Care Home: 296 - 298 Warren Farm Road

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What the care home does well Before a resident is admitted assessments are carried out about the needs of the residents. These assessments take place over a period of time and staff from the home visit the prospective resident in their home to try and develop a relationship. These assessments have enough information to deliver care whilst in depth care plans are developed. Resident`s care plans outlined the care needed to help with personal and health care. Staff were observed to be moving residents, giving meals and responding to agitation in the way it was described in resident`s care plans. Residents had access to health professionals when needed and this helped to keep them well. There are systems in place despite residents` communication disabilities to determine what residents like and do not like. Staff tried to ensure that care was provided to an individual way. For example toiletries were bought on an individual basis to meet residents cultural needs and preferences. Residents had risk management plans to help them access services such as going swimming as well as to keep them safe. Residents were involved in activities and were involved in the day to day home life. Relatives commented that the home provides a good all round life style. Arrangements were made for residents social and religious needs to be met. Residents had the opportunity for an individually planned holiday. Relatives were happy with the assistance they received in maintaining contact with the resident and with SENSE. Residents meals were planned and consideration was given to provide an individual healthy diet. Complaints and concerns raised with SENSE are taken seriously and action taken to resolve issues raised. This home is all on one floor and is suitable for residents with both physical and sensory disabilities. It had a relaxed atmosphere and was clean and fresh. There is a sensory room. Sense has a good system of recruiting new staff that ensures that checks are completed before they are employed. There is a good record of health and safety checks of the building and this helps to keep residents safe. What has improved since the last inspection? Another member of staff had been employed and more staff were now able to drive the home`s transport making access to activities better. Corridors and door ways were being redecorated to ensure that these could more easily be seen by the residents. The manager has now become registered with the us and this assists us in monitoring the home. What the care home could do better: Whilst medication is administered safely further actions could ensure that medication was easier to audit and systems clearer. Documents must be available for inspection at all times.Whilst the garden was safe and enclosed further development could make the garden more pleasurable and stimulating for residents. Relatives thought that there had been some changes in staff and use of agency workers that they felt made it difficult. Training for staff needed some improvement to ensure more staff have an National Vocational Qualification Level 2 in care and consideration should be given for some updates to be more frequent because of the level of physical disability the residents have. CARE HOME ADULTS 18-65 Warren Farm Road, 296-298 Kingstanding Birmingham B44 0AD Lead Inspector Jill Brown Unannounced Inspection 19th December 2007 09:30 Warren Farm Road, 296-298 DS0000030417.V348651.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 Warren Farm Road, 296-298 DS0000030417.V348651.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. Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warren Farm Road, 296-298 Address Kingstanding Birmingham B44 0AD 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) 0121 350 7076/7064 0121 3507076 julia.knight@sense.org.uk www.sense.org.uk Sense, The National Deafblind and Rubella Association Miss Julia Ann Knight Care Home 5 Category(ies) of Learning disability (5), Sensory impairment (5) registration, with number of places Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home may provide care for five 18-65 year olds with a learning disability and sensory impairments In addition to care manager, a minimum of 4 suitably qualified and competent staff are on duty throughout the working day at all times, 7.30am - 10pm One suitably qualified and competent member of staff and a sleep-in member of staff throughout the night, 10pm - 7.30am Date of last inspection Brief Description of the Service: 296 - 298 Warren Farm Road is registered to provide personal care and support to 5 adults with a learning disability, physical disability and sensory impairment, who have been assessed as requiring full assistance with daily living and other tasks. The home is staffed 24 hours a day including two waking night staff. Residents would be admitted to the home following a full assessment that would determine the level of support they require. The full range of medical services, leisure and social activities are provided for residents. A number of adaptations have taken place within the home in order to meet the assessed needs of residents. The adaptations include hoists and tracking ceiling hoists, moving and handling aids, wide doorways and corridors to accommodate wheelchairs. The front door bell and the fire alarm are linked to a flashing light system for the benefit of those who are hard of hearing. Communal rooms consist of a lounge, kitchen/dining room, assisted bathroom and a secluded rear garden. Each bedroom includes en-suite facilities consisting of toilet, wash hand basin specialist bath or walk in shower. An en-suite sleep-in room is utilised by a member of staff every night. Residents are encouraged and supported to maintain links with their families and the local community. The care needs of residents are monitored and reviewed and action is taken to address any concerns. The home is situated in Kingstanding, a residential area of Birmingham and has good access to local amenities. Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An inspector visited the home over 2 days in December without prior notice. A key inspection was undertaken which looked at all of the key standards. The inspection took place over about 9 hours. During the inspection two residents needs were case tracked. This case tracking involved looking at all the records and information about these residents, looking at their medication and their rooms and observing their care. This assists us to make a judgement about the care given. The people accommodated at this home have communication difficulties and it was not possible to fully ascertain their views of the service they receive. However contact was made with four of the residents’ families. Other documentation in regards to the running of this home were examined and a tour of the building was undertaken. We also took into account information we had received from all sources about the home since the last key inspection. Services are required to complete an Annual Quality Assurance Assessment (AQAA) on a yearly basis; information from this was used in this report. We have received a concern about the management of an activity for a resident since the last inspection this concern has been resolved appropriately. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: Before a resident is admitted assessments are carried out about the needs of the residents. These assessments take place over a period of time and staff from the home visit the prospective resident in their home to try and develop a relationship. These assessments have enough information to deliver care whilst in depth care plans are developed. Resident’s care plans outlined the care needed to help with personal and health care. Staff were observed to be moving residents, giving meals and responding to agitation in the way it was described in resident’s care plans. Residents had access to health professionals when needed and this helped to keep them well. There are systems in place despite residents’ communication disabilities to determine what residents like and do not like. Staff tried to ensure that care Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 6 was provided to an individual way. For example toiletries were bought on an individual basis to meet residents cultural needs and preferences. Residents had risk management plans to help them access services such as going swimming as well as to keep them safe. Residents were involved in activities and were involved in the day to day home life. Relatives commented that the home provides a good all round life style. Arrangements were made for residents social and religious needs to be met. Residents had the opportunity for an individually planned holiday. Relatives were happy with the assistance they received in maintaining contact with the resident and with SENSE. Residents meals were planned and consideration was given to provide an individual healthy diet. Complaints and concerns raised with SENSE are taken seriously and action taken to resolve issues raised. This home is all on one floor and is suitable for residents with both physical and sensory disabilities. It had a relaxed atmosphere and was clean and fresh. There is a sensory room. Sense has a good system of recruiting new staff that ensures that checks are completed before they are employed. There is a good record of health and safety checks of the building and this helps to keep residents safe. What has improved since the last inspection? What they could do better: Whilst medication is administered safely further actions could ensure that medication was easier to audit and systems clearer. Documents must be available for inspection at all times. Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 7 Whilst the garden was safe and enclosed further development could make the garden more pleasurable and stimulating for residents. Relatives thought that there had been some changes in staff and use of agency workers that they felt made it difficult. Training for staff needed some improvement to ensure more staff have an National Vocational Qualification Level 2 in care and consideration should be given for some updates to be more frequent because of the level of physical disability the residents have. 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. Warren Farm Road, 296-298 DS0000030417.V348651.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 Warren Farm Road, 296-298 DS0000030417.V348651.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements regarding pre-admission assessments indicate that adequate information is gathered to ensure that the individuals needs can be met by the home. EVIDENCE: Service users are only admitted after a full assessment. Sense have a referral and information officer that assesses residents suitability for placements. They and staff from the prospective home visit the new person in their home or their placement before they admitted. Staff spend time some time shadowing shifts to ensure that a relationship between staff and the service user can develop. Extensive information is collected about the service user, including health conditions, engagement, mobility, mood and behaviour, nutrition and so on. These assessments include specialist assessments, which are carried out by the Practice Development Workers. Whilst the newest admission did not have a care plan the assessment included transitional plans to ensure that staff knew how to give the care needed. Observation showed that care staff were giving the care appropriately. Warren Farm Road, 296-298 DS0000030417.V348651.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are generally reflected in their individual plans. Risks are identified and plans put in place to minimise them. EVIDENCE: The planning and risk assessments for two residents were inspected and it was found that appropriate levels of planning took place to meet residents health and personal care needs. It was clear from the assessments that needs were identified and good plans were devised to meet these needs. For example in care staff were informed in one plan that a service user gets impatient during personal care and this could be a trigger for aggressive behaviour. Staff showed during the inspection that they had read this information as one staff member apologised to the resident at one point for not being quick enough for them when getting the service user ready to go out. Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 11 Care plans were reviewed. Daily records indicated what the resident does during the day but also recorded information about residents’ likes and dislikes as they were identified. This recording helps plans and care become more personalised. Residents have information recorded about the ways that the individual communicates and this is important as this enables staff to determine when a resident is unhappy, ill and so on. Staff that had come on duty after being away had checked records and were aware of residents’ needs. Each resident has a core team of staff, who meet monthly, to monitor the care plan, progress on achievements, goals, health care and to action any points. Minutes of these core meetings were available. Sense is now training staff to develop person centred planning methods and these will assist the staff to make plans even more person –centred. Residents’ cultural needs were addressed and toiletries to ensure personal hygiene needs were met appropriately were found in the individual’s bedroom. Arrangements were made to ensure that risks had management plans devised to ensure that risks to residents were minimised and that residents could be helped to have interesting lives. This included a resident with epilepsy having a risk management plan so that they could go swimming safely and a resident had a risk management plan to minimise the effects of a house dust allergy. Warren Farm Road, 296-298 DS0000030417.V348651.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. People who live in this home have the opportunity to be involved in activities to meet individual needs and personal development is encouraged and supported by staff. A wholesome and varied diet is offered and specialist dietary needs are catered for. EVIDENCE: Leisure activities were arranged that fitted with the preferences of the residents. A new resident continued with their attendance at a day centre to ensure that there was a degree of stability in their life over the transition period of their move into the home. Care records showed residents had opportunities to go out into the community and to centres for activities. A resident had activities of swimming, foot massages, going shopping, listening to music, going for meals, helping with preparation of food, looking at interactive books and story telling, going to the library, going for a drive and going to a party over a period of 2 weeks. Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 13 Residents have been enabled to get out more as the home has more staff that are able to drive the home’s vehicle. The manager was looking at continual improving the activities available to the residents and activities that would be appropriate for residents with sensory losses. There has been an improvement in the number of staff that can drive and this increases the opportunities for the residents. During the inspection residents went out to the local shops to buy ingredients to make a cheesecake and then this was made. Residents were assisted to maintain relationships with their relatives despite the distance sometimes involved. A relative stated ‘We had a great weekend in July with (the resident) and (their carers) when they came to visit me.’ A resident’s plan had the information to phone the parent every Friday. It is an area of good practice that SENSE employs a Family Liaison Officer. Regular newsletters are sent out to relatives. Additionally, a family weekend is arranged annually at a local hotel where relatives can meet with SENSE representatives and other relatives. Attention is paid to residents cultural and religious backgrounds and a relative stated ‘My (relative) is Greek Orthodox and is taken to church about once a month and I feel (their) needs are met.’ Another relative said that the home ‘Provides a good all round lifestyle.’ All the residents have had the opportunity of an individual organised holiday including one resident going to Tenerife and one going to Centre Parcs. There are guidelines for all activities and to ensure that residents get the most out of these activities. Residents eating preferences and assistance needed are recorded. One resident’s record said that the resident liked Weetabix for breakfast and it was observed that the resident was having this with a banana. There is a good nutritional assessment undertaken and this helps for residents that are risk of choking to have these risk minimised. One plan explained that a resident prefers to feel food before eating. The staff were encouraging residents gain more independence and despite a recent assessment that a resident needed to be fed the staff were seen encouraging a resident hold a loaded spoon successfully. Menus were supplied for two residents these showed that residents’ dietary needs were individually considered and showed that residents were getting the healthy benefit of fruit and vegetables in their diet. Warren Farm Road, 296-298 DS0000030417.V348651.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Plans that enable the health care of residents are available and these are carried out in practice. Methods of understanding residents communication and systems to ensure that residents care is given in the way residents would wish are in place. Medication is administered in a safe way. EVIDENCE: There are detailed plans in place to ensure that residents are moved in a safe manner and in a way that maximises the independence of the resident. These include photographs of a staff member in the right position in slings etc to inform staff. A resident was observed being assisted to move from wheelchair to sofa and from sofa to wheelchair and these were consistent with the plans made. Residents were only restrained in wheelchairs where there was an identified need and these restraints were of a type to ensure there was no chance of slipping from the restraint. Whilst residents in some cases have Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 15 wheelchairs with no footplates records demonstrate that these have only been removed on advice from physiotherapists. The home has a level access to the front and into the garden so residents in wheelchairs could use these areas. Equipment and adaptations in the home were made to meet the specific needs of individual residents such as high low beds, high sided beds, tracking hoists and so on. Resident’s were well dressed appropriately to their age preferences and comfort. The home has both female and male resident’s and the staff group is also gender mixed. The home has staff from diverse cultural background and this assists residents to receive any cultural care they need. Residents’ health action plans showed that residents had access to specialist health staff to ensure that their health was maintained. The home was looking at a more user-friendly format for this information. One of the residents case tracked was having access to a consultant for a specified health condition, dentist, foot care, optician a weight clinic, neurology and physiotherapy there had been no need for contact with a GP since the last inspection. The resident’s health action plan also contained information about another specific rare health condition and this is useful for staff. Residents’ records had the dates and length of time of any seizures that residents may have had and this assists the home in determining whether there are any signals for these events. Medication was being administered appropriately with few errors in recording being made. However systems needed to be simplified so only one system is in use. For ease of auditing the amount of medication received should be placed on the Medication Administration Record (MAR) and hand written MAR should have a second signature to ensure that the information has been transcribed correctly. Warren Farm Road, 296-298 DS0000030417.V348651.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 arrangements for making complaints ensure that residents’ and relatives views are listened to and acted on. Arrangements are sufficient to ensure that residents are protected from abuse. EVIDENCE: We had one concern raised with us since the last inspection and this was about the management of an external activity and how this may have put a residents dignity at risk. The management of the home investigated this concern and steps were taken to overcome the concerns raised. There were no records of any other concerns being raised. The manager was aware that residents were unable to communicate concerns effectively and was looking at other ways of collecting residents’ views through a residents forum. All comment cards received from relatives were happy with the service offered. SENSE provides a 24-hour complaints line available to all an employs an investigations officer to ensure that complaints are looked into thoroughly. We have received no referrals of an adult protection nature about the care residents received. Previous inspections have found that the policy and procedures on adult protection have been satisfactory. A member of staff spoken to understood about their personal responsibility about reporting adult protection issues. There was an appropriate record of any accidents or unexplained marks on residents and these were routinely looked at for any Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 17 patterns or themes to ensure that these could be minimised. These were also reported in the individual’s monthly core meeting. SENSE arranges audits of the money held independent of the home’s staff. The management had responded to the areas suggested in that report. There were adequate records of residents money however was not available on the day of the inspection a photocopy of the entries was provided subsequent to this visit. There was one error where money had been put into the wrong residents wallet however after investigation this was found and the entries in the records tallied. We found evidence that residents’ money was used in ways to enhance the individuals’ lives. Although there is an independent audit of residents’ money it is recommended that the money be checked weekly to ensure any accounting errors can be spotted quickly. Warren Farm Road, 296-298 DS0000030417.V348651.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, comfortable, safe, hygienic and well maintained home and efforts are made to improve the environment to meet residents sensory and physical needs. EVIDENCE: The home was purpose built for its registered category and many adaptations have been incorporated. There is a range of specialist equipment to meet the current residents needs. The front door bell and fire alarm are linked to a flashing light system for the benefit of those who have hearing problems. The accommodation is all one level making it ideal for residents with mobility difficulties. The doorways were wide enough to accommodate wheelchairs. The doorframes were being painted black and corridors yellow to increase the visibility of the doorways for people with sight loss. Some objects placed on doors, that help residents know what room they were in, had to be removed whilst this decoration was undertaken. The home had a welcoming feel and rooms such as the office were well placed to greet visitors. The home was Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 19 clean, fresh and decorations were in place for Christmas. One relative commented ‘what they do well is provide a good, clean and friendly atmosphere. There is an enclosed garden that is neat and tidy however we and the manager feel that further could be done to improve the access around the garden and planting to make it a more sensory experience for residents. Bedrooms were decorated in an individual style to reflect the residents’ interests. The furniture and specialist equipment including beds were appropriate to the individual resident and tracking hoists where needed. All of the bedrooms have bathing facilities and these are of differing types appropriate to the needs of the residents. The décor of some areas were becoming tired however plans were in progress for the home to be decorated throughout. The home has a sensory room for residents to spend some time with staff and one of the corridors has a wall with items to feel and touch as they move along and this enhances residents’ experiences. The laundry room has a commercial washing machine and tumble dryer and this was adequate to ensure the risks of infection were minimised. Warren Farm Road, 296-298 DS0000030417.V348651.