Care Home: 2 - 4 Wraxall Road

Similar services:

• 2 Perhaver Park
• The Vicarage
• 7 Hyde Road
• St George`s
• 5 Seafield Road
• Radfords
• Trevaylor Manor

What the care home does well Generally the Home was found clean, warm, well lit and free from unpleasant odours. The atmosphere of the Home was friendly and relaxed. Residents looked well cared for and staff were noted interacting with residents in an informal and respectful manner. At a discussion, the home manager stated that the Home continues to maintain high standards of care through regular care review. The relationship between staff and residents remain informal and cordial including the relatives. The home continues to provide good training for its staff both internally and externally to ensure that the needs of the residents are met. Two staff members spoken with stated that there is good team working at the Home; this made a great impact in the care of the residents. Residents enjoy good nutritious food this had contributed to their feeling of wellness. This was evident on the day. What has improved since the last inspection? It was pleasing to note that the home has made tremendous efforts to ensure that the requirements and recommendation made at the last inspection had been met. What the care home could do better: Whilst the general environment was found clean we noted that the wooden handrails on the hallways had rough edges that could potentially cause injury to mobile residents, staff and visitors. We received information before the inspection was completed that work would be carried out to remedy the situation at Wraxall Road. The Commission further received information on the specific dates that this work was to commence. Ensuring that identified staff attend Protection of Vulnerable Adult Training would ensure that staff are aware of action to take in the event of suspected abuse in order to protect the residents. It could be better if staff receive regular supervision to enable them to raise concerns about any areas relating to the residents` care. The medicine fridge with fluctuating temperature must be repaired or replaced in order to maintain potency of the drugs stored in it. Ensuring that staff attend fire drills would provide them with the information of actions to take in the event of actual fire emergency in order to protect the residents. To ensure adequate protection to the residents staff and visitors in relation to health and safety gas safety inspection must be undertaken when it is due. In order to comply with Regulation 37 the Commission for Social Care Inspection must be notified of all deaths at the home. We have received an action plan from the home of how the above shortfalls would be addressed. CARE HOME ADULTS 18-65 2 - 4 Wraxall Road Cadbury Heath South Glos BS30 8DN Lead Inspector Grace Agu Unannounced Inspection 14th October 2008 09:00 2 - 4 Wraxall Road DS0000020293.V372731.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 2 - 4 Wraxall Road DS0000020293.V372731.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. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2 - 4 Wraxall Road Address Cadbury Heath South Glos BS30 8DN 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) 0117 9600430 0117 9605295 ian.cameron@brandontrust.org www.brandontrust.org The Brandon Trust Russell John Geach Care Home 14 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories; Learning disability (Code LD) Physical disability (Code PD) The maximum number of service users who can be accommodated is 14 25th October 2007 2. Date of last inspection Brief Description of the Service: Brandon Trust operates 2 - 4 Wraxall Road, which is registered to provide nursing care to 14 adults with a learning disability and a physical disability. The property is located in a quiet residential area, close to local shops and amenities. The houses are purpose built and equipped for disabled people. There are 14 single bedrooms of various sizes. There are parking spaces and grounds to the side and rear of the house. Fees range from £1110 to £12220 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. This visit took place over eight hours and was carried out following an unannounced inspection in 25 October 2007 to review the requirements made at the last inspection and also to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the Home. It was pleasing to note that the requirements including the recommendation made at the last inspection had been met. A tour of the building was undertaken and a number of records were viewed. Russell Geach New home manager, two staff members and one relative were spoken with at the home on the day. A cross section of the comments made by relatives and staff on behalf of residents on the surveys received before the visit will be reflected in the body of the report. What the service does well: What has improved since the last inspection? 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 6 It was pleasing to note that the home has made tremendous efforts to ensure that the requirements and recommendation made at the last inspection had been met. 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. