Care Home: 22 Argyll Street

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What the care home does well Information is accessible to all people living at the home because it is provided in a range of formats. People living at the home are involved in the development and review of their care plans. People living at the home are able to make choices about their daily lives. Good support is provided for people with developing and maintaining their personal relationships. 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 People have their healthcare needs met and are referred to the relevant healthcare specialist as required. The home supports those people who are able to, to manage their own medications. People living at the home are supported to access the community and take part in leisure pursuits of their own choosing including socialising with their peers outside of the home environment. People living at the home are listened to so the service is run taking into account their wishes. The management of the home seeks improvements for people living at the home. This includes plans to develop further information about the service on DVD`s and the use of role play in house meetings to explore issues about safeguarding. Responses from people living at the home in survey`s told us `the home is very special to me anal I could not wish for any better` and the home `looks after me well and staff are always here for me`. What has improved since the last inspection? The use of DVD`s means people who have no verbal communication are able to access and be involved in the presentation of information. What the care home could do better: No areas for improvement have been identified at inspection. But the home has identified areas to improve which have been included in the body of the report.22 Argyll StreetDS0000066058.V376326.R01.S.docVersion 5.2 Key inspection report CARE HOME ADULTS 18-65 22 Argyll Street Ryde Isle Of Wight PO33 3BZ Lead Inspector Gina Pickering Key Unannounced Inspection 12th June 2009 10:00 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 22 Argyll Street Address Ryde Isle Of Wight PO33 3BZ 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) 01983 565964 01983 539040 South Wight Housing Association Ltd Ms Amanda Victoria Smith Mr Dennis O`Hearn Care Home 8 Category(ies) of Learning disability (0) registration, with number of places 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 8. Date of last inspection 15th June 2007 Brief Description of the Service: Argyll Street is situated within an urbanised area of Ryde and is close to the facilities and amenities of the main town centre and local transport links. The property provides single occupancy accommodation across two floors and is able to cater for up to eight people. Communal areas are spacious and generous and the grounds whilst small well maintained, neat and tidy, with access for people in wheelchairs. 22 Argyll Street DS0000066058.V376326.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 three stars. This means that the people who use this service experience excellent quality outcomes. We considered information received about the home since the last inspection on 15th June 2007. This included information provided to us in the form of the homes Annual Quality Assurance Assessment (AQAA) in which the service tells us about improvements made in the past 12 months and how they propose to continue to improve the service. We sent surveys to people who live at the home and staff members. We received 6 surveys from people living at the home, 7 from staff members and 3 from health and social care professionals. We visited the home on 12th June 2009. We were unable to have conversations with people living at the home because they were all out of the home taking part in activities. We planned to visit the home at an alternative date to meet the people living at the home. But circumstances deemed that this was not in the best interests of people living at the home. During the visit to the home we had conversations 2 staff members and the registered managers Mandy Smith and Dennis O’Hearn. We a looked at various documentation including staff training and recruitment records, documentation relating to people living at the home, service certificates and looked at various areas of the environment of the home. What the service does well: Information is accessible to all people living at the home because it is provided in a range of formats. People living at the home are involved in the development and review of their care plans. People living at the home are able to make choices about their daily lives. Good support is provided for people with developing and maintaining their personal relationships. 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 6 People have their healthcare needs met and are referred to the relevant healthcare specialist as required. The home supports those people who are able to, to manage their own medications. People living at the home are supported to access the community and take part in leisure pursuits of their own choosing including socialising with their peers outside of the home environment. People living at the home are listened to so the service is run taking into account their wishes. The management of the home seeks improvements for people living at the home. This includes plans to develop further information about the service on DVD’s and the use of role play in house meetings to explore issues about safeguarding. Responses from people living at the home in survey’s told us ‘the home is very special to me anal I could not wish for any better’ and the home ‘looks after me well and staff are always here for me’. What has improved since the last inspection? What they could do better: No areas for improvement have been identified at inspection. But the home has identified areas to improve which have been included in the body of the report. 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 7 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. 22 Argyll Street DS0000066058.V376326.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 22 Argyll Street DS0000066058.V376326.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. People using 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. Procedures are in place to ensure that when people move into the home they will have made their own choice about suitability of the home for them and will be confident the home can meet their needs. EVIDENCE: The AQAA told us nobody has moved into the home since the last key inspection in June 2007. An admissions policy is in place that includes the provision of information and assessment of a person prior to them moving into the home. Both managers told us that the admission process is reviewed each time there is vacancy at the home and will be tailored to meet the individual needs of the person wishing to move into the home. Included in the admission process is the provision of information about the service provided at the home (the statement of purpose and service users guide) titled ‘Welcome to our Home.’ There is a copy of this in each persons file. The document is written in large print and has pictorial images so it is accessible to all people living at the home and people interested in living at the 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 10 home. This document includes all details as required in the Care Home Regulations 2001 including a statement of terms and conditions, details about the services at the home and details of the support provided by the key worker which includes support for each person to make decisions and reviews of care plans and person centred plans. 22 Argyll Street DS0000066058.V376326.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. People using 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. People living at the home know how their changing needs will be met by the use of clear care plans that are produced in an accessible format for them. People are encouraged to make choices and are supported to manage identified risks to lead an independent life as possible. EVIDENCE: The statement of purpose states that all people living at the home have a plan of care and person centred plan that details their needs, choices and goals which is devised with the person it relates to and their key worker. The AQAA told us these plans are reviewed every two months with the individual and their key worker. The AQAA told us that the service has been looking at ways to make the plans more accessible to people living at the home. Presently 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 12 plans are written in large print, plain English and relevant pictorial images are used such as makaton signs depending on the individual needs of the person to whom the plan relates to. The home has sourced funding and has produced with professional assistance a PCP in DVD format for one of the people living at the home who does not have any verbal communication. This person contributed to the making of the DVD clearly demonstrating with staff support his/her needs, how to meet his/her needs and his/her aspirations and goals. We were told that funding has been obtained for some other people living at the home to have their plans filmed and stored on a DVD. Both formats provided clear information about the needs and wishes of the person living at the home. Information is included in each format about the support needed by the individual to manage any challenging behaviours, whether this is verbal, aggressive or withdrawal from activities. Reviews of the individual’s person centred plan every eight weeks include the use of a photograph diary in which photographs are collected evidencing those activities taken part in, the achievements of the individual and significant events. This means that people living at the home have a visual record of their achievements and their progress to meeting their identified goals and aspirations. Individual plans detail choices of people with regard to activities and daily life. Staff at the home at the time of our visit told us that regular house meetings provide the opportunity for people living at the home to express their views and make choices about daily lives, activities and other aspects of the running of the home. One of the people living at the home records the details of house meetings which are distributed to all living at the home. People living at the home are encouraged and supported to manage their own finances within their capabilities, with some managing their own bank accounts. People living at the home told us in surveys that they make decisions about what they want to do each day. The home encourages people living there to be as independent as possible. Comments from health and social care professionals include the home ‘enables residents toward independence’ and ‘treats people as individuals, helps them plan and live their lives’. Risk assessments are included in the care planning process for all aspects of daily life, including accessing the community. Actions to be taken to reduce any identified risks are detailed. 22 Argyll Street DS0000066058.V376326.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): This is what people staying in this care home experience: 12, 13, 15, 16 & 17. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have the opportunity to make choices about their lifestyle. The service supports them to take part in activities and learning experiences they enjoy and to develop their skills. People have the opportunity and receive the appropriate support to mix socially with their friends and to develop relationships. People enjoy a healthy and varied meal provision and are involved in the choice of meals. EVIDENCE: The statement of purpose/service users guide detailed that each person living at the home with the support of their key worker develops a person centred plan that details their wishes and aspirations about activities, social life, work, education. The AQAA told us that each person living at the home has an 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 14 activity plan detailing their choice of activities for the week. This can include college attendance, paid or voluntary work and individual or group activities arranged in the home or in the community. The activity plans are presented in a variety of ways depending on the needs of the individual. This can be in the written word, pictorial, or makaton signs. One plan we looked at detailed that the plan for the next day for the individual is displayed in pictorial form on a chart in the individual’s bedroom in the evening. This was demonstrated in the DVD of this person’s plan. This means staff know how to use the chart and to support the individual to understand the activities for the next day. When we visited the home all people living at the home were out of the home accessing education centres and day centres. Comments made by people living at the home in surveys included that they enjoy the social evenings arranged by the home, they enjoy going swimming and what the home does well includes arranging holidays and social nights. The service explores many avenues for the personal development of people living at the home including people living at the home being