Care Home: 3 Moultrie Road

Similar services:

• The Lodge Nursing Home
• Bracken House
• Sunnycroft
• Field Farm House
• Edgeview Nursing Home
• Church Terrace Nursing & Residential Home
• The Forbury

What the care home does well Recovery plans (care plans) are in place providing the essential information that staff require to support people to develop their independence whilst they are at the home. The people at the home are properly involved in the development of personal goals and reviewing their progress to meet them. Support is available to help people to identify opportunities that suit them. This includes educational, employment and leisure pursuits. The home is situated close to Ruby town centre making it easy for people to walk shops, churches and other facilities.Support is provided for people to access health professionals where they need their advice and treatment. Suitable arrangements are in place for investigating complaints and allegations of abuse. Staff are trained to recognise and report any suspicions of abuse so that people are protected from harm. Talks on stranger danger and keeping safe have been provided to help people to stay safe when out in the community. Staff are provided with training to do their work safely and are provided with opportunities to take care qualifications that equip them for their role. Staff have been provided with equality and diversity training to support the delivery of care and support that is in keeping with individual`s needs, preferences and choices. Satisfactory arrangements are in place for checking that the home is running properly. Fire safety equipment is being properly serviced and maintained to make sure it works well in the event of a fire. What has improved since the last inspection? People moving to the home have their needs assessed before they move in and are provided with information about the service they may expect to receive so that they can decide if the home is the right place for them to move to. Medication risk assessments are carried out to ensure that people managing their own medication understand what medication they are meant to take and when they should take it. This is then monitored to ensure that people take their medication properly. A senior manager visits the home each month, to check that it is running well, so that any problems may be identified and addressed promptly. What the care home could do better: The current fees are not published in the service user guide. The manager said that she would address this so that people preparing to move in to the home have the correct information available to them. There has been personal relationship and sexuality training for staff at the home. This training is beneficial in helping staff to respond sensitively and appropriately to people involved in personal relationships within the home. The healthcare records are mixed in with other day records, making it more difficult to find evidence of health appointment outcomes. If health issues were recorded separately it would make it easier for staff to monitor and keep track of people`s health needs.Where people hold their own bank cards, a risk assessment should be drawn up to take account of any support they may need to keep it safe and protect them from exploitation, where necessary. Overall the home is comfortable and homely. There is scope for improving some of the carpets and floor coverings which are looking worn, to make the home nicer for people. New staff are vetted to make sure they are suitable to work at the home and they are provided with an induction and ongoing training to equip them for their work. A training matrix is recommended, to help demonstrate that staff training needs are being reviewed and monitored on an ongoing basis and gaps in staff training are being provided for. The manager said that she would expand the questionnaire used to survey the views of people at the home, to include more questions about the service. This will provide an opportunity for people to comment more widely on issues in the home. The manager said she would also send surveys to professionals who visit the home to seek their views of the service to contribute to the ongoing development of the service. The manager said that she would apply to register with us as soon as she has received her Criminal Record Bureau check, which should be through shortly. CARE HOME ADULTS 18-65 3 Moultrie Road 3 Moultrie Road Rugby Warwickshire CV21 3BD Lead Inspector Kevin Ward Unannounced Inspection 22nd September 2008 08:20 3 Moultrie Road DS0000004314.V372254.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 3 Moultrie Road DS0000004314.V372254.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. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 3 Moultrie Road Address 3 Moultrie Road Rugby Warwickshire CV21 3BD 01788 547585 F/P 01788 547585 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.rethink.org Rethink Manager post vacant Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 3 Moultrie Road is a large, three-storey, Victorian town house, close to the centre of Rugby. It is owned and managed by Rethink. The Home is domestic in nature and is indistinguishable as a care home from the neighbouring properties. The rooms are large and airy and generally well maintained. The home caters for six people with enduring mental health problems, providing 24-hour support and encouragement to enable service users to regain their independent living skills. The Home is within walking distance of the town centre; there are accessible gardens to the rear of the property. The inspection report is given to all of the people living at the home and a copy is available in the entrance hall for visitors. The range of fees was not available at the time of inspection. