Care Home: 4 College Road

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well Residents are able to take part in activities, outings and holidays as part of promoting an enjoyable and stimulating lifestyle. They are treated with respect and their health care needs are supported. They live in a comfortable and well maintained property. The first member of staff completing a survey form told us that the home respects the residents` rights and ensures that members of staff have been updated on information concerning the home and the residents. The second member of staff said that support is given to enable independence. Members of staff listen to residents and a stable, warm and comfortable environment is provided. The third member of staff said that care plans are reviewed on a regular basis and that the residents enjoy a good social life, which includes disco dancing and parties. A health or social care professional completing the survey form told us that the home provides real opportunities for the individual residents to become involved in community life, offer consistency and continuity in their approach in working with residents and actively promote the health and safety of the residents. Another professional said that support is given so that residents attend appointments punctually and regularly. What has improved since the last inspection? There were 3 statutory requirements identified during the previous key inspection and these have all been met. New carpet has been provided in the home, enhancing the appearance of communal areas, and in addition redecoration has taken place. Rotas now clearly show the hours worked by the manager and in addition she now records the evening and weekend shifts she carries out as part of her monitoring of standards in the home. All servicing or inspection certificates were present in the health and safety file to demonstrate that the maintenance programme is up to date. What the care home could do better: We identified 6 statutory requirements during this inspection. Due to the decreasing mobility of 1 of the residents, manual handling training and a manual handling risk assessment is needed so that the safety of the resident and of the member of staff assisting the resident is maintained. Closer matching of the food records with the menu sheet would enable a varied diet for residents to be maintained and avoid the main ingredient of a meal being repeated. Some minor redecoration is needed where scuffing has occurred or where a resident has picked at paintwork in their bedroom so that the smart appearance of the accommodation is maintained. Although testing of the fire alarms and smoke detectors is carried out on a regular basis this needs to be increased to a weekly check so that any problems or faults are identified quickly. In order that the manager is aware of legislative duties in respect of the Mental Capacity Act, training must be undertaken. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 4 College Road Striving For Independence Group 4 College Road Wembley Middlesex HA9 8RL     The quality rating for this care home is:   two star good 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: Julie Schofield     Date: 0 8 0 7 2 0 0 9 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. that people have said are important to them: They reflect the things 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 © (2009) 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.cqc.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: 4 College Road Striving For Independence Group 4 College Road Wembley Middlesex HA9 8RL 02089086894 02089009633 otis@sfi.me.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Striving For Independence Group Homes care home 3 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home This home is one of a group of 3 homes, in Brent and in Harrow, which are owned by the proprietors company (SFI - Striving for Independence). This care home provides a service for 3 adults with learning disabilities. At the time of the inspection there was one vacancy. The house is semi-detached and the property consists of two floors. The service users bedrooms are situated on the first floor, with bathing and toilet facilities Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 3 Brief description of the care home on both floors. There is an open plan dining area and lounge, kitchen and office (including sleeping in facility) situated on the ground floor. Patio doors lead from the dining area to the garden at the rear of the property. The proprietor is also the registered Care Manager. There is a close connection between the homes in the group and the company also runs a day care facility in Wembley. College Road is a quiet residential turning close to Preston Hill and within reach of both bus and underground rail services and local shops. Enquiries regarding fees charged for placements should be made to the manager of the home. 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: two star good 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: We visited the home on Wednesday the 8th July and arrived at 8.15am. We left at 2pm. During the time we were there we met and spoke with the manager, deputy manager and the member of staff on duty. We also spent time with the 2 residents living in the home and observed the daily routines, the interaction between staff members and residents and gained feedback on the quality of the service provided. We viewed the accommodation and examined records both relating to members of staff and to clients. We looked at policies and procedures, examined health and safety records and complaints records and checked financial records. Prior to the inspection we had received a copy of the agencys annual quality assurance assessment form and survey forms had been returned to us from the 2 clients, 3 members of staff and 3 health or social care professionals. The information from these documents was also used in the preparation of this report. We would like to thank everyone that gave their comments and assisted with this inspection. Care Homes for Adults (18-65 years) Page 6 of 31 What the care home does well: What has improved since the last inspection? What they could do better: 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.cqc.org.uk. You can get Care Homes for Adults (18-65 years) Page 7 of 31 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive assessment of need prior to the admission of the resident assures the resident that the home is able to meet their individual needs. Evidence: The home has an admission procedure, although no new resident has been admitted to the home since the last inspection. The policy is that if a referral is made a representative of the company will carry out a comprehensive