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wylds Lane, 180 Address 180 Wylds Lane Worcester Worcestershire WR5 1DN 01905 764276 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, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This service is primarily for people with a learning disability, but may also accommodate people with an additional physical disability. 22nd November 2006 Date of last inspection Brief Description of the Service: 180 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, 180 DS0000018705.V353338.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, viewing the Annual Quality Assurance Assessment (AQAA) and analysing the contents, 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, although 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, and 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, 180 DS0000018705.V353338.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 individuality of everyone is recognised, and the commitment of staff to supporting and enabling them to achieve as much as they are able is commendable. The home has a vehicle to provide transport for residents, and to enable them to undertake various activities in the community. The activity programme enables them to individually do the things they enjoy and to make choices about their daily lives, which are supported by risk assessments, to promote their safety and enable them to have greater independence. 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 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. Wylds Lane, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 7 Residents live in a homely, comfortable, safe and clean environment, where their privacy and dignity 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 Tenancy Agreement for each person living at the home has been reviewed and updated, and is now available in a format that is understandable to residents. An individual plan of care is now produced for each person based on the initial assessment undertaken during the admission process, and contains the information to enable staff to provide relevant care for residents. Training has been provided for staff on abuse and the protection of vulnerable adults, in addition to that received during induction, to ensure an in-depth understanding of the issues. Facilities continue to be 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 equipment. Wylds Lane, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 8 What they could do better: Further review of the Statement of Purpose and the Service Users Guide should be undertaken, to ensure that accurate information is provided about the care management arrangements at the home. Further review of the arrangements relating to food provision at the home, will give each person more choice about their meals and mealtimes, and help them to be more involved in the daily life of the home. The policies and procedures relating to the administration of medication help to ensure the safety of residents, but should be followed carefully at all times to ensure that residents are fully protected. The reasons for the various medicines being prescribed for residents should be included in their medication folder, to improve the awareness of staff regarding the use of medicines. The need for standards to be improved and then maintained in the bathroom was identified, specifically in relation to the general décor and also to the replacement of the toilet seat. The Commission should be notified regarding any event that may adversely affect the wellbeing or safety of a resident, specifically a medication error, and appropriate action taken to prevent a recurrence. The application for registration of the manager should be submitted to the Commission without delay, to ensure that residents benefit from a well run home. A reliable and efficient maintenance contractor should be available to ensure that appropriate standards are achieved in regard to the premises, and that the safety of the people who live and work at the home is promoted. Wylds Lane, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 9 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, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 10 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, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 11 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 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, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 12 EVIDENCE: The Statement of Purpose and the Service Users Guide, provide detailed information for service users and their families, about the services and facilities available at the home. The documentation is produced in an appropriate format, and retained by the service user, if this is their wish. The previous manager had been recommended to review the documentation more regularly, and this had been undertaken, although it will now be necessary to update the information again to ensure that it accurately reflects the new care management arrangements at the home. The admission procedure includes extensive assessment of a prospective service user by staff from the home, and a Community Care Assessment is also undertaken by the social worker. A gradual introduction is made to the home following the initial referral, and a place is only offered if it seems likely that a suitable service can be provided for the prospective resident. Admission is agreed on a trial basis initially, to give them the opportunity to decide if they like living at the home. There have been no admissions to the service within the last twelve months, although the tenancy agreements for each person living at the home have all been reviewed and updated recently, and they can be produced in a format that is understandable to residents. Wylds Lane, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 13 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 plan of care for each person 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. People living at the home are supported by their key workers 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, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 14 EVIDENCE: The needs and individual preferences of everyone living at 180, Wylds Lane, are identified, and their participation in the life of the home, is 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 resident, based on the initial assessment undertaken during the admission process. These plans, which are kept by the resident in their own room, have been further developed recently, and are very comprehensive, detailing the specific needs of each person, and how these are to be met. The person centred approach to care planning is also being implemented, and the participation of each resident in making decisions about their daily life in the home, together with the involvement of their family, is encouraged by staff. 