Care Home: 21 Longton Road

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What the care home does well Observation of staff showed positive attitude and relationships with people who used the service. Staff continue to strive for high standards within the home and have supported people who use the service in a sensitive and supportive way.Staff receive a thorough induction to the home which is "Skills for Care" based. This involves the completion of a workbook by both the staff member and a senior member of staff. Each person using the service has a plan of care, which they have helped to develop. Some people living in the home need support to communicate with others. People are involved in a variety of leisure and work activities. Staff support people to identify what activities they want to be involved in on a daily basis. People are able to develop life skills within a risk assessed framework, to complete domestic chores in the home, and take responsibility for shopping and cooking. Staff said they are committed to supporting people to achieve identified goals. People are supported to go out for meals, or to the pub, and food is prepared and cooked with the support of staff members. Staff enable and support people to keep in touch with their family and friends, either by arranging visits, and or by phone or letter. What has improved since the last inspection? What the care home could do better: Medication should be stored appropriately. This needs to be neatly and clearly stored in a cupboard fit for the purpose.Risk assessments for individuals should be clear with detailed contingency plans. To increase safety, fire risk assessments for individuals should be dated and signed in line with regular reviews. CARE HOME ADULTS 18-65 21 Longton Road 21 Longton Road Stone Staffordshire ST15 8DQ Lead Inspector Pam Grace Key Unannounced Inspection 11th June 2008 10:00 21 Longton Road DS0000004975.V366064.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 21 Longton Road DS0000004975.V366064.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. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 21 Longton Road Address 21 Longton Road Stone Staffordshire ST15 8DQ 01785 615505 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) loraine.lawton@ntlworld.com RMP Care Mrs Rosemary Jean Hulme Mr Paul Stevenson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th May 2006 Brief Description of the Service: The home is an end terraced house property set within walking distance of the centre of the market town of Stone. The appearance of the home is in keeping with the surrounding properties and as such does not present itself as a care setting. The location of the home provides for good access to public transport systems.The Home provides care for up to five younger adults with a learning disability. The accommodation is on two floors and consists of a lounge, large kitchen, utility room, toilet and bathroom, plus an en suite bedroom on the ground floor. There are four single bedrooms on the first floor. There is an enclosed courtyard to the rear of the property that leads to a grassed garden as well as giving access to Cross Street.The aims and objectives of the home are to provide a small comfortable home which is staffed to meet individual service users needs and enable development and integration into the local community. The fees charged for the service at 21 Longton Road, are from £498.00 £898.00 per week. The fee information included in this report applied at the time of inspection the reader may wish to obtain more up to date information from the care service. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. This visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over approximately seven hours by one inspector who used the National Minimum Standards for Younger Adults as the basis for the inspection. Prior to the inspection, the care manager completed an Annual Quality Assurance Audit (AQAA) for us. There were also four “Have Your Say” questionnaires received from people who use the service. A tour of the home was undertaken. On the day of the inspection, the home was accommodating five people. We spoke with people who use the service, examined records, carried out indirect observation, and spoke with two staff on duty. Three care plans and three staff records were examined and observation of daily events took place. Medication procedures were inspected so that we could see how safe they were. We did not make any requirements, but made 3 recommendations as a result of this unannounced inspection. What the service does well: Observation of staff showed positive attitude and relationships with people who used the service. Staff continue to strive for high standards within the home and have supported people who use the service in a sensitive and supportive way. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 6 Staff receive a thorough induction to the home which is “Skills for Care” based. This involves the completion of a workbook by both the staff member and a senior member of staff. Each person using the service has a plan of care, which they have helped to develop. Some people living in the home need support to communicate with others. People are involved in a variety of leisure and work activities. Staff support people to identify what activities they want to be involved in on a daily basis. People are able to develop life skills within a risk assessed framework, to complete domestic chores in the home, and take responsibility for shopping and cooking. Staff said they are committed to supporting people to achieve identified goals. People are supported to go out for meals, or to the pub, and food is prepared and cooked with the support of staff members. Staff enable and support people to keep in touch with their family and friends, either by arranging visits, and or by phone or letter. What has improved since the last inspection? What they could do better: Medication should be stored appropriately. This needs to be neatly and clearly stored in a cupboard fit for the purpose. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 7 Risk assessments for individuals should be clear with detailed contingency plans. To increase safety, fire risk assessments for individuals should be dated and signed in line with regular reviews. 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. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 8 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 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 9 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 and 5 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Annual Quality Assurance Assessment document (AQAA), which is completed by the care manager, confirmed the following: “We recognise that every prospective resident should have the opportunity to choose a home which suits their needs and abilities. To facilitate that choice and to ensure that our residents know precisely what services we offer, we will do the following. Provide detailed information on the home by publishing a statement of purpose and a detailed service user guide. Give each resident a contract or a statement of terms and conditions specifying the details of the relationship. Ensure that every prospective resident has their needs expertly assessed before a decision on admission is taken. Demonstrate to every person about to be admitted to the home that we are confident that we can meet their needs as assessed. Offer introductory visits to prospective residents and avoid unplanned admissions except in cases of emergency”. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 10 The home’s Statement of Purpose and Service User Guide was checked in detail, these had recently been reviewed and amended to include costs for transport and holidays for people who use the service, this now meets the National Minimum Standard. People had a copy of the Statement of Purpose and Service user Guide, which is used across the organisation. These documents had been explained to people who use the service with the use of pictorial support. The Guide included details of the terms and conditions of occupancy and fee level. The care manager and staff confirmed that pre-admission assessments had originally been undertaken by social services and or the specialist community learning disabilities service. However, because people who use the service had in many cases been living at the home for a number of years, records had since been archived. We were unable to view the original documentation in relation to people’s pre-admission assessments. This was highlighted and discussed with the care manager at the time. We looked at 3 care plans, and viewed 3 contracts. The fees had been reviewed. Contracts seen were signed, and the revised fees were in the process of being added to the paperwork. 4 x “Have Your Say” surveys received from people who use the service, confirmed the view that people were asked if they wanted to move into this home, and that they did receive enough information about the home prior to moving in. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 11 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 and 9 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Individual risk assessments could be improved upon to further reduce any risk to people who use the service. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, provided by the care manager, confirmed the following: “The choices, needs, values and empowerment of service users is at the very forefront of the homes ethos incorporation of service users in their own care and support is essentially mirrored by supporting the individuals needs and choices. Service users plans are agreed individually, pre-admission, but then constantly reviewed and service user plans are developed and changed as necessary at least every 6 months. This is not limited to time periods and 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 12 dependant on individuals needs and if/when they choose their plans can be changed at any time. Work with other agencies, health care teams and individuals wider support networks (family friends etc) where suitable has extended the understanding of individuals needs and improved the support offered. Access to Assist advocacy support to help individuals make choices and understand and take measured risks”. We looked at 3 care plans. All of which contained a client profile, with person centred information. Evidence of health services input was also seen. Each plan was individualised, and recognised the personality and needs of the person. The plans were reviewed on a regular basis; any changes to the skills achieved were recorded. Evidence contained within care plans seen pointed to there being six monthly reviews held for each person. However, care plans contained out of date paperwork, which should be archived on a regular basis. Risk assessments seen identified in detail the risks for each individual, however, these were incomplete, and did not have clear contingency plans in place. It is therefore recommended that the home strengthen their risk management recording to ensure that the people living in the home are kept safe and that the staff understand the action they need to take to prevent risk. We spoke to 5 people who use the service. (discussions took place mostly in the kitchen). People said that they were consulted and encouraged to be involved in their care plan, some people were able to explain their timetable for the week, what their favourite foods were, and what they like to do in their spare time. “I like to go shopping, watch television and dvd’s”, “I go to college every week”, “I enjoy going on holiday”. People spoken with said that they were consulted and encouraged to be involved in their care plan. This consultation was also confirmed when we spoke with staff during the inspection. Surveys received from people who use the service confirmed that they can make their own decisions on what they want to do each day. We saw that people were asked by staff if they wanted drinks, food and snacks, which were made available throughout the day, with a choice of options for hot or cold food and or drinks. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: The Annual Quality Assurance Assessment document (AQAA), completed by the care manager, confirmed the following: “We promote healthy lifestyles and support a wide range of lifestyle choices. Facilitate access to the community, leisure centres, sports grounds and local interest groups. Facilitate and promote healthy relationships whether these be with family, friends or a chosen partner and when deemed appropriate or where requested. Provide support and information regarding supermarkets and healthy options enabling people to decide for themselves what the menus are going to be. Supporting diverse lifestyles promoting responsible risk taking, whether this is concerning food, alcohol, smoking or any other aspect of their 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 14 lifestyle. Lifestyle choices are supported with access to all local facilities i.e gym westbridge park local shops and library and local services such as hairdressers. Other activities have been promoted with one lady accessing a stafford nightclub to celebrate a friends birthday. Residents are fully supported and their independence is promoted in all aspects of their home lives”. Information relating to the person’s culture and religious needs were included in the plan, and how these were to be met. People at the home are able to express their own sexuality with appropriate support, for example in regard to maintaining personal relationships and friendships. Personal risk assessments recorded identified risk, level of risk and how to support the person. However, we found that they were not complete, in that they did not have clear contingency plans identified and in place. It is recommended that risk assessments should include clear contingency plans, which minimise the risk to the individual. This was highlighted and discussed at the time with the care manager. Surveys received from people who use the service confirmed that people are given the choice of what to do each day, and are supported in making those decisions. Discussion took place with people who use the service throughout the visit. This covered their daily programmes, activities, visits to the local day service and to see their families and friends. Daily activities and life continued as normal during our visit. Staff explained the inspection process to people using the service, during the inspection visit. People spoken with said that they “do their own shopping”, “I can cook my own meals sometimes”. Staff spoken with confirmed that they go out shopping nearly every day, and people are supported in accessing their local community, i.e. shops, pubs, restaurants, hairdresser,post office, library and church. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, completed by the care manager, confirmed the following: “RMP has a specific policy underlining its core values on personal support and support with access to health care services. This specifies that every effort must be made to meet service users health care needs, and done so in a way that upholds their dignity and respect. Including ensuring that personal care is done in private, and with a staff member whom the service user is comfortable with, being of the same gender wherever possible. The policy also specifies that health care relates to all aspects of a persons well being, physical, emotional and mental health care needs. Each resident is registered with a local GP, dentist, optician and chiropodist. All residents are supported with access to health care services, including mental health services”. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 16 We looked at three health care plans, these recorded health care needs and how people were to be supported. For example: if a person had epilepsy, a record would be kept of any seizures, and actions taken. Each person was registered with a local General Practitioner (GP). There were good relationships fostered between the home, the learning disabilities service, the GP and the local pharmacist. Other specialists maintain further contact and support. For example: Speech and Language Therapist, and where necessary, district nurses were approached for advice, information and any equipment necessary. People using the service attend surgery and or clinics as appropriate to their health needs. The evidence to support this was contained within daily records, and care plans seen. The storage of medication was within a locked cupboard within the laundry. The cupboard was also used for the storage of other materials, and it was not possible to clearly and readily see the medication stored for each individual. This was highlighted and discussed at the time. It was recommended that this cupboard should be tidied and that medication should be clearly and readily accessible for administration. People who self medicate receive appropriate support from staff. People spoken with during the inspection visit told us, “ I know I can speak to staff if I’m not feeling well”, “I can see the doctor if I don’t feel well. Discussion with staff revealed that they knew people well, and how to support each individual. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure. People are protected from abuse, and have their rights protected. EVIDENCE: The Annual Quality Assurance Assessment document, which was completed by the care manager, confirmed the following: “The company holds specific complaints and protection of service users policies. The complaints policy outlines the procedure of dealing with complaints, how to make them and the named person for ensuring complaints are dealt with. Leaflets in homes in appropriate formats for service users have just been reviewed and updated with the latest address and contact details for CSCI. There have been no complaints and grumbles are dealt with in residents meetings, evidence for this is provided in the green file. The home firmly believes that in dealing with grumbles effectively this avoids complaints and ensures service user satisfaction. There are stringent procedures in place for the handling and accounting of residents’ monies, 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 18 Views listened to from parents, healthcare professionals, Commission for social care inspection, parents and other people who wish to voice concerns, complaints or protection. Parents/ family are informed of who to speak to and the central management team has been around since the company was founded therefore have always been known to new referrals and have been available. The staff are in contact with families and other individuals support networks, at regular intervals. Staff are provided with training on induction for vulnerable adults procedure. Copy of this procedure is available in every house. Staffordshire procedure but also material from Solihull social services with whom two of the service users from another service within RMP care are affiliated. This includes video instruction. Staff do not start work without a CRB check or POVA clearance, as detailed in staff section. Body maps are used to record any unusual marks noted especially for those service users who receive personal care and have difficulty in communicating. This is evidenced in one service users file. Staff are familiar with Mental Capacity Act and have used this to safeguard decisions made on behalf of a residents. Ongoing support given for resident who can be verbally abusive. Non-aversive behaviour techniques applied by staff to minimise the impact on other service users. One resident was concerned about the behaviour of a fellow resident, this was monitored and ultimately led to one service user receiving a higher level of support in a different RMP care service. Staff have all recently been refreshed with the whistle-blowing policy”. The care manager and the complaints log confirmed that the service had received no complaints since the previous inspection. Complaints are documented and recorded. There is also a “Grumbles book”, which is used on a daily basis for minor grumbles. The care manager said that they encourage relatives to approach them if they have a problem. It would be discussed and addressed where appropriate at a time convenient to the family. There had been no complaints and no safeguarding issues reported to us at the time of this visit. Surveys received by us from people who use the service confirmed the following, “Do the staff treat you very well? the response was “very well”. “I can speak to a staff member if I’m not happy”. All surveys received confirmed that people know who to speak to if they are not happy. People who use the service confirmed that they were very aware of whom to tell if they had a complaint. The complaints procedure had been printed into a pictorial and clear format to enable people using the service to understand it. This information was on view in the home, and easily accessible to people. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 19 Three staff recruitment records evidenced that staff are recruited following robust procedures, which included Criminal Records Bureau and Protection of Vulnerable Adults checks prior to commencement of employment. Staff spoken with at the time of the inspection also confirmed this. Staff we spoke with were very aware of the need to Protect Vulnerable Adults, and said that they had received training in respect of this. The home’s training matrix confirmed that training is undertaken by staff in regard to the Protection of Vulnerable Adults. A spot check of people’s finances revealed that the home appropriately records and receipts all personal monies held for people who use the service. Some people are responsible for their own finances, with support from staff. 21 Longton Road DS0000004975.V366064.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): 24,25 and 30 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, and comfortable environment, which encourages independence. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document completed by the care manager commented on the following: “We provide small homely environments for service users. Bedrooms are decorated to personal choice and suggestions on colour schemes are acted upon. Facilitate people to have access to or provide specialist equipment.Shared spaces compliment individual service users. the home is clean and hygienic. Bedrooms are decorated with personal effects and colour schemes chosen by the residents and families themselves. One service user purchased own bedroom furniture to a higher standard than the home could provide. All 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 21 service users have photographs of family and people who are special to them in bedrooms and communal areas. Ornaments situated around the home are of equal personal value to service users and some have been made personally by them including pottery from oak tree farm. The purpose of the home is to provide comfortable, family-like care. The environment has been designed to encourage and support the independence of individual residents while promoting their support and safety. The provision of private rooms and quiet, restful areas has been balanced with homely, communal areas where residents can socialise and be with each other. While residents may elect to eat their meals in their rooms they are encouraged to eat in the communal dining room, reflecting the homes belief that meal times are an important social occasion. Four residents have an upstairs bedroom access to a bathroom on the same floor. The one resident on the ground floor has an en-suite and shower section installed which was required as part of his ongoing care needs. The kitchen, hallways stairs and landing have been recently redecorated (29/8/07). Upstairs bathroom redecorated (12/7/07) and three of the residents bedrooms have been redecorated with in the last 12months, the remaining two bedrooms decorated within the last 2 years. The kitchen is modern and chosen by the residents, and was installed in September 2006.” The home is cleaned with the help of staff through service users individual plans to maximise independence. All service users are involved in the cleaning of the home to the best of their abilities. Cleaning jobs are shared appropriately and completed daily. Staff maintain a high level of cleanliness. Maintenance is carried out by suitably qualified technicians. Bedrooms seen had been personalised, furnishings and fittings were of a good standard, and rooms had been decorated to their individual choice. People who use the service told us that they were “pleased with their bedrooms”, and with their lounge. One person said that they “could have friends to visit”, and “I can watch television any time, because I have my own television”. Another person said “I help with the washing up every day”. Surveys received confirmed that the home is always fresh and clean. The AQAA document also confirmed that appropriate safety checks had been undertaken. Since the previous inspection, new fascias, and guttering had been fitted to the house. New floor covering had been laid in the hall, stairs and landing, and laundry room. To the rear of the house, the new garden – people who use the service had chosen plants and pots for the area which had new fencing, a patio, and level access paving. A new wall had been built to the rear of the house. The level access means that a wheelchair user can easily access this area. Plans for that area include a sensory garden. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 22 21 Longton Road DS0000004975.V366064.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): 32,34,35 and 36 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are trained, skilled and provided in sufficient numbers to support the people who use the service and to ensure the smooth running of the service. EVIDENCE: The Annual Quality Assurance Assessment document (AQAA), which is completed by the care manager, confirmed the following: “Staff roles and responsibilities are clear. Staff are competent within their job roles and suitably qualified. Recruitment procedures protect clients. Service users individual needs and joint needs are well supported. Staff employed at the home are a team of staff available to all homes within the RMP Care group. This allows for great flexibility whilst people visit friends at other houses and allows someone familiar to cover holidays for those staff who are more permanent at this home. RMP Care try not to use Agency staff and have only done so when this will not impact on the service users when for instance a lady whose needs altered and werent being met at RMP was waiting to go elsewhere to receive specialist health treatment waking night staff was required. We used Agency staff just for the waking night. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 24 We have a good team who will provide cover for other members of the team and provide continuity of care for the residents. We currently have 9 members of staff with NVQ. Level 2. 2 people qualified with LDAF level 2. Four people qualified with NVQ level 3. Two people qualified at level 4. Three people qualified as NVQ assessors qualified with D32 and D33.” “Current training courses include: Dementia Awareness Dec 07 First Aid Feb 08 Recognition of Protection of Vulnerable Adults 02/10/07, 20/02/08 20/03/08 General Risk Assessment 13/03/08 Basic Food Hygiene 1/02/08, 28/03/08 Equality and Diversity 5/3/08 20/3/08 Mental Capacity Act Jan 08 NVQ training Boots MDS system training” From our discussions with staff, the care manager, and the examination of staff recruitment and training records, we were assured that the recruitment and training provided, promoted an effective staff team. Staff spoken with confirmed that staffing levels were flexible to meet the needs of the people who use the service, and their commitment to daily activities, for example; attendance at college, transport to an appointment, or a shopping trip. A member of the staff team and or the care manager would be available at the home during the day. The staff rota for weeks commencing 02/06/08, 9/06/08 and 16/06/08 confirmed that 1 staff member was on duty all day till 