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good outcomes. This was a key inspection. A key inspection addresses the essential aspects of operating a care home. This type of inspection seeks to establish evidence of continued safety and positive outcomes for the people using the service. The inspection focused on assessing the main Key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file by us, such as notifications of accidents, allegations and incidents. The manager completed and returned an annual quality assurance questionnaire on time, containing helpful information about the home in time for the inspection. Questionnaires were completed and returned by 4 people at the home and a health professional, enabling them to give their views of the service. There are currently five people living at the home. The inspection included seeing 4 people living at the home and case tracking two people’s needs. This involves looking at people’s care plans and records and checking how needs are met in practice. One person was in the process of moving out of the home at the time of the site visit and was not seen. Documents in other people’s care plans were also sampled to verify health professionals’ involvement has been sought where necessary. Discussions were held with two daytime staff and a night care staff, as well as the manager. A number of records, such as care plans, complaints records, staff training certificates and fire safety records were also sampled for information as part of this inspection. What the service does well: Recovery plans (care plans) are in place providing the essential information that staff require to support people to develop their independence whilst they are at the home. The people at the home are properly involved in the development of personal goals and reviewing their progress to meet them. Support is available to help people to identify opportunities that suit them. This includes educational, employment and leisure pursuits. The home is situated close to Ruby town centre making it easy for people to walk shops, churches and other facilities. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 6 Support is provided for people to access health professionals where they need their advice and treatment. Suitable arrangements are in place for investigating complaints and allegations of abuse. Staff are trained to recognise and report any suspicions of abuse so that people are protected from harm. Talks on stranger danger and keeping safe have been provided to help people to stay safe when out in the community. Staff are provided with training to do their work safely and are provided with opportunities to take care qualifications that equip them for their role. Staff have been provided with equality and diversity training to support the delivery of care and support that is in keeping with individual’s needs, preferences and choices. Satisfactory arrangements are in place for checking that the home is running properly. Fire safety equipment is being properly serviced and maintained to make sure it works well in the event of a fire. What has improved since the last inspection? What they could do better: The current fees are not published in the service user guide. The manager said that she would address this so that people preparing to move in to the home have the correct information available to them. There has been personal relationship and sexuality training for staff at the home. This training is beneficial in helping staff to respond sensitively and appropriately to people involved in personal relationships within the home. The healthcare records are mixed in with other day records, making it more difficult to find evidence of health appointment outcomes. If health issues were recorded separately it would make it easier for staff to monitor and keep track of people’s health needs. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 7 Where people hold their own bank cards, a risk assessment should be drawn up to take account of any support they may need to keep it safe and protect them from exploitation, where necessary. Overall the home is comfortable and homely. There is scope for improving some of the carpets and floor coverings which are looking worn, to make the home nicer for people. New staff are vetted to make sure they are suitable to work at the home and they are provided with an induction and ongoing training to equip them for their work. A training matrix is recommended, to help demonstrate that staff training needs are being reviewed and monitored on an ongoing basis and gaps in staff training are being provided for. The manager said that she would expand the questionnaire used to survey the views of people at the home, to include more questions about the service. This will provide an opportunity for people to comment more widely on issues in the home. The manager said she would also send surveys to professionals who visit the home to seek their views of the service to contribute to the ongoing development of the service. The manager said that she would apply to register with us as soon as she has received her Criminal Record Bureau check, which should be through shortly. 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. 3 Moultrie Road DS0000004314.V372254.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 3 Moultrie Road DS0000004314.V372254.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 and 2 Quality in this outcome area is good. Suitable procedures are in place for assessing people’s needs and providing them with information before they move in, to ensure the service is suitable for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four people were staying at the home at the time of the site visit and one person was in the process of moving out and was staying at their flat in the community. One new person had been at the home for two days, over the weekend, as part of an ongoing assessment period, with a view to staying at the home if they liked it. The person concerned said that they had been made to feel welcome and already knew some people at the home, which was making it easier to settle in. Their file was checked. A care co-ordinator’s (e.g. social worker) assessment was seen and an assessment had also completed by a team leader and staff member at the home. In surveys completed by the people at the home, everyone confirmed that they had received an information pack (service user guide) when they were preparing to move in, so they knew what the service had to offer. Licensee agreements, detailing people’s rights 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 10 and responsibilities, have been issued by the landlord, evidence of which was seen on care files. The service user guide does not contain the current fees. The manager agreed to add this information so that it available to new people. The manager also said she had plans to review and update the Statement of Purpose. This is important so that placing officers have current information about the home and the service provided. 3 Moultrie Road DS0000004314.V372254.