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 a support folder, a medication folder and a financial folder. Many of the comments are written as if from the point of view of the resident, and every aspect of their life is covered, from the daily routines, the personal and healthcare needs, the activities they are involved with and how these are accessed and implemented, to the risk assessments that are completed for the premises, moving and handling, the activities undertaken, and any restrictions that may need to be imposed. Residents each have two key workers, who have responsibility for ensuring that their needs are met in the way that they want, and this also helps with their care. Monthly meetings are held, and any changes are monitored over a period of time and amendments recorded as necessary. The special communication needs of each person are identified, and understood by staff. Everyone living at the home understands the spoken word, although they have some difficulties at times with speaking. Objects of reference are used and one person is able to use sign language. Wylds Lane, 180 DS0000018705.V353338.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): 12,13,15,16 & 17 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 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 right 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. The health and wellbeing of residents is maintained by the provision of a nutritious and wholesome diet. A planned review of the arrangements should mean greater flexibility and choice for them. Wylds Lane, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 16 EVIDENCE: Residents living at the home are encouraged to follow an ‘ordinary’ life style as far as possible, by using the same facilities as other members of the community, and being involved in a wide range of leisure activities. The home has a vehicle for transporting residents to their various community activities Everyone has an Activity Planner that assists them in organizing the various things that they like to be involved in, which may be undertaken at home or out in the community. This includes shopping, swimming, ten-pin bowling, horse riding, music sessions, hydrotherapy or relaxing at the Snoezlan. Some people like to attend the film club, go to a discos, or to a pub for lunch sometimes, or a café for coffee and cake, while others just enjoy a walk in the park. One service user attends a local day centre, and is also involved in a recycling project. The activities that residents are involved with are supported by risk assessment, to promote their safety and enable them to have greater independence. Cookery sessions were a very popular activity at one time, but these have been withdrawn at present, although staff are hoping to make alternative arrangements in the near future. Holiday destinations this year have included Blackpool, Nothumberland, and Euro Disney, Paris. Occasional trips out in the car are planned and one person went to Hatton Country Park, and another resident went to see Marty Wilde. Residents help with the selection of new staff, and are also encouraged to attend Forum meetings. These are arranged by Dimensions to enable the people they support to be involved in the development of the service. Links with family and friends are promoted. Staff offer support to both the service user and their family, and they are encouraged to be involved with the home. Service users all have relatives, therefore advocacy services are not used at present. General food stocks for the home are purchased each week with the involvement of service users. The arrangements for the provision food reflect the individual likes and dislikes of each service user, although the menu and the times of serving meals is usually a communal arrangement. The acting manager explained that the way in which food is provided at the home is being reviewed, and various proposals are being tried to enable a more individual approach to the planning, purchase, preparation, and the timing of meals. Wylds Lane, 180 DS0000018705.V353338.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 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 rights of the people they support are respected, when meeting their personal and health care needs. Advice and guidance is requested from the primary healthcare teams, and other professionals, to ensure that the health needs of residents are fully understood, and that appropriate responses are made. Arrangements for the safe administration of medication are in place at the home, although these have not always been followed recently. Wylds Lane, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 18 EVIDENCE: The personal and healthcare needs of each individual 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 is responded to appropriately, and these are also recorded. Staff confirmed that personal care is undertaken in private, and that intimate care is always provided by at least one person of the same gender, whenever possible, depending on the needs and wishes of the resident. Health Action Plans have been implemented for each person living at the home, and additional specialist support and advice is sought from the primary health care team, and other health professionals, when necessary. Routine eye care, chiropody and dental treatment is arranged when needed. The independence and dignity of everyone living at the home is promoted, and a relaxed and flexible approach was evident at all times in the interactions of staff with the people they support. Medication arrangements at the home, and the policies and procedures that are in place should ensure that residents are protected, although evidence was seen of an error that had been made recently, but had not been notified to the Commission. The records showed that otherwise the management had dealt with the situation appropriately. The Medication Administration Records were checked and had been completed appropriately, and a detailed profile was recorded for each resident. 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. A review of the procedures relating to the administration of medication has been undertaken recently as part of quality monitoring by the organization. The inspector checked these and recommended that the reasons for giving the medication are included with the list of specific medicines for each resident, which will help to ensure that the safety of residents is promoted. Wylds Lane, 180 DS0000018705.V353338.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, 180 DS0000018705.V353338.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 noted 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 and compliments are recorded to give a more balanced view of the service. The staff had recorded some very positive comments from the mother of a resident who had spent some time in hospital recently. She was particularly appreciative of the care shown by staff from the home, who supported him while he was in hospital, and also for their ongoing support. An appropriate procedure is in place relating to the many aspects of abuse and the protection of vulnerable adults. The acting manager confirmed that all staff receive training as part of their induction process, and that several staff attended a 5 day course on understanding abuse. 