Care Home: 32 Bentinck Road

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What the care home does well People are properly assessed before they are admitted to live at the service so that they know that their needs can be met at the home. They have access to good information as well as visits to make sure the home is right for them, and they can make informed decisions because of this. We found that people`s needs are assessed very well in discussion with them, that their views and decisions are clearly recorded and respected. We found the service balances well the risks people face with their right to make decisions about their own lives. Where people may lack capacity the staff use imaginative ways of trying to support them with their memory. People live very flexible lifestyles at the service, activities and opportunities to learn and develop are available if people want to do this. We found that people are encouraged to take control of their own lives and circumstances and that their independence is promoted very well. We found that very few people need support with personal care, but where this is needed the staff are considerate and respectful towards them, preserving their dignity. People`s health needs are assessed well and referrals for treatment are offered, if people refuse this and they have the capacity to make that decision their wishes are recorded. Medication is safe and well managed. The environment is safe, well maintained and suitable for the needs of people who live at the service. People told us they like their rooms and they like living at the service. The people who live at the home told us, "I am aware of the complaints procedure and how it works. I use the form." They also told us they feel safe at the service. We found they are protected by well trained staff. The staff have very good access to a wide range of training, much of it focused on the particular needs of people who live at the service. The people living at the service told us, "If I want something to if I`ve got a problem there is always someone there to listen or help." Staff and people living at the service told us that the home is well run. People commented, "the manager is a lovely man and he will always make time to speak to you". "They act on what we say. They send out questionnaires for us to fill in telling them what we think of living here. I tell them what I am telling you, I love it here, I really do". What has improved since the last inspection? Everyone who works at the service has a Criminal Records Bureau check before they start working at the home so they can make an informed decision as to whether to employ people. What the care home could do better: We found there are several documents and pieces of information we would expect tosee on the staff files which were missing. We were assured by the manager that these have been obtained but we have no way of proving that this is the case. This means we cannot be certain that the recruitment procedures at the service protect people from those who may not be suitable to work with them. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 32 Bentinck Road 32 Bentinck Road Hyson Green Nottingham NG7 4AF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Linda Hirst     Date: 2 2 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: 32 Bentinck Road 32 Bentinck Road Hyson Green Nottingham NG7 4AF 01158417730 01158417731 dave.milburn@frameworkha.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr David Milburn Type of registration: Number of places registered: Framework Housing Association care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 32 Bentinck Road is an extended detached house within easy access to various community facilities, public transport and Nottingham City centre. The service is provided for up to 17 people aged 49 years and above who have been homeless or who may have mental health needs a dependence on alcohol. People are allowed to consume alcohol in a wet lounge, in the home, there is also a dry lounge for people to use who do not want to drink. All of the bedrooms are single and they are available on both the ground and the first floor of the home. As the first floor is only accessible by stairs these bedrooms are unsuitable for people who may have mobility needs. The ground floor entrance can be accessed at the back of the building, where the ground is level. The service will shortly be temprarily accommodated elsewhere whilst major alterations, building works and improvements are made to the accommodation. The Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 17 17 17 17 Brief description of the care home current weekly fees are £456.31 there may be additional costs for hair dressing and food. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The Quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is based upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the people Care Homes for Adults (18-65 years) Page 6 of 31 who live there and how they can and intend to improve their service. We received this back from the manager in good time and the form was well completed and helped us to plan our visit and to decide what areas to look at. We also reviewed all of the information we have received about the home since we last visited and we considered this in planning the visit and deciding what areas to look at. We received 8 surveys from people living at the home and 2 from staff to get their views on the service being provided. Comments included, there is excellent care and support, communication between the staff and myself is excellent. If I want something or if Ive got a problem, there is always someone there to listen or help. The main method of inspection we use is called case tracking which involves us choosing three people who live at the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. English is the first language of all of the people living at the home at the moment, but there are several people living at the home who come from minority ethnic groups and we case tracked one person to make sure their equality and diversity needs are assessed and met at the service. The staff team come from a wide variety of backgrounds and experiences. We spoke with two members of staff and three people who live at the service to form an opinion about the quality of the service being provided to people living at the home. