Care Home: 197 Henwick Road

Similar services:

• Polesworth Group Friary Road
• Polesworth Group Pooley Heights
• Polesworth Group 32 Station Road
• Polesworth Group 70 Long Street
• Breme
• Polesworth Group 64 Long Street
• Polesworth Group 68 Long Street
• 10 Whitfield Avenue

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 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. 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 family and friends of each resident 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 residents 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. Food arrangements at the home give each person a choice about their meals and mealtimes, and helps to encourage their involvement in the daily life of the home. 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. Residents live in a homely, comfortable, safe and clean environment, where their privacy and dignity is respected, their independence is promoted, and with their personal possessions around them. The building and equipment is well maintained, the house is nicely decorated, and provides good facilities and a pleasant place in which to live and work.The Organisation follows satisfactory recruitment and selection procedures, and is clear about the support and supervision, and training and development for the staff it employs. Staff confirmed that they have good training opportunities and regular supervision sessions. 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. What has improved since the last inspection? There is an ongoing commitment from 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. The information about the home and the services that can be provided has been reviewed and updated, and produced in an appropriate format, to reflect the purpose and aims and objectives of the home, and the outcomes for the people living there. 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. 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 equipment. 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. Fire drills and practices are now being held at six monthly intervals to ensure that people working at the home are aware of the procedure to be followed in he event of fire. What the care home could do better: The information available about the home and the services that can be provided has been reviewed, although will need further amendment to reflect the new management arrangements for the home in due course. 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. Further work should be undertaken to both the front and rear access to the property, and also a check made on the stability of the tree in the front garden, to ensure the security of the people who live and work at the home. Consideration should be given to the provision of additional overhead tracking at the home to enable the residents to be more independent. The home has been without a registered manager for an extensive period of time, although Ms Lisa Jones has recently been appointed, therefore an application for registration should be submitted to the Commission without delay. The need for fire awareness training to be provided every three months for staff at the home was identified, to ensure that residents and staff will be better protected in case of fire. 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. CARE HOME ADULTS 18-65 Henwick Road, 197 197 Henwick Road St John`s Worcester Worcestershire WR2 5PG Lead Inspector Rachel McGorman DRAFT Unannounced Inspection 15th October & 2nd November 2007 3:00pm Henwick Road, 197 DS0000018659.V346017.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 Henwick Road, 197 DS0000018659.V346017.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. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Henwick Road, 197 Address 197 Henwick Road St John`s Worcester Worcestershire WR2 5PG 01905 429915 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 Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Home is primarily for younger adults with learning disabilities but may accommodate one person over the age of 65 The Home may also accommodate people who have an additional physical disability. 3rd November 2006 Date of last inspection Brief Description of the Service: 197, Henwick Road is registered to provide residential care for up to four people who experience a learning disability, who may also have a physical disability, and whose needs are diverse and complex. The range of fees varies between £1,100 & £1,250 per week. The premises is a large dormer bungalow, situated in the St. Johns area of Worcester, approximately 1 mile from the city centre, 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. Henwick Road, 197 DS0000018659.V346017.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 two visits to the service were unannounced and took a total of 5 hours. The inspector spent some time with the people who live 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, 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 there. In addition the opportunities for training and the support 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 who was on duty during the second visit to the home. A tour of the house was undertaken, and the records kept in respect of the maintenance and servicing of equipment, and safe working practices were also seen, including the fire log and the accident book. Henwick Road, 197 DS0000018659.V346017.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 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. 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 family and friends of each resident 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 residents 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. Food arrangements at the home give each person a choice about their meals and mealtimes, and helps to encourage their involvement in the daily life of the home. 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. Residents live in a homely, comfortable, safe and clean environment, where their privacy and dignity is respected, their independence is promoted, and with their personal possessions around them. The building and equipment is well maintained, the house is nicely decorated, and provides good facilities and a pleasant place in which to live and work. