Care Home: 306 Southend Road

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What the care home does well Residents received very individual care and it was evident during the inspection that the staff were there for the residents and the service provided enhanced their lives. Feed back from relatives was very positive and included `I am in constantly in touch with the home and staff. All discussions are frank and open and decisions are arrived at amicably`, another added that their relative was in a `caring and loving environment and is happy and content`. Care is provided with dignity and respect and residents are involved in the day to day running of the home. Staff incorporate the residents in conversation about general issues and there was a real family feeling. One relative stated in their questionnaire that `I can only hope that if I should ever need to be taken into care, such a home can be found for me`. There is a very open atmosphere in the home and the staff were very positive about the Manager and stated she was approachable and offered advice when needed. What has improved since the last inspection? The Manager has now produced a pictorial Service Users Guide for residents, which provides simple pictures and signs to explain the service provided by the home. The Manager has been working on care plans during the past 12 months and information is now there to enable staff to provide the care required. They have been written from the residents` point of view, which gives the feeling that the resident has been involved in the process and includes their own wishes and choices. Some decoration has been completed around the home, to include the communal areas and also individual residents bedrooms. The home is clean and tidy and provides a good homely feeling for residents and relatives. The Manager has been working to get the paperwork side of the home in order. Information was easily available and evidence for recruitment, supervision and training could be produced, although all these areas still need some further development. Medication practices have been reviewed and a new `buddy` system introduced to enhance safe practice. CARE HOME ADULTS 18-65 306 Southend Road 306 Southend Road Wickford Essex SS11 8QW Lead Inspector Mrs Sharon Lacey Unannounced Inspection 24th June 2008 10:00 306 Southend Road DS0000018121.V366472.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 306 Southend Road DS0000018121.V366472.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. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 306 Southend Road Address 306 Southend Road Wickford Essex SS11 8QW 01268 570702 F/P 01268 570702 michellejones@hamelintrust.org.uk www.hamelintrust.org.uk Hamelin Trust 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) Michelle Jones Care Home 4 Category(ies) of Learning disability (4), Physical disability (4), registration, with number Sensory impairment (2) of places 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2007 Brief Description of the Service: 306 Southend Road is a modern purpose built bungalow providing care and accommodation for up to four people with profound physical, learning and sensory disabilities. The premises are owned by Mosaic Essex, but managed and run by Hamelin Trust. A web site is available for the organisation on www.hamelintrust.org.uk The home is located a short distance from Wickford. Local facilities are available in the village of Shotgate where the home is located and both Basildon and Southend town centres are a short journey away. The home provides residential accommodation on one level and there is adequate space for wheelchair users. Specialist equipment and adaptations such as hoists and bathing aids have been incorporated into the design to enhance the facilities for residents. There is an enclosed garden with a small patio area to the rear of the property. Limited parking is provided to the front and side of the property. The home is located on public transport routes. The home has their own minibus to facilitate community access. The fees were advised as being between £264.27 and £265.52 per night (£1849.89 to £1858.64 per week). The fee includes an annual seven-day holiday. Additional fees were advised as being for personal toiletries and individual leisure items such as the theatre. Further information about the home can be found in the Service Users Guide and Statement of Purpose. 306 Southend Road DS0000018121.V366472.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 two stars. This means that people who use this service experience good quality outcomes. This was a routine unannounced inspection, which took place over seven hours. It was a Key Inspection covering 29 of the National Minimum Standards. A tour of the home and an inspection of the environment was completed and records and documentation were viewed. Areas looked at included information given to residents about the home and its services before being admitted, information gained by the home from residents when they first come into the home, how this information is then given to staff on the care required, the facilities and environment of the home, and any complaints that may have been received since the last inspection. Also the staffing and management of the home were inspected. An Annual Quality Assurance Assessment (AQQA) was sent to us by the Manager. The AQQA is a self-assessment which focuses on how well they considered they are meeting the outcomes of the people using the service. It also provides statistical information about the service and how the service intends to improve over the next 12 months. Information from this document has been used in this report where appropriate. All residents at Southend Road are unable to communicate verbally. Due to this much of the evidence gathered from residents was through observation and