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who live at the service. What the care home does well: What has improved since the last inspection? What they could do better: We found there are several documents and pieces of information we would expect to Care Homes for Adults (18-65 years) Page 8 of 31 see on the staff files which were missing. We were assured by the manager that these have been obtained but we have no way of proving that this is the case. This means we cannot be certain that the recruitment procedures at the service protect people from those who may not be suitable to work with them. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who want to live at the service have their needs fully assessed to make sure that they can be met at the service. They are given good quality information on which to base their decision about living at the service. Evidence: The manager told us in his Annual Quality Assurance Audit that the staff carry out a comprehensive needs assessment, interview and tour of the service as part of the referral process. He told us that each person who wants to live at the service is given a copy of the service users handbook and a full assessment of their needs is undertaken before admission. We found that there is a clear statement of purpose and service user guide in place in addition to a tenancy agreement which indicates expected levels of behaviour when living at the service. Each person has an assessment done by the staff at the home to make sure their needs can be met at the service before they are admitted. This incorporates drug and alcohol use, mental health, offending, issues around gender, Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: sexuality, race and religion. It is a well rounded assessment document. People who live at the service told us that they either already knew about the service as they were living at other places owned by the provider, or they came to look around, liked the home and decided to move in. People who returned surveys to us all said they received enough information about the service to make an informed choice and they commented, I was very well informed, and I have learned a lot as I have gone along. I feel a bit in the dark sometimes because of my memory. We found the staff have worked extensively to assist people who need extra support because of their memory loss and there are white boards in every bedroom for staff and people living at the service to use to remind them of key information. The staff we spoke with were knowledgeable about the admissions process and told us, referrals can come from anywhere, people have a formal interview, usually here. We try to consider the dynamics of the existing service user group, especially if there has been a previous volatile history but we would try most people. The referral form and interview is here for staff to access. I feel we are well informed. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: The manager told us in his Annual Quality Assurance Assessment that that each person who lives at the service has a support plan taking account of their needs and preferences which is constantly updated. He told us that every person has risk assessments linked to their support plans, and there are agreed risk assessments for each person reflecting what they want to happen if they are absent from the home for a given period of time. The service uses a Written Agreements, Preferences and Instructions form and people complete these with their key workers to indicate their preferences in their day to day life. The manager told us that there are weekly residents meetings, and everyone who lives at the service is informed about the Service User Participation and Empowerment advocacy service. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: We found the support plans are well written; each person who lives at the service has two files, one which offers quick access to key information for staff and the full file for all other documentation. We found the plans are written in a person centred way and they take account of the entirety of peoples lives. They cover issues around cultural isolation, physical and emotional vulnerability and sexuality well. They give staff clear and comprehensive information about peoples preferences and decisions. The people who live at the service have very diverse and sometimes complex needs and there is a well balanced approach towards risk taking which takes account of peoples rights and wishes as well as potential harm. The support plans, risk assessments and Written Agreements, Preferences and Instructions are signed by the people living at the service. The staff we spoke with confirmed, the support plans are written with the residents and the standard has really improved, we review them at team meetings. I think service users wishes and decisions are given a high priority here. If people dont recognise a need and there are real risks, we will devise that plan without their input but in most circumstances we would include them. I have experienced people who refuse to acknowledge the issues but I chip away, we try and meet somewhere in the middle. We look for solutions as a staff group but it can be really difficult at times. People who live at the service told us, they care for you well here. They know what theyre doing and how to help. Another commented, Its been great living here, it really has, I love it here. Some people need a lot more help but Im fine, I can manage myself. I come and go as I want. I think the staff listen to us and they act on what we say. People living at the service also commented to us in their surveys, if I want something, or Ive got a problem, there is always someone there to listen and help. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: The manager told us in his Annual Quality Assurance Audit that the service provides a fully holistic service to all, encapsulating the cultural, spiritual and emotional needs and wants of all of the people living at the service. He said the staff are looking specifically at how the pathways to employment, social inclusion and healthy living can be improved. We found that any activities are written or posted on the whiteboards in communal lounges and the dining room so people know what choices they have. Student Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Occupational Therapists have been organising activities, including collages, creative writing, art, personalised mugs, name plates, reminiscence, pottery, potting plants and sweet making. The people who live at the service also have access to an allotment, and there are various voluntary activities on display e. g. assisting rangers at Attenborough Nature Reserve. One person is due to start attending a culturally appropriate group which staff researched and found to ease the persons sense of cultural isolation. People we spoke with told us, We have had regular themed barbeques and there is an activities room with a computer in it, craft material and so on. We go to the panto, to the theatre and out for meals. I would like them to go to the cinema more often but thats because I love films. Others commented, I dont usually take part in activities as I like my solitude.One person told us, I a do carpentry course, an access to Arts course, a computer course and Ill take part in anything going. Another told us about a holiday they have just been on, I went to Robin Hoods Bay, it was excellent, I really enjoyed it. The staff came with us, it was really nice to get away. Staff we spoke with told us they encourage people to take control of their own lives, for example encouraging them to use the computer to find out information they are interested in or they want to know about, such as the side effects of any medication. Another person told us, we run an arts group fortnightly, we do event nights once a week. We have books on tape, games afternoons at the local pub, we do walk and talk groups, have picnics at the Park, we go to the cinema and for meals out. The Assistant Manager told us about a trip to Ireland some of the people living at the service went on. They planned their itinerary and did a video of the trip which they thoroughly enjoyed. The manager told us in his Annual Quality Assurance Audit that the life skills worker helps every person work towards independence in cooking, cleaning and other domestic chores. The manager told us that this is a driven service that works with service users strengths so their independence can grow and they can develop life skills with pride and dignity. The manager told us that meals are nutritious and varied after consultation with service users, the service has implemented themed nights that explore the food of different countries and cultures. The people we spoke with confirmed their independence is encouraged, they told us, I cooked Sunday lunch the other day, staff asked me so I agreed. I enjoy cooking. The staff help me change my bed, theyre good like that. Another person told us, I keep my room tidy, I wash my own clothes and we take it in turns to wash up. We can make our own dinner or they give us money to buy lunch out. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: Staff confirmed, almost everyone takes an active part in cleaning and doing their laundry, washing up, people have generally accepted this. I see the service as both trying to move people on to greater Independence and maintaining care for vulnerable people. Staff told us that a couple of people living at the service have had partners visit them at the service and stay over, some people have told us they would like a relationship and staff have tried to give them guidance on how and where to meet people. People living at the service told us they tend to have friends who live outside of the service and they prefer that. Issues around sexuality are openly discussed with people living at the service and the manager told me that people are given advice about sexual health and protection by appropriately qualified people, or those they feel comfortable with. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people living at the service are fully assessed and are well provided for in line with peoples needs and preferences. Evidence: We found that a person living at the service has difficulties with their mobility and the person has appropriate equipment to assist them with this area of need. They told us, I have had a fall and have broken my leg, that is why I have this tripod. I cant walk far with it though. The support plan shows that falls have been risk assessed and there are plans in place to minimise risks. The plan is signed by the person concerned. We could not find any evidence from records or staff interviews to show that staff have had training on supporting people with safe moving and handling, although it is recognised that this is not a current area of need. When we spoke to the area manager he told us that none of the staff have had this training. He told us that this has been a deliberate decision because of the risks involved with staff moving people who are under the influence of alcohol and doing more harm. He also said no one needs any specialist help, support or equipment at present. It is recommended however that such Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: training be considered as a proactive measure so staff have this knowledge in case they need it. Staff told us, The assistance people need with personal care can depend on their alcohol