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The policy and procedure for admission of a prospective service user is robust to ensure that the individual(s) make positive choice of moving to the home with assurance that their needs will be met. EVIDENCE: The home has had no new admissions since the last inspection and the individuals living at the home have been together for many years. However the manager stated in the Annual Quality Assurance Assessment that the home provides good quality care that reflects the individuality of each resident. The admission procedure is satisfactory and would ensure a thorough Care management assessment is undertaken before any resident is admitted to the home. Furthermore the admission policy states, “ When a vacancy occurs at the home the manager will complete a vacancy profile and forward to head of service. The prospective service user and their relatives/advocate will visit all the service users at the home and be shown the home and bedroom. They should also be given a copy of the Service User Guide. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 9 If the service user approves the placement an admission programme will be drawn up. This will include length of visits and frequency. After this introductory period a trial period may be agreed”. The manager stated that the Statement of Purpose and the Service Users Guide is in the process of being reviewed. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 10 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): 6,7,8,9,10. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individualised care plans are provided for the residents to reflect their assessed need. Required support with risk assessments are provided for the residents to live independent lives with the assurance that information about them will be kept confidential. EVIDENCE: Two care files were reviewed at this visit. There were records of individual personal profiles, communication needs, daily living routine including personal care, mobility, individual preferences and dietary needs. Other information noted on two cares file includes an ‘Essential Life Plan’ which provided detailed information about the resident’s likes and dislikes, important things in his/her life and things people need to know about supporting the person. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 11 Each resident has a key worker who advocates for individuals with the parties involved with Essential Life Planning. Goals are set and there is a reviewing process in the home to monitor whether those goals are being met. Due to the profound nature of the residents’ disabilities their ability to participate in the day-to-day running of the home and their ability to contribute to the development and review of policies, procedures and services is very limited. However staff told us that through observation such as facial and/or vocal expression staff enable the people to make choices. There was evidence of detailed risk assessment in relation to health and safety and related areas. One relative we met on the day of the visit told us that the family is satisfied with the care provided at the home. The individual states “ I am satisfied with the care given to my son. Staff are very caring, I don’t know what I would have done without them. I am picked up every Tuesday to have lunch with my son. I am very grateful to them”. Staff also acknowledged that they have to make choices and decisions on behalf of the residents and are mindful about how they do this in order to safeguard the peoples’ welfare and rights. Residents are unable to manage their own financial affairs. This responsibility is carried out by the home and appropriate financial records are maintained and were seen. None of the residents is likely to go missing as total support is required for all the individuals and staff always accompany the service users on all external activities. Whilst staff members spoken with demonstrated a clear understanding of the importance of keeping information about residents confidential they are also aware of the possible information, which may have to be shared to protect people living in the home. The home has a confidentiality policy. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported to maintain links with the community, family and friends. Their individual rights are protected and the home provides them with healthy diets at chosen times. EVIDENCE: Evidence from discussion with staff and reviewing the care files of two residents show that individuals are supported to lead active lifestyles based on their level of understanding and choice. Whilst individuals living at the home are unable to engage in employment opportunities due to the profound nature of their disabilities each person has an activity plan. The home stated in the Annual Quality Assurance Assessment that the philosophy behind this to give each person a sense of achievement and to enable them to access quality community activities. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 13 The home has its own transport, which is used by the staff and day care for recreational activities and holidays. Records indicate that residents go on holidays at least once eachyear. For example some residents have visited Blackpool, Stack Poole in North Wales, Centre Parcs and a Hotel in Poole. Brandon Trust provides Day Care activities from Monday to Friday. Other activities include, shiatsu weekly, Aromatherapy weekly, hydrotherapy weekly, Hippodrome visit to see ‘Mama Mia’. External entertainment in-house from a theatre Group and shopping at Asda. For most of the residents, contact with relatives is maintained and some choose to have an active involvement in the care decisions that are made. Day care facilitate visits between some residents and their relatives either within the family home, or enabling the resident to meet with their family whilst out for a meal. One