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 7 The Organisation follows satisfactory recruitment and selection procedures, and is clear about the support and supervision, and training and development for the staff it employs. Staff confirmed that they have good training opportunities and regular supervision sessions. 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. What has improved since the last inspection? There is an ongoing commitment from 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. The information about the home and the services that can be provided has been reviewed and updated, and produced in an appropriate format, to reflect the purpose and aims and objectives of the home, and the outcomes for the people living there. 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. 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 equipment. 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. Fire drills and practices are now being held at six monthly intervals to ensure that people working at the home are aware of the procedure to be followed in he event of fire. Henwick Road, 197 DS0000018659.V346017.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. Henwick Road, 197 DS0000018659.V346017.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 Henwick Road, 197 DS0000018659.V346017.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 & 3 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. 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. Henwick Road, 197 DS0000018659.V346017.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, although this will need to be to be reviewed and updated to reflect the new care management arrangements. The documentation is produced in an appropriate format, and retained by the service user, if this is their wish. Information provided at the home is reviewed regularly, to ensure that it accurately reflects all the specific aspects of the care that can be provided. The admission procedure includes extensive assessment by staff from the home, and a Community Care Assessment is undertaken by a social worker from the placing authority. 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, but the procedures had been implemented appropriately for a resident who was admitted to the home last year. Henwick Road, 197 DS0000018659.V346017.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. Good risk management strategies are in place to enable a responsible approach to the risks associated with the various activities of daily living. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 13 EVIDENCE: The needs and individual preferences of every person living at 197, Henwick Road are identified, and their participation in the daily life of the home, is constantly encouraged as far as they are able. Staff demonstrated an in-depth understanding of the needs and wishes of the people they support, and who are 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, are very comprehensive, detailing specific needs, and how these are to be met. 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. Many of the comments were written as if from the resident, and were documented under various headings, including for example, wishes and needs, and likes and dislikes. A specific area covered was entitled ‘Never/Ever’, and was intended to ensure that some things must never ever be done! The daily routines and details about such things as getting up in the morning and going to bed at night were also recorded. Several documents combine to form the plan of care and include the following: A Support Plan details daily routines, basic communication needs, feeding requirements, and specific guidelines for staff to follow. A medical file contains information relating to health care needs and details about visits to the doctor, nurses, or the physiotherapist. A Lifestyle Plan includes all the activities that the person is involved in, and how these are accessed and implemented. The Key-worker Plan contains information on the monthly review meetings held with the resident, and cover every detail of the care and support that is needed. Risk Assessment Plan provides details about the risks identified in respect of every aspect of the life of the resident. These are completed, for the premises, the activities undertaken, and any restrictions imposed. Two key-workers are assigned to every resident, and they each have responsibility for ensuring that appropriate care is provided. Monthly meetings are held, on-going assessment is undertaken, changes are monitored over a period of time, and any amendments made when necessary. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 14 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 opportunities made available to service users, enable them to live as fulfilling a life as possible. The involvement of each individual in their proposed activities, both within and outside the home, ensures that everything revolves around them. The health and wellbeing of service users is promoted by the provision of a nutritious and wholesome diet. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 15 EVIDENCE: The people 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. Limited communication skills experienced by all the residents preclude involvement in paid employment or educational opportunities, although one resident had been rehearsing for a concert to be presented in November. Each resident is supported by staff to be involved in various social activities, which may be undertaken in-house or in the community, and may include, swimming, visits to the Jacuzzi or hydro, attending a disco, or going to a concert. Music making is very much enjoyed by some, and in-house entertainment is also arranged from time to time. A birthday celebration is also organized for each person. The activity folder of one service user contained a weekly plan of the things they proposed to do, and the outcome was recorded in the daily log. These were many and varied and included cookery sessions, going to church, watching a video, going out for lunch, relaxing in the blue room with sensory equipment, spending time with a key worker, having a massage, going to the snoezlan, visiting parents at their home, going into town for shopping and a coffee, listening to music and visiting the bank. Links with family and friends are promoted, with a high degree of support provided by staff, to both the family and to the residents, and discussions with the relative of one resident during the inspection visit confirmed this. 