supported to help in the running of the home and the development of staff at the home. People living at the home are encouraged and supported to make use of community facilities. Individual preference about accessing community facilities are detailed in the care plans such as whether people like to be in large crowds or prefer quieter places. Risk assessments identify the support people need to access the community, whether this is one to one support or they are able to access the community independently. Discussion with staff at the home and information in the care planning process evidenced that people living at the home are supported to retain link with their families and their friends. The home arranges social evenings at local function rooms to which the peers and friends of people living at the home are invited including people from other care homes, day centres and people with learning disabilities that are living at their own home. This means people living at the home can meet and socialise with their peers outside the home and outside day centre/education centre settings. Comments in records of house meetings and in care plan reviews indicate that people living at the home enjoy these social occasions. Care plans detail the support people receive in developing personal relationships. People receive support from a relevant organisation about respect and sexual relationships. We were told by staff that routines at the home are flexible to meet the needs and wishes of people living at the home. Individual preferences about daily routines are included in the care planning documentation. We were told by people living at the home in surveys that staff respect their wishes and they are able to make choices about what they do and when they do it. The menu plan for four weeks is displayed on kitchen wall. We were told by staff that this plan is developed with people living at the home and is used as a 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 15 guideline for preparing meals. Records are kept of meals provided to people living at the home. Care plans detail nutritional assessments for people living at the home and any involvement of relevant health care professionals. 22 Argyll Street DS0000066058.V376326.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective care planning means people receive care and support in the way they like and their health care needs are met. Medication practices mean people have their health protected. EVIDENCE: The AQAA told us that care plans detail how each individual prefers to receive their personal care support. This includes personal preferences about bathing, details of what a person can do for themselves and what they need support with, any preferences of gender of carer providing personal care and support and personal preferences regarding toiletries. If a person requires the use of equipment, such as bath hoists, and shower chairs, clear details of how to use the equipment is included in the care planning. Individual records detail the health care input they receive. Each person has a 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 17 document that details all their health care needs. Records indicate the health care support individuals have recently received such as physiotherapists and GP’s. The sexual health of people living at the home is met by the involvement of relevant health care support agency which includes vice for the individual regarding breast and testicular checks and support and counselling about personal relationships. The service has policies and procedures about the safe management and administration of medications that include procedures to protect people who chose to manage their own medications. The AQAA told us that people living at the home are encouraged to manage their own medications. Of the two plans we looked at one of those people was managing their own medications. A relevant risk assessment was completed that identified any risks the person might be exposed to by managing their own medications and action to be taken to reduce identified risks. Staff records identified they have recived training about the safe management and administration of medications. Medication administration records we looked at identified the name of medication, the dosage required and the time and date when administered. For medications prescribed to be taken as required clear information is included in the medication records detailing the indications that show the medication is needed, the expected outcome after having the medication, the dose and any contraindications to having the medication. The manager confirmed that the prescriptions for each person living at the home are seen before medications are ordered. This means it is assured that people are receiving the medications that their medical practitioner has prescribed for them. We looked at the storage of medicines, which was in a clean and orderly manner. Surveys from people living at the home and health and social care professionals indicated that the health care needs of people living at the home are always met. Comments received included ‘I have seen residents in surgery, they are always accompanied by a well informed carer who appears to have a good relationship with the patient,’ and that the service ‘follows through on commitments made i.e. exercises regimes completed every day’. 22 Argyll Street DS0000066058.V376326.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are protected against the effects of abuse by a staff team that has a good understanding about safeguarding procedures. The service’s appropriate implementation of safeguarding procedures’ means people living at the home are protected relevant support is put in place promptly for people living at the home to resolve the issues that lead to such referrals. The service uses a variety of resources to ensure people living at the home have a good understanding about safeguarding issues and voicing concerns and complaints. EVIDENCE: Information about how to voice a complaint is included in the information a person receives when they move into the home. Details about how to voice a complaint or concerns are in each persons file and are produced in the format the individual will be able to understand whether it is written or pictorial. Responses that we received from surveys indicate that people living at the home know who to speak to if they are unhappy or have any concerns and they are aware of the complaints procedure. Regular house meetings provide opportunity for people living at the home to raise any concerns about the service before they escalate to being a complaint. Staff that