family choose to visit each day to assist their relative with the evening meal. Staff that I spoke with informed me that whilst it was difficult to ascertain the extent of relationships formed between residents in the home, it is evident that some residents enjoy the company of each other, which is demonstrated in the way in which they behave together, for example, laughing. Records show that the menu is the planned on a four weekly basis. The inspector was informed that all the individuals require liquidised meals. This was noted to be appropriately and attractively prepared. The atmosphere of the home was relaxed and calm and staff were noted to be interacting with residents in a dignified manner. One staff member stated that residents are treated like equals and this was evident in the manner that the staff were interacting with residents while supporting them with daily routines. The bedrooms viewed showed individual taste and choices in their personal belongings and decorations. The kitchens on both units were found clean and tidy food found in the fridge was labelled and the freezer temperature was recorded regularly. Staff stated that kitchens were recently refurbished. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents receive preferred personal support as required, their emotional and physical needs are met, also respect is given to their wishes in the event of their death. However, some of the home’s medication practices fail to protect them. EVIDENCE: The two care files reviewed showed evidence of how individualised personal care is provided for the residents. Personal care is provided in private and respects the dignity of the individual resident. One staff member stated that although the residents have profound learning disability staff treated them with respect and always knocked at the door before going to the bedrooms to provide personal care. The staff member spoken with gave a comprehensive account of how personal care is given to the resident with very complex needs. The staff member stated that most staff have worked at the Home for many years and knows the residents very well. The staff member ensures that the door is closed when providing personal care, speaks to the resident while providing personal care to ensure that privacy is maintained. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 15 The care files showed evidence of regular GP and other professional visits including reviews from the Speech and Language Therapist. All the care files reviewed had individual risk assessments and were regularly reviewed. Medication administration was checked and was found to be satisfactory. There was medicine policy in place. Evidence of receipt and disposal of medication was seen. The controlled drugs were properly recorded and signed by two registered nurses and balances were tallied. However we also observed whilst reviewing medication that the recording of the fridge temperature was irregular. According to the records seen the average fridge temperature reading was below the normal. At the last inspection we made a requirement that the fridge be repaired or replaced. We received information that the fridge had been repaired. Evidence from the recordings indicates that the fridge had been working satisfactorily until recently. This potentially could affect the potency of the drugs stored in it. We have issued a requirement that for this fridge to be replaced. The Commission had received in formation from the home that the fridge had been replace. Staff demonstrated knowledge of how to treat residents when they are terminally ill and the procedure in event of death. The Home has a Death and Dying policy. The manager stated that the two recent deaths at the home were well managed. The manager stated that whilst staff have not received End of Life training the home was supported by district nurses, General Practitioner and the palliative team to administer pain control medication to ensure that the individuals were comfortable before and at time of death. The manager would arrange this training for staff from St Peter’s Hospice. One staff member stated that the funerals were well attended by all staff including those who were off duty because of the number of years they had spent caring for the two residents. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The residents are enabled to complain with the confidence that their views will be listened to and acted upon, identified staff need to receive appropriate training for protection of residents from abuse. EVIDENCE: There were no recorded complaints seen since the last inspection. Evidence from the records and discussion with the manager showed that staff and service users are aware of the complaints procedure. The complaints procedure was also noted in picture format, which is suitable for residents in that category. The document had details of the Commission for Social Care Inspection to enable the complainant to contact the Commission if they were not satisfied with the outcome of their complaint to the organisation. The complaint procedure was displayed at the entrance of the home. Whilst the service users were unable to talk to us on the day due to profound Leaning Disabilities the feedback we received from the surveys from relatives indicated that they had no complaints. For example one comment states, “ We are more than satisfied with the overall care that our relative receives at the home. Further we are always consulted over issues as and when they arise. We noted a complimentary letter from a student who did a placement at Wraxall Road. The individual stated that they felt very welcomed at the home and that the quality of care given to the residents was very good. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 17 The inspector noted from the staff files reviewed that some staff had not received training on Protection of Vulnerable Adults. The manager stated that the home is waiting for availability of spaces for the training and had recently secured places for the training from Brandon Trust for 1st and 11th December 2008 and those identified staff will be given priority. This will be the focus of the next inspection. South Gloucestershire Policy and Procedure for reporting abuse of vulnerable adults was noted at the home and the manager demonstrated awareness of the responsibilities in relation to protecting individuals living in the home from harm and abuse. The inspector viewed residents’ money and noted that the money stored for one individual in the safe tallied with the balance in the book. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 18 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): 24,25,26,27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a homely and comfortable environment for the residents. It fails to provide adequate maintenance to specific areas to protect the individuals living at the home. EVIDENCE: 2-4 Wraxall Road is registered to provide nursing care to 14 adults with a learning disability and a physical disability. The property is located in a quiet residential area, close to local shops and amenities. The houses are purpose built and equipped for disabled people. There are 14 single bedrooms of various sizes. There are parking spaces and grounds to the side and rear of the house. No changes had occurred in relation to the home’s suitability for its stated purpose. Residents who were not attending Day Centre Services were found sitting in the communal areas and appeared relaxed in their homely environment. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 19 The premises were generally clean tidy and free from unpleasant odours. There are arrangements in place to dispose of clinical waste. The home has a comprehensive policy on Infection Control provided by Brandon Trust to ensure that people living in the home, staff and visitors are protected. The laundry area was found clean tidy with good flooring and ventilation. Staff spoken with were aware of safe practices necessary to prevent the spread of infection should it occur. The manager stated at a discussion and this was confirmed in the home’s Annual Quality Assurance Assessment (AQAA) sent to the Commission that two staff work hard to improve the environment n the communal area and also try to create individual personal space within the bedrooms. Whilst the general environment was found clean we noted that the wooden handrails on the hallways had rough edges that could potentially cause injury to mobile residents, staff and visitors. We also noted that the walls on the corridors were looking tired due to scratches created by residents’ wheelchairs and in need of redecoration. We received information before the inspection was completed that work would be carried out to remedy the situation at Wraxall Road. The Commission further received information on the specific dates that this work was to commence. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents enjoy good warm relationships with skilled and competent staff and are protected by the Home through appropriate staff recruitment. However it fails to offer regular staff supervision and identified relevant training courses. EVIDENCE: The available staff training records at the home and from speaking to staff on the day showed that all staff have attended training on Epilepsy awareness and understanding positive communication for residents with severe communication problems. Other training attended included Active listening, Basic first aid, Manual Handling, and Health and Safety and Fire awareness. One staff member interviewed stated that she has attended manual handling training and also a Learning disability award framework and training course on using the suction machine. All staff are aware of their roles and responsibilities in relation to the care of residents. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 21 The Annual Quality Assurance Assessment (AQAA) undertaken by the home also stated that most support staff hold an National Vocational Qualification (NVQ) for example 9 Support Workers have NVQ 2 and 4 Support workers have NVQ 3 and all nurses hold appropriate nursing qualifications and all registrations are current. However while reviewing staff records with the manager we noted that a number of staff have not attended Protection of Vulnerable Adult from Abuse (POVA) training. The manager admitted that this training is very essential to ensure that staff are aware of actions to take in relation to protecting individuals from harm/abuse. The manager informed the Commission For Social Care Inspection after the inspection that two full days have been allocated (1st and 11th December) in an external venue for identified staff to undertake this training. We have issued a requirement to ensure that this happened. This will also be a focus of our next visit. One staff member spoken with stated that there is a good communication within the team. Evidence suggests that the last staff meeting was in May 2008 and 12 staff members attended. Review of staff duty rotas evidenced that the home is adequately staffed