use, but only one or two people need a bit of help. I am careful to make sure I offer them privacy. We do respect gender preferences here, but I have known the service users for a long time so they are pretty comfortable with me. We found the support plans provide good evidence that people have their physical and mental health needs assessed and provided for well. There is clear evidence of regular liaison with healthcare professionals, of referral on for specialist support, advice and guidance when necessary and of people having access to opticians and dentists as needed. Where people are refusing such treatment there is an assessment of their capacity and their decisions are recorded and signed by them. People living at the service told us, I have a lot of physical needs, I have fits, I get no warning I just fall down. I dont sleep well, but they have put something on my mattress to help me sleep. I dont like to see the Doctor, I dont want to go to Hospital and thats their answer to everything. There are some really nice staff here who are supportive and kind. Others commented, I receive support to access medical support, and no problems have been experienced in this area. Staff we spoke with told us, generally speaking the health care professionals we deal with are pretty good, but compliance with treatment can be an issue for some of the people who live here. They showed a very good understanding of how to prevent the transmission of infection between people living at the service and staff. We looked at the arrangements for medication and found that people are encouraged to collect their own medication from the chemist when they have been risk assessed as being able to do this. Medication is securely and appropriately stored. There is a photograph of each person on the front of their Medication Administration Record along with specific guidance instructions for staff and the persons preference in terms of how they take their medication. This is good practise. The Medication Administration Record is well recorded, refusals are documented along with any other reasons for omitting medicines. Some medication is in blister packs and some is boxed, random checks on medication in boxes shows that the amounts remaining tally with the records of administration and receipt. Staff we spoke with told us, I am doing some training run by the Local Authority on medication, I have done a day course at Basford college as well as the training provided by Boots. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: People living at the service told us they collect their tablets from the Pharmacy and they also said, staff encourage me to use the computer to see what side effects my medication has. Care Homes for Adults (18-65 years) Page 20 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to a robust and effective complaints procedure. They are protected from abuse, and have their rights are supported and upheld. Evidence: The manager told us in his Annual Quality Assurance Assessment that the complaints procedure is made clear to all people who are new to the service and that this is detailed in the service user guide. He told us that staff will talk through this with people living at the service, and support them through the process and any subsequent appeals. He told us that all complaints are responded to within 28 days. We found that the complaints procedure is displayed in the service so all people are aware of how to raise any issues. We looked at the record of complaints and found these are usually made by one person living at the service about another. There is a clear record of the investigation and action taken. No complaints have been made directly to us since our last visit to the service. One of the people we spoke with said they have made a complaint about a comment made by a staff member, the person said this has been investigated and the staff member has apologised on several occasions since. If I had a complaint I would make it and I think they would respond. Another said, I have never made any complaints Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: but I would if I needed to. I would talk to the staff and I know they would respond. The people who returned surveys to us all said that they know how to make a complaint, I am aware of the complaints procedure and how it works. I use the form. The staff we spoke with were clear about the complaints procedure and told us, people are encouraged to raise complaints at the residents meeting, they can ask for the matter to be referred to an independent advocate. We use the Service User Participation and Empowerment advocacy group. The manager told us in his Annual Quality Assurance Assessment that all staff have had training on safeguarding, that there are referral forms in the office which staff can use in the event of allegations being made and that they have a copy of No Secrets and the local procedural guidelines. He told us that all staff have received training on supporting people whose behaviour may challenge the service and there is a tracker form in place to assess and monitor incidents which happen. There has been one safeguarding referral since our last visit to the service concerning one person living at the service verbally abusing and intimidating another. This was referred on to the Local Authority and appropriate action was taken. We have not been directly informed of any safeguarding allegations. The people we spoke with told us they feel safe at the service, they told us, they care for you well here, they know what they are doing and how to help, and another said, I have never seen any of the staff get angry with people living here. They are very patient and caring. If I saw any awful behaviour I would report it. Staff showed a clear understanding of what kinds of behaviour are abusive and they told us, If I witnessed or heard of any inappropriate treatment I would whistleblow. The managers would deal with this effectively