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 and 9 Quality in this outcome area is good. The people living in this home are involved in decisions about their lives and are playing an active role in planning their care and the support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three people’s care plan files were checked. Two people had recovery plans and risk assessments on file containing the essential information required for staff to meet their needs appropriately, such as support with medication, money and staying safe. In discussions with a team leader and a member of staff they were able to demonstrate a satisfactory knowledge of people’s support needs. The manager confirmed that everyone’s mental health was currently stable and no specialist services were required for people. Comments by staff and the manager confirmed that no one at the home currently requires practical assistance with personal care tasks, which might require more advice in the support plans. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 12 A care plan had yet to be developed for the new person at the home. The team leader said that a care plan would be written with the involvement of the person concerned and would take account of the home’s assessment information and clinical risk assessment that were seen on file. The home has a number of measures in place for monitoring and reviewing people’s ongoing care. Weekly evaluations are carried by staff whereby they record progress and events in relation to the achievement of people’s individual goals recorded in their recovery plans. One of the evaluation records contained a good summary of progress whereas the other was not very informative. The manager said that she would remind staff of the purpose of the forms and how they are to be completed to ensure that the information recorded is purposeful. Monthly support sessions also take place with people, involving their care cocoordinators and keyworkers to review their progress and set new goals. Review notes were seen on file as evidence that people’s needs are being formally reviewed with their involvement. Two people confirmed their involvement in regular reviews and planning meetings. Their signatures were also seen on meeting notes, as further verification of their involvement. The risks to people in their day-to-day lives have been assessed. Again, people have been involved in the development of these assessments. These have been reviewed and updated as needed, following any changes in people’s well being. The home promotes a culture of positive risk taking to encourage people’s independence in a supportive way. Good work has taken place to develop links with the local community police service. This service has been used to provide people with advice on staying safe in the community and “stranger danger”. 3 Moultrie Road DS0000004314.V372254.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): 12,13,15,16 and 17 Quality in this outcome area is good. Daily living activities promote independence and opportunity for people to live ordinary and meaningful lives in the community where they are living. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The people at the home confirmed that they are consulted in everyday issues that affect them and that regular meetings take place to discuss routines and make plans, such as occasional holidays and activities. This was also verified in meeting records. A rota is in place for carrying out domestic tasks, such as emptying bins and cleaning in the communal areas. Two people spoken to confirmed that the arrangements had been discussed and agreed at house meetings. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 14 The manager explained that the home makes purposeful use of the organisation’s education and employment officer to help people to identify training and employment opportunities. A person at the home explained that they currently enjoyed voluntary shop work and were completing a computertraining course, as well as regularly playing golf and snooker. One person has just started a new college course to develop their employment skills and another person has accessed English and maths training. A person at the home explained that they like to attend the local church social activities during the week, including music recitals. People confirmed they are free to come and go as they please but are asked to let staff know if they are not returning home at nights, to reduce concerns about their personal safety. In a survey a person comments “ You are always allowed to do whatever routine you have, unsupervised or if necessary assisted”. Everyone is issued with a key to their bedroom and the front door so they can exercise their independence so that their privacy is respected. A person at the home confirmed that they had somewhere to lock their personal belongings to keep them safe. A person at the home explained that they are allowed to have visits from friends and relatives. The manager explained that visitors are able to stay till 10pm and that the people at the home are responsible for their visitor’s whereabouts. The manager said that restrictions are only placed on visits from people who are assessed to be a danger to anyone at the home, to ensure that everyone stays safe. Entries in the visitors’ book further demonstrate that people are receiving regular visitors at the home. Comments by staff indicate that proper consideration is being given to appropriately supporting people involved in personal relationships. However there has been no recent staff training with regard to sexuality and personal relationships. This training may be beneficial in assisting staff to respond sensitively to personal relationship issues in the household. People are provided with an individual food budget for purchasing their personal groceries and they take it in turns to shop for shared items, such as washing powder and cleaning materials. A person at the home explained that everyone has their own kitchen cupboards and a designated space in the fridge and the freezer for storing their foodstuffs so that it does not get mixed up with other people’s provisions. The people at the home confirmed that they are encouraged to at healthily but can make their own choices. Two people explained that staff support is available should they need help with cooking. A person at the home confirmed that they are being provided with help to cook a wider variety of foods so that they have more mealtime choices available to them. The staff on duty 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 15 confirmed that they are provided with food hygiene training to support safe kitchen hygiene practices. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People are provided with the care and support they need to meet their needs. There is scope for improving health records to assist in the monitoring of people’s health needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments by people at the home indicate that they find the staff to be friendly and supportive. The staff on duty were seen to approach people in a respectful manner and to be responsive to their requests for advice and assistance. The people at the home confirmed that they have control over their lives, coupled with support when they need it. Three people who were spoken to all confirmed that it is a nice and friendly place to live in and that overall people get on well together. Comments by people at the home confirmed that staff are mindful of their privacy and respect their personal space. As previously noted the manager explained that everyone at the home is currently well and not in need of extra support from health service 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 17 professionals. Review notes demonstrate that people’s care is being reviewed with the involvement of care co-coordinators, including a consultant psychiatrist in some instances. Two peoples records were checked for evidence of health professional appointments. The outcomes of people’s health appointments are currently recorded in the day records, which also contain all other forms of daily information. This made the health information difficult to find and does not assist staff to monitor people’s health needs or to determine when check ups may be due, e.g. dental checks and eye tests. The manager agreed to keep a separate record on each person’s file for recording their health appointment outcomes and to add more information in recovery plans concerning health monitoring and check ups. Comments by two people at the home confirmed that they receive all the support they need to attend health appointments. Entries in a persons health notes show that support has been provided to attend consultant-monitoring appointments to meet their personal physical healthcare needs. A lockable cabinet is in pace for the safe storage of medication. People are encouraged to manage their own medication where they are able to do so. To achieve this, their tablets are set up in a weekly dosage box by the pharmacist. This is underpinned by a risk assessment, (checked on two files) which is completed by staff with the involvement of the person concerned. The risk assessment includes checking that people understand the reason for taking their medication as well as the times when it is due. Entries in a person’s record show that they stopped taking their own medication for a brief period following two missed doses. A member of staff explained that the monitoring was increased so that the person concerned had their medication checked on a daily basis rather than weekly. The manager explained that no one at the home is currently prescribed PRN (as required) medication for the treatment of mental illness. The manager said that she would arrange for PRN protocols to be written. These are necessary to advise staff of the purpose of the medication and to make sure it is given out appropriately. Two staff on duty and the manager said that they had received medication training. Two staff training certificates were seen as verification of this. A medication workbook was seen, that staff complete as part of their training, which includes assessment by an external assessor before they receive their training certificates. The manager said that a number of staff have also received accredited medication training at Warwickshire college. The manager said that any unused medication is returned to the pharmacist. Evidence of this was seen in the medication returns book, which contains the signature of staff and the chemist to verify the return of unused medications. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 18 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 19 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 Suitable complaints procedures are in place and staff are trained to recognise and report suspicions of abuse, so that people are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no complaints to us about the home since the last inspection. The complaints log was checked. There has been one minor complaint since the last inspection involving differences between people at the home, which was resolved with advice from staff. There is a written complaints procedure that is available to people and their families or representatives. Four people at the home completed surveys to inform the inspection process. In the surveys everyone reports that they know how to complain. Comments by people spoken to, indicate they have confidence in the staff and the manager to act upon their concerns and take them seriously. The manager stated that most staff have been provided with adult abuse training in the last 2 years and said that more training was planned in the coming months. The manager also explained that she is attending more adult protection training, including abuse reporting procedures, shortly. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 20 The manager explained that there has been an allegation of assault made by a person at the home involving a stranger. The records show that this was reported to the police and Warwickshire Social Services Department and properly investigated. The incident was not reported to us as required. The manager said that she would ensure that any future allegations are reported to us in the correct manner so that we are kept properly informed of serious events at the home. The manager explained that people manage their own money and she does not hold anyone’s cash for them. The manager said that she currently holds one person’s bankcard in safekeeping on their behalf. The manager said that the card is kept safe and could only be accessed by herself and the team leader. She explained that the organisation’s policy is changing and in future and she would not be able to hold cards for people and they would need to keep it safe themselves. The manager agreed to ensure that this is underpinned by a risk assessment, detailing appropriate staff support and monitoring. This is necessary to safeguard people against financial exploitation and to ensure that they are supported to manage their money properly, where necessary. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 21 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 and 30 Quality in this outcome area is adequate. 3 Moultrie Rd provides comfortable, homely accommodation. There is scope for improving some of the floor coverings in the home to make it nicer for people to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The main lounge is comfortable and homely and provides a nice area for people to relax in. Two people’s bedrooms were viewed with their agreement. Both people said that they enough space and were satisfied with their rooms. One person’s carpet was badly stained and would benefit from cleaning or replacement. A carpet cleaner is available in the home for people to use. The carpets in the hallway, stairs and landing are looking old and showing signs of wear and tear. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 22 The Communal areas also include a smoking room and a large kitchen diner. People chose whether they wished to spend time in the communal areas or in their own rooms. The kitchen has sufficient cupboard space to enable people to store their food separately from others. Two kitchen units had drawer fronts missing where they had broken off. The manager said that she had reported this matter and it was being addressed. Communal bathrooms and toilets were clean and had toilet rolls and facilities for washing and drying hands. The tiles on the floor of an upstairs bathroom are old and cracked, which would make it unpleasant for people to walk on. A member of staff reported a leak in one of the toilets in the morning. This was promptly reported to a plumber who dealt with the problem the same day, so that the people at the home were not inconvenienced any longer than necessary. People take responsibility for the cleaning of their own rooms and there is a shared rota for the communal areas. People spoken with were happy with sharing the domestic cleaning, which is agreed at house meetings. Cleaning schedules are in place for day and night staff, which are signed as tasks are completed. People do their own personal laundry and staff wash the towels and bed linen. There are enough washing and drying facilities. Protective aprons and gloves are available in the conservatory for staff to use. The manager said that she intended to purchase new storage units so that this equipment could be located in bathrooms around the house, to make it easier for people to make use of. 3 Moultrie Road DS0000004314.V372254.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 and 35 Quality in this outcome area is good. Staff are vetted and trained to do their work so that the people at the home are supported by a suitable staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager reports that there are typically two staff on during the day and one in the evening during the week. This was verified in recent staff rotas. There is one staff in the morning and evening at weekends and an extra worker is employed during the middle of the day when things are busiest. The manager said that extra staff are made available in the event that there is an increased risk due to changes in people’s needs or to support extra activities and holidays. Discussions with the people at the home indicate that this is sufficient for them to access the level of help and support they currently need. The home employs two male staff and some shifts are covered by a male member of bank staff. This means that the people at the home are able to access staff of the same gender for advice and support, where this may be more appropriate on occasions. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 24 The manager explained that interviews include people supported by the organisation and said that two people at the home have agreed to fulfil this role at forthcoming interviews. This is good practice and demonstrates a commitment to enable people to exercise a degree of control over decisions that affect them. Two people’s training records were checked. The records indicate that staff are being provide with access to a good range of training to support them in their work role, such as mental health awareness, relapse, anti discrimination, suicide awareness and equality and diversity. The manager reports that all the staff employed at the home now hold National Vocational Qualifications (NVQ) at level 2 or above, to equip them for their work. A newer member of staff, already holding NVQ, level 2 explained that she has now enrolled for NVQ level 3 training. Comments by staff on duty indicate that they are provided with periodic updates to refresh their knowledge of safe practice subjects, such as, first aid, food hygiene, moving, safe handling of medication and safeguarding against adult abuse. A training matrix, summarising staff training was not available at the home. The manager provided a matrix following the site visit summarising the this information along with two people’s individual training records, as verification of training carried out to date. The information indicates that most staff have received safe practice refresher courses and where this is not the case, training is being identified for staff. There has been no personal relationships and sexuality training provided at the home. This training is beneficial in helping staff to respond sensitively and appropriately to people involved in personal relationships within the home. The manager said that she would look out for suitable training in this subject, to further support staff in their work. Staff files containing staff full recruitment information are held at organisation’s head office in Birmingham and were not seen on this occasion. Copies of two staff members Criminal Record Bureau reference numbers and references were seen, providing evidence that suitable vetting checks are carried out to ensure that only suitable staff are employed at the home. POVA first checks (banned workers list) are being carried out when staff start work before the full Criminal Record Bureau check is processed, in keeping with safe practice. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Satisfactory quality assurance systems are in place to support the ongoing development of the home. Appropriate measures are in place for maintaining a safe environment for the people to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has completed the National Vocational Qualification in Care, level 4 and explained that she has enrolled to complete Management and Leadership training in Social Care Services. These qualifications are suitable to quip the manager for her role and responsibilities at the home. A team leader is also employed to support the manager to run the home. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 26 The manager said that she is waiting for her Criminal Record Bureau Check to be processed by the Criminal Records Bureau. She said that she would send in her application form to register with us promptly once she has received it. A number of quality assurance measures are in place at the home to support it to run efficiently. At the time of the site visit, a quality assurance assessment was being carried out by “Re Think” quality assurance team. They explained that they would be examining all the systems that are in place for the smooth running of the home and would complete a report with their recommendations for further improvement, where necessary. Questionnaires were sent to the people at the home to complete in April 08. The questionnaires focused on the support provided by keyworkers and provided an opportunity for people to pass comment on this area of staff practice. The manager said that she intended to devise a more expansive questionnaire to enable people to comment on other aspects of the service they receive in future. She also said she would send questionnaires to professionals to seek their views. As previously noted, regular house meetings take place, which provide an opportunity for people to get together to discuss domestic routines and make plans for occasional outings and activities. “Re Think” also runs a consultation group for people using their services. The meeting is used for people to comment on policies and receive advice on issues that affect them. This has included a citizen advice workshop and talks on debt, safety, direct payments and employment advice. Three staff at the home confirmed that they receive regular access to planned supervision, most months. This was also verified in staff supervision records. The records demonstrate that supervision sessions are used purposefully to consider care practices and training issues. Regular staff meetings (notes seen) are also carried out to consider the changing needs of people at the home and support good team working. A shift handover meeting takes place between shifts, at which significant information is passed on including, issues related to people at the home and any appointments. A shift handover record is in place to prompt and record the completion of tasks that are essential for the smooth running of the home, such as medication checks, care notes recorded and cleaning tasks carried out. Reports of recent monthly monitoring visits were checked. The reports show that the visits include seeing people at the home and talking to staff to assess any concerns. These visits indicate that managerial support and monitoring is taking place to support the effective running of the home. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 27 A number of Health and Safety records were sampled. The fire log shows that the fire alarms and emergency lights are being tested and fire drills are carried out in the home. This was also verified in comments by staff and the people that live there. Maintenance certificates were seen, verifying that the fire equipment is being maintained by a fire maintenance contractor to keep it in good working order. The homes fire risk assessment has been dated to indicate it has recently been reviewed. The manager confirmed that everyone in the home is ambulant and able to exit the building via the stairs, in the event of a fire. Hot water in the home is being routinely monitored and logged to ensure that it odes not present a risk of scalding. Records show that a contactor is employed to check the cold water to prevent the risk of legionella developing in the home. The maintenance records show that electrical and gas appliances have recently been checked to make sure they are safe. The manager said that she is awaiting the gas certificate to be sent to the home as payment for the maintenance check is still being processed. 3 Moultrie Road DS0000004314.V372254.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 2 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 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 2 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 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 3 x 3 Moultrie Road DS0000004314.V372254.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 2 3 Refer to Standard YA2 YA15 YA19 Good Practice Recommendations The current fees should be included in the service user guide, so that people planning to move in have clear information about the charges. Staff should be provided with personal relationship and sexuality training to help them to support people where necessary. A separate record should be set up for the recording of healthcare appointments, in order that health needs are not confused with everyday recordings so that people’s health needs can be more easily monitored. Where people hold their own bank cards, a risk assessment should be drawn up to take account of any support they may need to keep it safe and protect them from exploitation, where necessary. Plans should be made to review the carpets and floor coverings in the home, with a view to replacing those that are in poor condition. A training matrix should be kept updated, providing an up DS0000004314.V372254.R01.S.doc Version 5.2 Page 30 4 YA23 5 6 YA24 YA35 3 Moultrie Road 7 8 YA39 YA39 to date summary of training provided to staff. This is necessary to help demonstrate that effective monitoring of training needs within the team is being carried out. Proceed with pans to expand the survey sent to people to encourage them to comment on more areas of the service, so that they can affect the development of the home. Proceed with plans to send surveys to professionals involved at the home, to enable them to pass comment on the service, to contribute to the development of the home. 3 Moultrie Road DS0000004314.V372254.R01.S.doc Version 5.2 Page 31 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. 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