to meet the complex needs of the residents living in the home. For example, there were two trained nurses working from 07am to 1430 and 6 carers working from 07am to 1430pm. In the afternoon there were two trained nurses from 1430 to 2130 and four carers from 1430 to 2130 also one carer from 1430 to 2000pm. On night duty there is one trained nurse on sleep-in duty from 11pm to 0730 and two waking night carers from 2100 to 0730. In addition there is a domestic and a housekeeper. The manager Russell Geach is supernumerary full time and is supported by an administrator. There was evidence that staff are receiving supervision however this is not regular to enable them to perform their duties effectively and to discuss any areas of difficulties. It was agreed that this should improve for the benefit of staff and residents. We have issued a requirement in relation to this practice. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42,43 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is managed by a competent leader who safe guards the rights and interest of residents and also protects them through application of policy and procedures and appropriate risk assessment. EVIDENCE: Russell Geach recently took over the management of 2-4 Wraxall Road after the departure of the previous manager and after a successful “Fit Persons Interview” at the Commission for Social Care Inspections. Russell is a Registered Nurse for Mental Handicap (RNMH) and holds a Bachelors Degree on Community Care Nursing and a diploma in Primary Health Care. Russell also has the Registered Managers Award. And National Vocational Qualification in Care Management at Level 4. He is well experienced in the care of people with learning difficulties. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 23 Staff spoken with on the day of inspection commented positively on the manager’s ability in relation to managing a care home for people with learning difficulties. Staff stated that the manager is caring, kind, approachable and will listen and act upon any concerns raised. The manager stated that his objective is to draw up care plans for the needs of the residents using the Person Centred Plan; this will be ready amongst other things to be viewed at the next inspection The residents at the home were unable to make comments about the manager, however it was clear that the manager had good positive relationships with the residents as was seen in interaction with them on the day of inspection. The home is currently monitoring its quality of service through the monthly provider visits, relative and professional questionnaires, team meetings, good relationships with the local General Practitioner practice, Care plan reviews and checking of the residents monies on a daily basis. Policies and procedures noted at the home to ensure that the residents are adequately protected include record keeping policy, confidentiality and control of infection. The fire logbook was viewed and was found to be well maintained. However. It was noted at reviewing the records that only thirteen staff had attended the fire drill on 18/06/08 and six staff on 31/12/07. Evidence suggests that night and some day staff have not attended fire drills The manager is required to ensure that all staff attend regular fire drills in order to have knowledge and awareness of how to deal with actual emergencies if and when they occur. Other Health and Safety checks seen included, maintenance book, portable appliance testing certificate (for electrical appliances) and service certificate for bath hoist. We noted that gas inspection was overdue however the manager informed us in writing that the inspection had been completed on 15/10/08. There were no accidents recorded however the manager stated that accidents would be recorded appropriately and reviews satisfactorily carried out to enable staff to detect and deal with injuries promptly if and when they occur. It was also noted that guidelines were in place in the accident book in relation to how to deal with any resident who had behavioural problems and could be aggressive towards other residents and/or staff. We noted that the home has not sent us the Regulation 37 Notification in relation to one of the recent deaths at the home ar required by the legislation. We have issued a requirement to ensure to prevent occurrence. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 24 Residents’ money kept at the home was checked and the balance was correct, other records were seen to be securely locked away. The home is part of a group and is financially stable. 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 25 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 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 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA39 Regulation 37 Requirement The home must ensure that the Commission for Social Care Inspection is notified of any deaths at the home in line with the legislation. Repair the wooden handrails with rough edges to prevent injury to residents staff and visitors. Ensure that staff receive regular supervision to enable staff to perform their duties effectively. Ensure that identified staff receive training on Protection of vulnerable Adults from Abuse in order to protect the residents. Timescale for action 14/11/08 2. YA24 23.2 (c) 30/11/08 3. YA36 18 30/11/08 4 YA35 18 31/01/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 2 - 4 Wraxall Road DS0000020293.V372731.R01.S.doc Version 5.2 Page 28 - 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!