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 around the provision of food reflect the individual needs and preferences of each person. Staff are aware of the specific likes and dislikes of everyone, and any food allergies are recorded in their care plans. All residents need assistance with eating, and staff were observed to attend to this in an unhurried and sensitive way. Two people require their food to be prepared in a semi-solid form, and one resident is fed through a P.E.G. feed (Percutaneous Endoscopic Gastrostomy). Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 manner in which support is provided by staff helps to ensure that the privacy and dignity of each resident 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 service users 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. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 17 EVIDENCE: The personal and healthcare needs of each resident at the home are extensive, and evidence was seen 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 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, depending on the needs and wishes of the resident. The independence and dignity of everyone living at the home is promoted, and a relaxed and flexible approach maintained at all times. Health Action Plans have been implemented for all service users living at the home. The plan of one resident was seen, and contained detailed information about their very extensive health care needs, providing evidence that staff monitor their care constantly. Specialist support and advice is sought from health professionals, and this is also recorded in their plan. The dentist and optician visit the home on a regular basis. Chiropody services can also be accessed if necessary, although staff attend to the nails of each person regularly. The residents are unable to walk independently, but the high standard of physical care provided has ensured that the skin integrity of each individual remains intact. There is also the need for intrusive treatments to be undertaken by staff from time to time e.g. administering suppositories, but staff said they are given the appropriate training, and this was confirmed in the records. 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 two errors that had been made recently, neither of which had been notified to the Commission. The records showed that otherwise the management had dealt with the situation appropriately. A Monitored Dosage System is in use, and the Medication Administration Record charts seen by the inspector, are being maintained to a good standard. A detailed profile, together with a photograph was completed for each service user, and guidelines were in place for the administration of ‘PRN’ (as required) medication. 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. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 19 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 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 the, ‘positive attitude of staff’, and their ‘competence and thoughtful consideration’. Their ‘co-operative approach with everyone’, and the ‘progress made in developing the garden’, has also been ‘very much appreciated’. An additional comment from a professional visitor to the home was very complimentary about ‘the way in which staff had cared for a resident whose skin was very vulnerable due to difficulties with mobility’. An appropriate procedure is in place in relation to the many aspects of abuse and the protection of vulnerable adults. Staff were able to show they had 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. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28, 29 & 30 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 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 standard of the accommodation is good. The décor and furnishings are well maintained, and provide service users 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 helps to enhance the quality of life for the people who live there. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 21 EVIDENCE: The premises at 197, Henwick Road is a large, detached bungalow, that provides a safe and well-maintained environment for the people who live there, and is suitable for its purpose. A dormer area has been developed which includes the office and sleeping area for staff, a bathroom, and also some storage facilities. The loft has been recently boarded to provide safe access for staff and further usable space. The communal areas of the house are homely, nicely decorated and comfortably furnished, and there is a warm, welcoming and friendly atmosphere at the home. There are three communal rooms, which include a pleasant lounge with a conservatory, and also a large kitchen/dining room. Proposals for upgrading the kitchen have now been implemented, and have enhanced this facility for everyone at the home. The gardens, which are extensive, have been given considerable attention recently. The provision of a large patio area with good access, has greatly improved access for residents, and the whole area has now been cleared and tidied. During the summer there have been tubs and pots of bedding plants around to provide colour and add more interest to the area. The improvements are really positive, and the home is to be commended on providing such a pleasant facility for residents to enjoy. An assessment is in place in relation to use of the garden, and includes the risk of pears falling from the tree and causing a slipping hazard for anyone using this area, which provides evidence that almost every eventuality is considered. The garden to the front of the house is quite small, but provides pedestrian access to the property from the main road. The wooden gate at the entrance is broken and therefore should be repaired or replaced, and advice also obtained about the safety of a tree that overhangs the pathway, that may possibly be uprooted in strong winds. Consideration should also be given to the rear entrance gate and the need for a lock to be fitted in the interests of security. The acting manager agreed that these matters would be addressed. An ongoing maintenance programme is followed, and has included the fitting of a new bath. Redecoration of this area is now to be undertaken, and there are also proposals for a bedroom to be redecorated. Several areas of the house are fitted with overhead tracking to assist the staff in supporting the people who live at the home with moving. The design of the existing equipment had previously raised some issues in regard to health and safety, therefore a review of the present provision was recommended. New tracking for the hallway is also being considered for the coming year. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 22 There are four single bedrooms for residents, which are furnished to reflect the personality of their occupants, and some have sensory equipment, specific to their needs. When bedrooms are redecorated or refurbished, it is the policy of the home for with the wallpaper and colour schemes to be chosen by the resident or their family. 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 following the previous visit. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 23 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): 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 effective team of staff, who are able to ensure that the needs of the people living at the home can be 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 service users. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 24 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. One member of staff remains on extended sick leave. Agency staff are not used at present, although 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, 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 for staff is provided, 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. The need for specific training on the Protection of Vulnerable Adults was identified at a previous inspection, and this has since been provided. A training course on Mental Health Awareness was attended by some staff within the last few weeks. A resistance to doing the NVQ (National Vocational Qualification) Level 2 in Care was detected within the staff group, and the acting manager confirmed that this issue has now been addressed by management and resolved, to ensure that all staff have the competence and skills to do their work. Formal supervision sessions, which include an annual appraisal are provided for all care staff by the manager, to ensure that staff 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. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 25 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 have recently been addressed, and should now provide appropriate leadership for staff, and ensure that the needs of service users are met. The policies, procedures and records maintained at the home, comply with legislative requirements and therefore help to safeguard the rights of service users. The health, safety and welfare of service users is promoted and protected in respect of all safe working practices. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 26 EVIDENCE: The home has been without a registered manager for an extensive period of time, although there is acting manager in post, Ms Lisa Jones, who has responsibility for the day-to-day running of the home. An application for registration is to be submitted to the Commission in the near future. There was evidence of effective person centred care being delivered by the staff team at the home, who were obviously very committed to their work, and whose interactions with the people they support were pleasing to observe, but more stable management arrangements will be of benefit to the service and 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. The plan also identifies who they will need to help them to get there, the building bricks and the strengths required, and who will do what. The Quality Monitoring Officer visits the home on a regular basis, and undertakes an audit of the various areas which form part of the quality assurance system. 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. Routine maintenance and servicing of equipment is undertaken, and the fridge and freezer temperature checks are recorded appropriately. 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 have been two recent omissions relating to medication. Regulation 26 reports, following visits made to the home by or on behalf of the registered provider, are submitted to the Commission on a regular basis. The home has not received a recent visit from the Fire Safety Officer. The Fire Log Book was seen, and appropriate checks have been undertaken with the required frequency. The Fire Risk Assessment for the home had been reviewed in September 2007. Fire drills and practices have been undertaken, but fire awareness training is not yet being done every three months. Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 27 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 2 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 2 30 3 STAFFING Standard No Score 31 X 32 X 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 3 x Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 28 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 YA20 YA28 YA29 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 The procedures for the administration of medication should be followed at all times to ensure that residents are protected To ensure the safety and security of the people who live and work in the home, repair or replacement of the gates, and a survey of the tree should be undertaken. Further consideration should be given to the provision of additional tracking within the home to enable residents to have more independence To ensure that residents benefit from a well run home the acting manager should apply for registration without further delay Fire awareness training should be provided every three months for all staff at the home, to ensure that residents and staff will be better protected in case of fire. DS0000018659.V346017.R01.S.doc Version 5.2 Page 29 Henwick Road, 197 7 YA42 Notifications should be made to the Commission regarding any event that adversely affects the well being or safety of a resident Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 30 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. Extracts may not be used or reproduced without the express permission of CSCI Henwick Road, 197 DS0000018659.V346017.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!