we had conversations with during our visit to the home indicated they have a good 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 19 understating about the complaints procedure and that if they received a complaint about the home they would follow this procedure. Surveys from health and social care professionals indicate the home always responds appropriately if concerns are raised about the service provision at the home. The home has a procedure about safeguarding of vulnerable people that includes the local authoritys procedures for safeguarding and managing safeguarding alerts. Training records detail staff have received training about safeguarding adults and conversations with the staff group at the home at the time of our visit indicated a good level of understanding about safeguarding procedures. This means that people at the home are safeguarded from the effects of abuse with staff having a good understanding about what actions must be taken if they suspect an act of abuse has occurred. The service keeps records of any safeguarding referrals made. Discussion with the managers and details in the records of incidents at the home indicate that the service reports to the relevant authorities any events or issues relating to people living at the home that have a safeguarding element such as arguments between people living at the home that result in some physical aggression. The managers told us that by reporting these incidents it means people living at the home receive the appropriate support to manage or resolve any issues that are contributing to behaviours such a physical aggression. The AQAA told us that by working with independent advocates people living at the home have been made aware of their rights under safeguarding legislation. The service indicated it’s commitment to ensuring people living at the home have good understanding about making complaints and safeguarding issues by the use of role play in house meetings to explore issues and the development of a DVD covering relevant issues. 22 Argyll Street DS0000066058.V376326.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. People using 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. People live in a well maintained, comfortable and safe home that provides the relevant equipment so their needs can be met. EVIDENCE: The statement of purpose details the environment of the home including communal facilities and private facilities for people living at the home. Communal areas consist of two lounges, a kitchen diner, a conservatory and an accessible garden. All areas of the home are wheelchair accessible. The kitchen has work surfaces that can be adjusted to the height required by a person in a wheelchair or some one that needs to sit down whilst preparing meals. Bedrooms are situated on the ground and first floor of the house. Each bedroom is personalised with belongings of each individual, reflecting their 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 21 personal interest and hobbies. The AQAA told us that colour schemes for bedrooms are decided by the individual whose bedroom it is. Sufficient bathing and toileting facilities are located throughout the home. There is signage on all doors in written and makaton signs so people living at the home are able to find their way about. We were told that people living at the home have opportunity to discuss health and safety and maintenance issues at house meetings and in individual conversations with staff members. Details recorded of house meetings indicated issues about the maintenance and safety of the home are discussed. Details in the monthly reports made under regulation 26 indicate planned improvements for the environment of the home which include the refurbishment of one of the bathrooms to make it a wet room and the provision of a trampoline in the garden. Housekeeping of the home is completed by the staff and people living at the home. The degree of staff support to each person with this activity depends on the individuals needs. The home was clean and tidy on the day of our visit to the home. Surveys received from people living at the home indicate the home is always clean and fresh. The laundry is located away from food preparations areas reducing risks of contamination of food stuffs. Training records detailed that staff have undertaken training about the control of infection. 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. People using 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. People living at the home receive support and care from a staff team in sufficient numbers and with the relevant skills and experience. Recruitment procedures protect the wellbeing of people living at the home. EVIDENCE: The statement of purpose provides people with details about the staffing structure at the home and the skills and experience of people working at the home including the role of the key worker in relation to the needs of the person living at the home. The written rota is available that details which ambers of staff are working at any one time. A daily rota is displayed in the hall way of the home that details which members of staff is on duty that day, this is supported by photographs of the staff members so each person living at the home knows which members of staff are working for a twenty-four hour period. 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 23 We were told in the AQAA that the training department for South Wight Housing Association Ltd coordinates the training for staff members. Records detailed that in the past year as well as being up to date with training about mandatory topics such as moving and handling, fire safety, infection control and food hygiene staff have undertaken training specific to the needs of people living at the home such as training about Makaton. The training for makaton is provided by one of the people living at the home with support from a staff member who has recived additional training about makaton. A procedure is in place for the formal supervision of staff that covers all areas of the running of the home, care practices and the carer development of the individual. Staff records detail that staff receive formal supervision sessions at six times a year. The home encourages staff to undertake NVQ training and training about the needs of people with a learning disability. At present the home meets the required number of staff with NVQ level 2 in care or above. Records detail that that all staff have completed induction training that meets Skills for Care common induction guidelines including specific care practices for people with learning disabilities. This means that even a