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): 32,34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been improvements in the staffing since the last inspection however further recruitment is needed to ensure that continuity of care can be maintained. Staff recruitment is robust and this helps to safeguards residents. Training needs to be more consistent to meet the needs of residents. EVIDENCE: There were good interactions between staff and residents seen throughout the day. Staff that were in the home following leave had a good questioning approach to gaining updates on residents needs. Relative comment cards said that the use of agency staff and the changing of staff caused them concern. There are currently 2 vacancies and one member of care staff had recently been employed and there had been consideration to the ethnic and cultural backgrounds of the residents. Staff rota looked at showed that staff worked overtime or that agency staff were used to cover shortfalls. The Annual Quality Assurance Assessment Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 21 showed that there was an intention to recruit to the remaining two vacancies and this should alleviate these staffing issues. Staffing levels were being increased to meet the needs of residents that had increased since the admission of a new resident. The previous inspection found that staff were employed in a robust and appropriate way. The newest member of staff employed since the last inspection had the appropriate, application form, interview references and checks to ensure the safety of the residents they would be caring for. A staff member interviewed felt that they were supported in their role and received regular supervision. Staff were encouraged to undertake a National Vocational Qualification level 3 in care which is above the required level 2, however only 30 of staff have this qualification and a further 23 are undertaking it this is below recommended levels. The home has a rolling programme of training and this covers a wide range of issues including requirements for LDAF training. There were gaps in mandatory training for some staff such as the fire safety and moving and handling. The frequency of moving and handling training updates needed to be reviewed as the residents of the home had extensive moving and handling needs. Warren Farm Road, 296-298 DS0000030417.V348651.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): 37,39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager is experienced and possesses the skills to oversee the day to day management of the home. The quality assurance system serves to promote continual improvements for the benefit of residents. Arrangements in respect of health and safety are robust and prevent residents from injuries. EVIDENCE: The manager of the home has recently become registered with us. She has successfully achieved an National Vocational Qualification level 3 in care and is working towards a level 4 in care and a Registered Managers Award. Since her appointment as manager she has undertaken several in house courses to support this role such as Supervisions and Appraisals , recruitment and selection and Management of risk assessments. There have been no disciplinary issues with staff. She has also undertaken some mandatory Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 23 training. Staff spoken to found that the manager to be approachable and committed to the good care for residents. There were good quality assurance mechanisms and audits in place. This includes monthly visits to the home by a service manager who completes a report. The Annual Quality Assurance Assessment indicated that data is collected monthly which gives analysis of the homes performance and that the home had achieved investors in people. An example of this was the homes monitoring of accidents so that any themes can be identified and acted upon to minimise any problems. The organisation ensures good contacts with relatives to ensure that their views can be part of the planning of future performance. Health and safety documents about fire, electrical wiring and gas safety were sampled and found to be in date. Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 24 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 X 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000030417.V348651.R01.S.doc 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Warren Farm Road, 296-298 Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 25 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 YA2 Good Practice Recommendations The amount of medication received should be written on the medication administration record (MAR) for ease of auditing. The handwritten MAR should have two signatures to ensure that transcribing of medication details remains correct. Further clarity on the process of administration of medication should be undertaken so all staff use the same system. Residents financial documents must be available for inspection at all times. Consideration should be given to further development of the garden area. At least 50 of all care staff must successfully complete training in NVQ level 2 or equivalent. DS0000030417.V348651.R01.S.doc Version 5.2 Page 26 2 3 4 YA23 YA24 YA32 Warren Farm Road, 296-298 5 YA35 Reviews of the time intervals between update training must be reviewed to reflect the vulnerability of the home’s residents. Warren Farm Road, 296-298 DS0000030417.V348651.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Birmingham Office 77 Paradise Circus Queensway Birmingham B1 2TD 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 Warren Farm Road, 296-298 DS0000030417.V348651.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!