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 also confirmed that training on abuse and the protection of vulnerable adults has been provided. Wylds Lane, 180 DS0000018705.V353338.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, 28 & 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 overall standard of the accommodation is good, although some areas require attention. The décor and furnishings are well maintained, and provide residents with an attractive and homely place to live. The location of the house is convenient to local services and facilities, and the layout provides adequate communal space for the needs of each individual. The maintenance programme and the ongoing development of the premises and facilities help to enhance the quality of life for the people who live there, although work is outstanding in some parts of the house. Wylds Lane, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 22 EVIDENCE: The premises at 180, 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 nicely decorated and comfortably furnished. There are three communal rooms, offering choice for service users. These consist of a spacious lounge, a large kitchen/dining room, and a recently developed sensory room providing a peaceful and relaxing environment, away from the hustle and bustle of the house. The gardens are now well maintained, and provide a suitable area for service users during the warmer weather. There is also a patio that can be accessed through a French window from the lounge. The roof has been replaced recently on the garden shed. There are four single occupancy bedrooms for service users, which all comply with space and furnishing requirements. The rooms are furnished to reflect the personality of their occupants, and some have sensory equipment, specific to the needs of the individual. Appropriate aids and adaptations are provided. There have been some improvements in facilities for people living at the home, and several items of equipment have been repaired or replaced, including the printer, the vacuum cleaner, a tap on the bath, a glass pane in a door, the guttering has been cleared, the call bell system repaired, and the pull cord in the shower repositioned. Concerns were expressed to the acting manager about repairs to a toilet seat that have been outstanding for some time, and another toilet did not have a seat fitted. These need to be replaced without further delay, to ensure that the dignity of residents and basic standards in the home are maintained. In addition the bathroom is to be redecorated to rectify the damage caused by a leak. The acting manager confirmed that a recent maintenance review was done by an officer from Dimensions, and that the findings will be implemented in due course to ensure that the premises continues to be suitable for the people who live there. There have been previous concerns about the poor service provided by the maintenance contractor, and some of the issues at the home relate to this. The acting manager confirmed that the Organisation are seeking to award the contract to another company. Wylds Lane, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 23 The home received a visit in August from the Environmental Health Officer, and the subsequent report confirmed that no requirements were made. 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. Wylds Lane, 180 DS0000018705.V353338.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 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, 180 DS0000018705.V353338.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. A thorough recruitment and selection procedure has been produced by the organisation, and includes 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. Staff confirmed that they complete a probationary period for the first three months of employment, and that they are required to follow an induction programme during this period. 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 continuity of care for the people they support. The home is fully staffed, and any relief staff who may be used will know the residents in all the homes run by Dimensions. The acting manager confirmed that staffing is maintained at a level that is adequate for the needs of the people who live at the home, and enables opportunities to be provided for residents to do the things they like to do, and to follow their regular activity programme. A training programme is provided for staff, and those spoken to by the inspector confirmed that 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 risk assessment. Medication training, which all staff have to attend has been further developed, the inspector was told, and is now in three parts, and competency testing is also included. 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 the staff file. Wylds Lane, 180 DS0000018705.V353338.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 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 the service 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, 180 DS0000018705.V353338.R01.S.doc Version 5.2 Page 27 EVIDENCE: The home has been without a registered manager, in recent months, following the transfer of Mr Andrew Russell to another service within the organisation. The acting manager with responsibility for the day-to-day running of the home, is Ms Helen Smith, who is a Registered Nurse Mental Health, 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, and 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 are 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. 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 appears 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 omissions relating to medication. 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, 180 DS0000018705.V353338.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 3 29 X 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 2 X Wylds Lane, 180 DS0000018705.V353338.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 7 Refer to Standard YA1 YA17 YA20 YA27 YA27 YA37 YA42 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 A review of the arrangements for the provision of food should be completed and the proposals implemented to enable greater choice for residents The procedures for the administration of medication should be followed at all times to ensure the safety and protection residents The bathroom should be upgraded to improve the facilities available to residents The toilet seat should be replaced without delay to ensure that the dignity of residents is preserved 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 DS0000018705.V353338.R01.S.doc Version 5.2 Page 30 Wylds Lane, 180 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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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