assessment of the needs of the prospective resident. This information would be in addition to the information provided by the placing authority, which would include a copy of their needs assessment for the prospective resident. In addition to the combined information, a programme of pre-admission visits to the home, by the resident, would be carried out so that the home is able to determine whether a service can be provided that would meet the individual needs of the resident. The content of these visits would be recorded. Care Homes for Adults (18-65 years) Page 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal planning programmes have been drawn up for each resident so that the service provided can meet the individual needs of the resident. The home is able to demonstrate that changes in the needs of residents are identified and addressed through a system of regular review meetings. However, care plans also need to reflect changes in circumstances by the inclusion of new risk assessments e.g. for manual handling when there is a deterioration in the mobility of a resident. Offering a resident choice encourages and supports the resident to develop their independent living skills. Staff support residents to take responsible risks so that residents can develop an independent lifestyle. Evidence: We looked at the case files of each of the 2 residents. They contained a Personal Planning Programme or PPP. These were dated October 2008 and November 2008. In the PPP needs were identified and immediate, short term, medium term and long term goals were attached. Identified needs included those in respect of physical health, choice, leisure and accommodation. An Action Plan had been developed to map how Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: needs would be met. Care plans were also on file and these had been updated in January 2009, on the first file, and in June 2009, on the second file. The care plan gave details of the support to be given to meet identified needs, with timescales. Files contained guidelines for staff when they worked with the resident. One file contained a copy of the FACE Core Assessment that had been completed by the placing authority in May 2008. The manager said that since then a review had taken place in April 2009 but the home was still waiting for a copy of the minutes of the meeting to be forwarded. The other file contained minutes of a review meeting convened by the placing authority in October 2008. We saw that internal review meetings had taken place in the home and the last ones had taken place in January 2009. Due to the deterioration in the mobility of 1 of the residents and the fact that they were unsteady on their feet and needing assistance from staff to mobilise we would have expected to see a manual handling risk assessment on this residents case file but this was absent. When asked on the survey form whether they were given up to date information about the needs of the residents they supported 2 carers said always and 1 carer said usually. We looked at opportunities for residents to exercise choice in daily living. The member of staff confirmed that residents were able to have choice in terms of food, activities and getting up in the morning and going to bed at night. An advocate has supported residents in other SFI care homes and they visit the companys day centre. If necessary, the advocate could provide support to residents at College Road. We looked at the records in respect of residents finances, as the manager is the appointee for both residents. We saw that the account books were up to date. These recorded a balance of the money kept in the home on behalf of the resident and itemised individual transactions and expenditure. Bank statements and savings books were made available. Each file contained a risk management form that had been updated in January 2009 on 1 file and in May 2009 in the other file. Risk assessments were in respect of sexual awareness, leaving the premises without first speaking with a member of staff and crossing the road etc. The form identified the hazards, the risks, risk provoking factors and the action needed to reduce the risk. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents attend day centres and this provides them with opportunities to develop their social and independent living skills. Residents are able to use facilities in the community. The residents quality of life is promoted by the provision of an annual holiday and by attending clubs and taking part in outings they have the opportunity to develop and maintain a stimulating and enjoyable lifestyle. Residents rights are respected and involvement in daily routines encourages residents to develop a sense of home. Providing a varied diet at all times contributes towards the well-being of residents and food records should match the balanced and varied diet detailed on the menu, as far as possible. Evidence: Each resident has a programme of activities, although the programme has been changed recently for 1 of the 2 residents. Previously this resident had attended a day centre in Harrow on 4 days of the week and attended the SFI day centre on a Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Wednesday. At the moment, due to their decreasing mobility, they have been attending the SFI day centre on a daily basis. They are joining the second resident who also attends the SFI day centre on a daily basis. The manager has previously told us that residents have literacy and numeracy sessions at the day centre and also cooking, music and pottery sessions. Residents use resources and facilities in the community including parks, restaurants, pubs, shops, the church, leisure centres and swimming pool. To gain access to these they either walk or use public transport or use the companys minibus. The manager confirmed that residents names are entered on the electoral roll. Residents attending the SFI day centre take part in a weekly outing on a Wednesday during the summer months. On the day of the inspection they were due to go to a park in Golders Green. The summer programme was available and we saw that it included trips to the seaside, the zoo, theme parks and Hyde Park. Residents have opportunities to enjoy activities and attend clubs taking place at the weekend and in the evenings and SFI holds its own evening disco, with buffet, once a fortnight. We discussed annual holidays and the member of staff on duty confirmed that the residents had enjoyed a holiday at a caravan park in Sussex in 2008. Plans for 2009 have not yet been finalised. Neither of the residents has contact with any family member and so there are no family visitors to the home. Residents do have opportunities to socialise with residents living in other SFI care homes when social events are organised and