interaction with the staff. Questionnaires were sent out to residents (4), relatives (4) and also health care professionals . Four residents and two relatives returned completed questionnaires and feedback from these has been included in the report. All staff members on duty were spoken with informally during the inspection and any feedback has been included as part of the report. Staff questionnaires were also distributed and three were received back. At the end of the day the inspection was discussed with the Manager and advice and guidance was given regarding the findings. There is an easy read summary of this report available. What the service does well: 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 6 Residents received very individual care and it was evident during the inspection that the staff were there for the residents and the service provided enhanced their lives. Feed back from relatives was very positive and included I am in constantly in touch with the home and staff. All discussions are frank and open and decisions are arrived at amicably, another added that their relative was in a caring and loving environment and is happy and content. Care is provided with dignity and respect and residents are involved in the day to day running of the home. Staff incorporate the residents in conversation about general issues and there was a real family feeling. One relative stated in their questionnaire that I can only hope that if I should ever need to be taken into care, such a home can be found for me. There is a very open atmosphere in the home and the staff were very positive about the Manager and stated she was approachable and offered advice when needed. What has improved since the last inspection? What they could do better: 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 7 Although staff received daily support from management and monthly meetings are also arranged, one to one supervisions still need to be developed. Southend Road have a core group of staff who have been at the home for a long time. Although training has been provided, updates are needed on some of the mandatory areas. 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. 306 Southend Road DS0000018121.V366472.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 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is information available to enable people to make a choice about living at Southend Road and through assessment, be reassured that their needs can be met. EVIDENCE: The Statement of Purpose and Service User Guide were reviewed. Both documents had recently been updated and were well presented and provided good information on the services Southend Road offered. The Manager had recently produced a pictorial Service User Guide using simple language for those residents who were unable to read. Both documents are kept in the Managers office, but it was recommended that each of the four residents and relatives were provided with a copy. The AQAA stated that new residents are only admitted when a full community care assessment has been provided by social services and a full health care assessment provided by a community nurse. The resident is involved in the assessment by gaining details of their likes and dislikes, community activities, preferred routines for getting up, going to bed etc. and other formal day services or employment. The AQAA stated that senior staff would visit the prospective service user in their own home There had been no new admissions since the last inspection. Two of the residents had been living at Southend Road for at least 14 years and the remaining two have been there for a number of years. There is a set 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 10 assessment form, which covered all the areas listed in Standard 2.3 of the National Minimum Standards and would provide sufficient information to write the care plan. One relative spoken to during the inspection confirmed that they had been part of the assessment process when their relative first came to live at Southend Road. It was established that introductory visits to Southend Road are organised and this is usually completed over a six-week period and would include an overnight stay. The Service User Guide clearly provided information about trial visits to the home. A copy of the homes last inspection report and registration certificate were also made available. 306 Southend Road DS0000018121.V366472.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. This judgement has been made using available evidence including a visit to this service. All residents had care plans that identified their specific needs, with clear instructions to staff which would ensure that safe and individualised care is constantly provided. Residents are encouraged to participate in everyday life at the home and systems had been put in place to help them be actively involved in any decision-making processes. EVIDENCE: The AQAA stated that care plans had been improved over the past 12 months and this process had involved the relatives. Evidence showed that resident care plans had been developed since the last inspection and were now more detailed. Two residents files were inspected and these contained a residents profile form, which included information on the persons’ care needs and clear details on how these were to be met. These documents described the needs of the individual resident and had been regularly reviewed and updated. Other areas covered in each resident’s file included behaviour charts, care plans for epilepsy and detailed daily record sheets. One relative spoken to during the inspection confirmed that they had been involved in their relatives’ care plan 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 12 and was always informed of any changes. Staff spoken to were very knowledgeable of residents’ needs and abilities and