recently appointed staff member is provided with the skills to meet the needs of people living at the home. Staff told us in surveys that they always receive training that is relevant to their role and that their induction training covered everything they needed to know when they commenced employment at the home. Comments include ‘enthusiastic team- always keen to learn more’. The statement of purpose details that staff are only appointed after a thorough recruitment process has been completed. An agreement has been made that staff recruitment records are held at South Wight Housing Association Ltd main office base. However a record is held at the home of the start date of each member of staff and when checks against the Criminal Records Bureau and Protection of Adults list were received. These records indicated that staff do not commence employment before the necessary recruitment records have been received. Staff members told us they did not commence employment at the home until the home had received all their recruitment checks. This means people living at the home are supported and cared for by people who have the relevant skills and experience and of a suitable character to work in the care industry. We were told by the managers that people living at the home are supported to be involved in the recruitment procedure. Prospective staff members visit the home in an informal basis during which time people living at the home are encouraged to voice their own questions to the prospective staff member. The managers’ are hoping to use the recently developed personal centred plans on DVD with the individual’s permission as part of the recruitment process. This will mean that even those people who do not have verbal communication will 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 24 be able to be included in the recruitment process. 22 Argyll Street DS0000066058.V376326.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from an open and transparent management ethos that takes their views and opinions into account regarding day to day running of the service and seeks innovative ways to improve outcomes for them. The health and safety of people living at the home is protected. EVIDENCE: The statement of purpose provides people with details about the management structure at the home. There are two people who share the manager’s role of the home. Both these people are registered with the Commission as manager and both have the relevant qualifications and experience to run the home. There is effective communication between these two people that ensure the 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 26 home managed effectively with both having access to the same information. The managers provided information to support that they endeavour to run the home with the aim of improving outcomes for the people living at Argyll Street. This includes developing effective methods of producing accessible information for people living at the home for example personal centred plans being developed on DVD’s, supporting people to access relevant agencies to support them with their sexual and relationship concerns and providing access to a range of social activities where people living at the home are able to mix with their peers from outside the confines of the home. We received positive comments about the management of the home is surveys including ‘it(the home) has a great team morale and all line managers and seniors are approachable if needed’ and we have ‘a good relationship with the managers’. Quality assurance systems are in place and used effectively to monitor the environment and care planning documents. This includes the use of annual surveys of people living at the home, reviews of care planning documents, house meetings and continued dialogue with people living at the home. The views pf people living at the home are seen as an integral part of the running of the home. Changes made as a result of listening to the views of people living at the home include choices of individual, group activities and colour and decor schemes for communal and private rooms and the purchase and planned instalment of a trampoline in the garden. People living at the home are involved in the running of the service in that assistance is provided from one f them in the documenting of house meetings and the involvement of one person in the training of staff about makaton. The plan to utilise Personal Development Plan DVD’s with the permission of the relevant person in the recruitment procedure includes that person in the recruitment of staff for the home. Monthly reports (regulation 26 reports) on the conduct of the care home are completed which include the views of people living and working at the home, reviews of documentation and the environment add to the quality assurance of the service. Policies and procedures are in place for health and safety issues. Staff training records and their development plans detail training has been provided about health and safety issues such as moving and handling, infection control and first aid. Risk assessments for the environment of in the process of being completed, but risks posed to people living at the home as a result if the environment of the home is included in their care planning documents. Risk assessments are in place for working practices such as lone working, driving and health and safety for the staff members along with action ot be taken to reduce any identified risk. We looked at certificates for the servicing and maintenance of equipment at the home. These evidenced the health and safety of all at the home is protected by the regular maintenance of equipment and services as 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 27 recommended by relevant legislation or manufacturers guidelines. The fire log book was seen detailing the fire safety checks the home completes. The accident book is completed for all accidents or incidents occurring. 22 Argyll Street DS0000066058.V376326.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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 3 25 X 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 X 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 4 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 4 X 4 X 4 X X 3 X Version 5.2 Page 29 22 Argyll Street DS0000066058.V376326.R01.S.doc 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. Refer to Standard Good Practice Recommendations 22 Argyll Street DS0000066058.V376326.R01.S.doc Version 5.2 Page 30 Care Quality Commission The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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