I am sure. Care Homes for Adults (18-65 years) Page 22 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is suitable for the needs of the people who live there and provides warm, comfortable and clean accommodation. Evidence: We did a partial tour of the building, including all communal areas and a selection of bedrooms. There are two lounges at the service, one where people may drink and smoke and the other where they are not allowed to do either. There are fridges and access to soft drinks in both areas, and whiteboards inform people living at the service of key events and activities. There is also a dining room with a large fridge stocked with food which the people living at the service can use to prepare themselves snacks. Breakfast and tea are prepared in the main kitchen and people who use the service will help prepare meals for the others who live at the home. There is a weekly menu and daily menu choices are displayed in the dining room. We found there is an ongoing programme of redecoration and repair and that the staff try to balance the need for comfortable and pleasant accommodation with the need for practical and safe fixtures and fittings which are suitable for peoples needs. The service is shortly to relocate whilst the premises are upgraded and they have been in consultation with us about this process. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: The home is clean and well maintained throughout. The gardens are well kept and are maintained by the people living at the service. People who live at the service told us, the staff help me change my bed and keep my room tidy, they are good at that. I have what I want in my bedroom. The home is fine, it has what you need. Another told us, the home is clean, well maintained and comfortable, they have refurbished a few times and they are doing it again soon. Staff we spoke with told us, I have no concerns about the environment and it is being refurbished but it will be great to have the en suite bathrooms. Care Homes for Adults (18-65 years) Page 24 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the service are supported by well trained staff but the recruitment processes are not robust enough and people cannot be assured that they are supported by those who are suitable to work with vulnerable adults. Evidence: The training records show that staff have attended training on Child Protection, the Mental Capacity Act, The Social Fund, Leadership Development Programme, problem solving counselling, Housing Law, Basic Food Hygiene, Basic First Aid, working with sex offenders, Mental Health Awareness, Alcohol dependency, Dealing with challenging behaviour and Equality and Diversity. Staff files show that people have undertaken inductions and have completed or are undertaking National Vocational Qualifications. The people living at the service told us, some of the staff are great, but I do get on better with some than others. Another told us, the staff are lovely, I get on with all of them, they are good at their job and they know what they are doing. Other people commented in their surveys, the staff are very obliging, there is excellent care and support, if I want something or if Ive got a problem there is always someone there to listen or help. One person did feel however that, there are too many staff meetings. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: The staff we spoke with told us, We get really good access to traininig, this year I have done courses on the Mental Capacity Act, suicide and self harm, challenging behaviour, safeguarding, Basic Food Hygiene, Fire and I find there are a lot of courses which focus on the needs of service users. We looked at three staff files and found that there are documents missing, one person did not have any written references on file, others had no evidence of identification, no photograph and some had no evidence of training in the form of certificates. We discussed this issue with the manager who told us that files are centrally held. This is not acceptable and the service is not acting in compliance with legal requirements. The staff we spoke with told us, I provided references, had a Criminal Record Bureau check and completed an application before I started working at the service. Care Homes for Adults (18-65 years) Page 26 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is managed well overall and runs in the best interests of the people who live there. Evidence: People who live at the service told us, the home is well run, the manager is a lovely man and he will always make time to speak to you. They act on what we say. They send out questionnaires for us to fill in telling them what we think of living here. I tell them what I am telling you, I love it here, I really do. Staff we spoke with confirmed, the managers are really good, regular supervision is important as you can feel drained by the work. The service runs well and the managers are approachable, very accessible. There is a lot of respect. The home is safe, well maintained and my health and safety is well looked after. All of the necessary health and safety tests and servicing have been conducted as required to ensure they are working well. Care Homes for Adults (18-65 years) Page 27 of 31 Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 19 People must not start working at the service unless you have evidence that you have all of the information and documentation specified in Schedule 2 and 4(6). To ensure that people who live at the service are protected from those who may not be suitable to work with them. 10/11/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 18 Training should be provided to make sure that staff can support people safely with moving and handling if the need arises. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: 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 We want people to be able to access this information. 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