5pm, with a sleep in duty over night. The staff rota also evidenced that staffing levels had been maintained. There are currently no extra staff needed at weekends or evenings. This is because of the routines of people using the service. Some support is shared with staff from the sister home. The provider’s ability to retain their staff has resulted in existing staff having worked at the home for many years. This has had a very positive outcome on the consistency of support and care that people who use the service have received. Recruitment records examined evidenced that appropriate police and security checks had been made prior to their employment. However one file did not contain an application form, this was thought to be because the staff member had been recruited 8 years earlier by an agency, and the form had since been archived. This was highlighted at the time, and discussed with the general manager. 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 25 We saw the service’s training matrix for 2008, which covered the whole of the organisation. Staff spoken with, and records seen confirmed that mandatory and update training was current, and that they received regular supervision via their line manager. Staff meetings are held wherever possible on a three monthly basis. Staff meeting minutes for 7/4/08 were available for us to view. The AQAA confirmed the current training courses being undertaken by staff and the numbers of staff qualified to NVQ standard. These were seen to be satisfactory. New members of staff would receive a “Skills for Care” induction package, which includes a workbook that is signed off by a senior member of staff during the induction period. 21 Longton Road DS0000004975.V366064.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 and 42 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. The service has effective quality assurance systems which; have been developed by a qualified, competent manager. EVIDENCE: The AQAA document confirmed the following: “The registered manager has been employed by RMP Care since 1993 and works closely with the company General Manager. The care manager has regular contact with the company proprietor. The care manager ensures all financial records are kept to safeguard residents financial interests. A general Risk Assessment course has been attended by the manager to continue good practice and the General Manager is undertaking an accredited 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 27 10 day leadership and management course to increase knowledge. We want everything we do in the home to be driven by the needs, abilities and aspirations of our residents, not by what staff, management or any other group would desire. We recognise how easily this focus can slip and we will remain vigilant to ensure that the facilities, resources, policies, activities and services of the home remain resident-led.” People who use the service are well supported by the sensitivity, training, and experience of the staff employed by the company. Meetings for people who use the service, and for staff are held on a regular basis. People are encouraged and supported to speak out at meetings. Feedback from quality assurance audits are featured in those meetings. There is evidence that the service has a robust recruitment procedure in place. This evidence came from the staff we spoke with and records we sampled. The ethos of the home was reflected in the policies and procedures, the records, attitude and competence of the staff in addition to comments received from the people who use the service. People’s citizenship and their rights, are protected by the staff and the training that they undertake. There is a suggestions pro forma for everyone to put forward ideas, these are listened to and acted upon by the care manager in a timely way. Records seen confirmed that the practice and procedure for weekly fire alarm testing and fire drills were current. The home had a fire risk assessment for people who have special needs in relation to fire evacuation, all people using the service had been fire risk assessed. However, clear contingency plans need to be in place for each individual. The Annual Quality Assurance Assessment (AQAA) document, completed by the general manager, had previously contained too much information in relation to policy and procedures, and did not contain enough information in regard to the outcome groups. This was highlighted and discussed with the general manager during other inspections, and has been rectified. 21 Longton Road DS0000004975.V366064.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 X 5 3 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 3 26 X 27 X 28 X 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 3 2 X LIFESTYLES Standard No Score 11 3 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 3 X 3 X 3 X X 3 X 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 29 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. 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. Refer to Standard YA9 Good Practice Recommendations To minimise risk to people, the service should strengthen their risk management recording to include contingency plans, and to ensure that the people living in the home are kept safe and that the staff understand the action they need to take. Medication should be appropriately stored. To increase safety fire risk assessments for individuals should be dated and signed in line with regular reviews. 2. 3. YA20 YA42 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 21 Longton Road DS0000004975.V366064.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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