were observed trying to encourage independence and choice as much as possible. Residents at 306 Southend Road have no verbal communication, but staff were observed interacting with residents and including them in a day-to-day tasks within the home. There was regular communication between staff and they incorporated the residents in any conversations and spoke about what each individual resident had done during the day and encouraged residents to responded in their own way. Due to the restricted abilities of the present residents, systems have been put in place, which take this in to account to ensure that they are involved in the decision making processes as much as possible. Staff were observed watching the residents’ expressions and behaviour to gain feedback. Regular meetings have been organised with residents, relatives and staff to discuss issues about the running of the home, these occur on a six weekly basis and minutes of meetings were made available. All present resident’s had relatives who are actively involved in their care. Systems were in place to assist with residents’ finances, but some relatives also helped in this matter. Advocacy services are arranged if needed. The AQAA stated that risk assessments had been developed due to a new Health and Safety representative who had recently been trained. Risk assessments were in place and these had been updated and reviewed as necessary. Individual risk assessments for fire evacuation were found to be on each residents file. These raised some questions due to only one staff member being on duty at night and it had been written that when each individual resident was evacuated, they were not to be left due to their epilepsy. This would not be possible due to the remaining three residents being left at risk and this needs to be reviewed. 306 Southend Road DS0000018121.V366472.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. This judgement has been made using available evidence including a visit to this service. Activities are provided which enhance each resident’s leisure and educational opportunities. The menu available offers choice, but still meets each individual residents dietary needs. EVIDENCE: From the evidence gathered it was clear that the residents of Southend Road are given opportunities for personal development and to maintain social, emotional and communication skills. Every resident at the home attends some form of formal day care services and there are also one-to-one activities organised. On the day of inspection one resident was taken out by staff and their relative to organise attendance to a local college. Also, on the day of inspection three residents had been to formal day care services and on their return, much of the communication with the staff was around how their day had been and what they had been doing. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 14 There was clear evidence that all residents living at the home were provided with a range of activities and community contact. Community links had been developed and one relative stated that the home is part of the community and that efforts have been made by the staff to achieve this. Residents use the shops and services within the local vicinity for haircuts, pharmacy, dentist, GP and also the local church. The Manager stated that the staff try to arrange activities that residents can easily participate in. The activities folder contained evidence that residents had been involved in bowling, going to the cinema, swimming, watching the TV, pamper nights, music, DVDs, shopping and going out for meals. One relative also reported that trips to the local theatre had also been arranged in the past. They also added that their relative did more at the home than they would be able to arrange themselves. Evidence of both individual and group trips was gained. All the residents had just returned from a weeks holiday at Centre Parcs. It was stated that this had been huge success and the Manager was in the process of trying to organise another visit next year. Southend Road has its own minibus to help facilitate community access. The AQAA stated social activities had increased considerably. As part of the improvement planned for the next twelve months they want to provide staff with training on planning activities to help increase their awareness of the importance of planning in advance. Once planned, they want to introduce picture formats for residents so they have a better understanding and can be involved in this process. Whilst observing during the inspection it was clear that the staff, residents and relatives had good relationships and residents are supported to maintain family links. There was a relaxed feeling within the home and relatives spoken to stated they were always made welcome and could call in at any time. A three week menu is used within the home. The staff advised that the menu had been made up using their knowledge of the residents likes and dislikes. The menu seen offered variety and had been organised taking the dietary needs of each resident into account. A nutritionist is also involved if there are concerns in regards to residents’ dietary needs. Clear records were available of what each resident had eaten at each meal time and also the quantity. On the day of inspection it was noted that fresh vegetables were being used and there were plenty of food stocks in the kitchen. Feedback from relatives regarding food included the meals are good and choice is offered. The Manager advised that there is an option of a cooked breakfast at the weekend for residents. The AQAA stated that they wanted to encourage social meal events, where family and friends can be invited. One relative reported that they had often been invited to stay for a meal. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to receive personal support in the way they prefer and have their physical and emotional care needs monitored and met. There are clear procedures on the safekeeping and administration of medication, which safeguards residents. EVIDENCE: There was written evidence on individual files that the physical and emotional needs of the residents were being monitored, and that they had access to community health facilities. Care plans contained information on the health care needs of the individual and there were details of hospital visits, GP visits and dental visits etc. Staff were observed providing personal care and assistance, whilst ensuring they maintained the residents privacy, dignity and independence. Each resident was advised by care staff what care was going to provide and what was happening. The AQAA stated that they want to improve a better working partnership with parents/carers on agreeing the best interest of the service user and agreeing on age appropriate matters such as clothes, hairstyles etc. One relative spoken to confirmed that residents are encouraged to choose their own clothes and hairstyles. Support is given to try and enable the residents to have choice in getting up, going to bed and also other general routines within the home. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 16 The residents had also been involved in choosing the colour of their bedrooms when they were recently decorated. Written evidence was available that the residents received personal support in a way they preferred and their individual care plans were very detailed and included residents’ preferences where possible. Southend Road also has a Key Worker system, which enables the staff member to get to know the individual resident and provide care in the most appropriate way. The AQAA stated that they also have an associated key worker who can support the resident when the main key worker is not on duty. Whilst observing staff it was very clear that they were all aware of each individual residents care needs and also their likes and dislikes, which aided continuity of care. The staff had identified each individuals ethnic, religious and cultural background and this has been incorporated as part of their individual care plans (if and when appropriate). Both staff who returned questionnaires confirmed that they felt they had the experience and knowledge to meet the different needs of the people they cared for at this included disability, age, gender, race, ethnicity and faith. There were individual pieces of equipment around the home to meet residents’ needs regarding their physical disabilities. This included chairs and beds, which provided the right support and comfort; they also had their own hoist slings to ensure their safety. Southend Road has a medication policy and procedure. None of the present residents are able to administer their own medication and rely upon staff to assist in this process. During a tour of the home the medication was checked and it was noted that bottles of medication had been dated when opened, storage was good and two of residents had photos to assist in identification. The Inspector has since received confirmation that the remaining two residents photographs have now been put in place. Of the records sampled these were well maintained with no anomalies noted. It was confirmed that staff had been provided with medication training, which consisted of going through a workbook to ensure their competency. One staff member was observed administering the tea time medication. Due to recent medication error, Southend Road have introduced a Buddy system, so each individual residents medication is double checked by two staff before being administered. A member of the management team also audits medication on a monthly basis. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their families can expect to be provided with sufficient information to enable them to make a complaint about the service. People can be confident that the policies and procedures in place are there to assist in the protection of abuse, neglect and self harm. EVIDENCE: There is a clear complaints procedure, which is available to all residents and their families and is also part of the Service Users Guide. The manager did not have a complaint/compliments folder, but information had been stored in a separate cardboard folder. On looking through this information it was apparent that the last complaint the home had received was in 2005. The information had not been stored in any particular order and it was difficult to establish the actual investigation and outcome. The proprietor has recently produced a set form to record details of any new complaints, and this included space for the investigation and outcome. None of the residents would have the ability to make a complaint and would need to rely on family members or friends. Feedback from the two relatives questionnaires confirmed that they knew how to make a complaint and when this had occurred the Manager had always responded appropriately. The AQAA stated that over the next 12 months the complaints procedure and fire notice will be made into a user friendly format. Policy and procedures were available on Whistle Blowing and Safeguarding Adults. The Manager had produced a training matrix and from the evidence taken from this, all but three staff had completed training on Safeguarding 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 18 Vulnerable People. There have been no safeguarding referrals since the last inspection. There are clear policy and procedures regarding residents’ monies and financial affairs. Many of the present residents also have some assistance from relatives and regular audits are completed by the organisation. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a homely, comfortable and safe environment, which meets their individual needs. EVIDENCE: Southend Road is a purpose-built home and is suitable for its stated purpose and offers residents a safe and well maintained environment. The corridors and rooms provide sufficient space and there is adequate space for wheelchair access. There are good furnishings and fittings around the home, which help provide a homely atmosphere. Each resident has their own bedroom, which had recently been decorated to a colour of their choice. Each bedroom contained personal belongings and photographs, which helped individualise and make it a personal space. None of the bedrooms have ensuite facilities, but there is access to a hand wash basin. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 20 The Manager explained that some decoration had been completed around the home whilst the residents were recently on holiday. She added that they were still waiting for the lounge carpet to be replaced due to a large stain where the radiator had leaked. The bath in the bathroom had recently been replaced and staff commented that it was now more suitable for residents, as it was deeper. They added they were still waiting for the hoist to be changed to accommodate the new bath. It was noted during a tour of the home that the bathroom was still being used to store equipment. Residents had been provided with the specialist equipment they required to help maximise their independence. This included hoists, special beds for each individual, special chairs adapted for each individual and the use of a minibus with a lift to maximise access to the community. Southend Road offers a safe and well maintained environment, which was clean and free from odours. Five staff files were checked for infection control training, but only two contained evidence that this had taken place. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 21 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, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents cannot be confident that they will receive care from a skilled, experienced and supervised workforce. Residents can be assured that they are supported and protected by the homes recruitment policy and practices. EVIDENCE: The files of two new staff were inspected to see whether the proprietor’s recruitment policy had been correctly followed. Both files contained evidence of all the required information. Whilst looking through the files it was noted that one applicant had not provided a full employment history and there was gaps, which did not appear to have been investigated and the outcome recorded; this was brought to the Managers attention. New staff are provided with a five-day induction course, which incorporates the Skills for Care requirements. It was stated that the induction incorporates moving and handling training, the Care Standards, learning disabilities, person centred training, health and safety, food safety, safeguarding, first aid, infection control, epilepsy, communication, report writing and challenging behaviour. Certificates are issued to staff on the completion of this training and evidence of some training was seen on the files inspected. Of the two 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 22 staff who responded to questionnaires both reported that their induction covered everything they needed to know about the job before they started. Most staff have the skills and experience necessary for the care tasks they are expected to do. The Manager provided a copy of a matrix showing staff training. From this it was confirmed that staff had attended training in moving and handling, fire safety, first aid at work, food safety, health and safety, medication and gastrostomy feeding. From the information it was evident that some staff needed to attend or have further updates on moving and handling training (8), fire safety (6), health and safety (1) and medication training (4). With regard to staff that had completed NVQ training it was established that five staff had completed their NVQ 2 and four more had recently registered. The Manager has NVQ 4 in Management and Care and is to commence a leadership management course in September 2008. At present the home has not achieved the recommendation that 50 of its care staff achieves NVQ 2, but the AQAA submitted recognised that this was an area for improvement. Most staff had worked at the home for a number years and from observation were well aware of each individual residents needs. Comments received from relatives regard the staff were very complimentary and they felt the staff had the right skills to look after the residents properly. Comments included the care received has been all that I could have wished for and my relationship with the staff is one of mutual respect and friendship, I am kept fully informed of my relatives health and well being. Another relative added they are a good team who ensure the residents needs are met and are fully focused on the individual. Staff rotas viewed contained details of the staff member, their job title and the shift to be completed. At present the home has three staff members on duty for the a.m. and p.m. shift, which is sufficient and allows some one to one time for residents during the day or the evening. At night there is only one staff member on duty for the four residents. Due to the complexity of the residents care needs and their abilities it was considered that this was insufficient. One resident needed hourly attention and it also raised concerns about the safety of the residents of the staff member became ill or injured themselves. As previously stated the fire risk assessments completed for each individual residents highlighted that none should be left alone once evacuated from the home, which would make this impossible. This issue was discussed with the Manager who advised that they were presently in the process of talking to individual social workers to try and rectify this issue. During the last inspection it was established that staff had not been provided with supervision. During this inspection four staff files were randomly inspected and some contained evidence that supervision had occurred, although it did not meet the recommended number. There was written 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 23 evidence that staff meetings and senior meetings had occurred since the last inspection and these had almost been on a monthly basis. Southend Road is a small home and staff were observed gaining support and advice from the Manager during the inspection. The Manager stated that there is a policy and procedure for supervision and was aware that this was an area that still needed further development. The AQAA submitted also confirmed that this was an area they planned to improve over the next 12 months. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home is run by person who has the necessary experience and skills. Residents and relatives can expect to be approached to gain their views about the running of the home and the care provided. EVIDENCE: The Manager has the experience and knowledge to run the home. She has achieved her NVQ 4 in Management and Care and is aware of her responsibilities with regard to running the home. One relative spoken to stated they had extreme confidence in the Manager and staff reported that the Manager was very approachable. The Manager advised that she receives regular support in the running of the home and is able to gain advice if and when required. During the inspection she showed a good knowledge of the standards and regulations, but did not always have systems in place to provide the written evidence that may be required. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 25 There were systems in place to gain the views of the residents and relatives about the care provided and the running of the home. Questionnaires had been sent out to residents and relatives, but to date no feedback or reports had been written. Relative and residents meetings are organised on a six weekly basis and clear evidence of these were available. There are also systems in place for management to visit the home and complete certain checks each month. Evidence of these visits were made available. Due to the home being contracted with Essex County Council, they also receive an annual visit for contract compliance. The AQAA stated that they intended to improve their quality assurance system for their residents over next 12 months; this was also an outstanding requirement from last year’s inspection. The Manager was aware of her responsibilities regarding the health and safety of both staff and residents. Evidence was gained that regular checks had occurred on the fire alarms, electrical appliances, hoists, pest control, gas appliances and a fire risk assessments. The only area that had not been regularly checked was with regard to the water temperatures around the home. The last time these had been recorded was the 24th of October 2007, but none of the present residents would have the ability to use the hand wash basin without assistance from a staff member or a relative. There was a regular record of bath temperatures the staff had recorded. The homes insurance certificate was seen and was in order. 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 26 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 3 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 3 26 X 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 36 2 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 3 X 2 X X 2 X 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 1 YA32 18(1)(c)(i) Staff should receive 31/10/08 sufficient training and updates to ensure they have the skills and are suitably qualified to provide the care required. This is in connection to staff receiving regular updates on moving and handling, infection control, medication and fire safety training to ensure they are within health and safety guidelines. 2. YA33 18 (1) (a) Staffing should be reviewed at night to ensure that the needs of residents are being met and it is appropriate to the health and welfare of residents. To ensure residents’ safety, regular checks need to be kept on the water temperatures. This is a repeat requirement, the first time scale for this was the 23/05/07. Second timescale set. 31/07/08 3. YA42 13(4) 31/07/08 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 28 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. Refer to Standard YA1 YA22 Good Practice Recommendations It is recommended that all residents receive a copy of the new pictorial Service Users Guide. It is recommended that a complaints/compliments folder is introduced to ensure this information stored in some form of order. It is recommended that at least 50 of staff should be trained to NVQ level two or above. The homes communal bathroom areas should not be used for storage. Outstanding recommendation from last inspection. 5. YA34 It is recommended that any gaps in employment are explored and the reason clearly recorded. All new staff must provide a full employment history. It is recommended that staff should receive supervision at least 6 times a year and this should be clearly recorded. It is recommended the quality assurance systems with in the home are developed further. So that service users are provided with quality care outcomes, the quality of the care provided must be monitored and the registered provider must establish and maintain a system reviewing the quality of care at the home that involves all stakeholders and produce an annual development plan for the home. 3. 4. YA32 YA28 6. 7. YA36 YA39 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 306 Southend Road DS0000018121.V366472.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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