they are invited to attend. Residents are looking forward to the annual BBQ. Both residents help with the daily routines although the resident with decreasing mobility is not doing as much at the moment. Previously he used to make his bed and make a drink or a sandwich, with support. The other resident takes his laundry to the machine and helps to fold the clothes. He also likes to help with the shopping by pushing the trolley. There is a 4 week rolling menu in use in the home. Amendments are made to this for the resident that is diabetic. The menus include lots of fruit and vegetables. We looked at the food records and compared the previous days meals with the menu sheet. We noted that although the menu sheet demonstrated variety the food records indicated that the residents had been served lamb on the 3 consecutive days, prior to the inspection. The member of staff on duty confirmed that she had served lamb for the evening meal on the day before the inspection. We spoke to the manager and she said that this should not have happened and confirmed after checking supplies in the kitchen that a varied diet could have been provided. We noted when we were in the Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: kitchen that the food hygiene certificate that was on display for a member of staff was dated 1998. It is recommended that this is removed as there is evidence that members of staff have undertaken food hygiene training recently. Residents are able to help themselves from a large bowl of fruit on the dining room table, if they wish. Care Homes for Adults (18-65 years) Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive assistance with or prompting with personal care in a manner, which respects their dignity. Residents health care needs are met through access to health care services in the community. Residents general health and well being is promoted by staff that assist the resident to take prescribed medication in accordance with the instructions of the residents GP. Evidence: We discussed the personal care needs of the residents. We saw that they were clean and tidy and smartly dressed. Although residents are offered a choice of clothing in the morning the member of staff will give advice regarding dressing appropriately for the season. We noted that the residents were both going out on the Wednesday outing arranged by the SFI day centre and were taking a hat and suncream. When we inspected the medication we noticed that certain items advised avoiding direct sunlight. Both residents now require full assistance with personal care and within the rota there are male and female members of staff. As this is a home accommodating up to 3 residents, each of the members of staff has a comprehensive knowledge of the individual needs of the 2 residents. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: We saw that 1 of the residents had lost a significant amount of weight since we had last visited the home. The resident has lost approximately 3 stones in 6 months. The loss in weight has been accompanied by a deterioration in the mobility of the resident and we were told that he was not attending his regular day centre at present but was going to the SFI day centre instead. We spoke to the manager who showed us the record of appointments with the GP and records of tests undertaken to try to establish the cause of the weight loss. She told us that she has contacted the placing authority to suggest a move to another of the companys care homes so that the resident could be accommodated in a more suitable bedroom. We discussed the use of the ground floor office as a temporary bedroom for the resident as the CSCI (the previous regulatory authority) had approved its use in the past, for a similar purpose. When we looked at the 2 resident case files we saw that letters had been sent regarding a physiotherapy appointment for the resident whose mobility had deteriorated. There was evidence on both files of regular appointments with health care professionals including the psychiatrist, psychologist, chiropodist, dentist, optician and GP. There was also evidence of attendance at out patient clinics and support when the resident was there from a member of staff. One of the residents is diabetic and there were details on file of the support needed to manage this. There was also information for staff about this condition and guidance in the home about dietary needs. When asked on the survey form about the training given the 3 carers agreed that it gives them enough knowledge about health care and medication. Two social or health care professionals that completed a survey form agreed that the service always seeks advice and acts on it to meet residents social and health care needs and improve their well-being. The member of staff on duty confirmed that she had undertaken medication training. Neither of the residents self medicates. We inspected the storage of medication and saw that it was safe and secure. We looked at the records of the administration. These were up to date and complete. The home uses a weekly dosette box system and these are filled by the pharmacist. The empty compartments were in accordance with the time of day and the day of the week that the boxes were examined. A separate weekly dosette box is prepared for medication to be taken at the day centre. We noted that the companys training plan identifies medication training as a key training course. Care Homes for Adults (18-65 years) Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The rights of residents are protected by a clear and simple complaints procedure. An adult protection policy and protection of vulnerable adults training for staff contribute towards the safety of residents. Evidence: A clear complaints procedure is in place, which includes timescales for each stage of the process and refers complainants to other agencies that have an involvement. Records are kept of complaints made. The manager said that no complaints have been recorded since the last inspection. She also said that matters are resolved at an early stage, before developing into a complaint. One of the residents is unable to speak and the manager was previously asked how the resident signified their concern or distress. The manager said that if the resident was not happy about something the resident would not have eye contact. The member of staff on duty was also familiar with the ways that the resident communicated concern or distress. A protection of vulnerable adults policy is in place, which includes a whistle blowing procedure. This was reviewed recently. The home has a copy of the local authority inter agency guidelines, in the event of abuse. We spoke with the member of staff on duty who confirmed that she had undertaken training in regard to protection of vulnerable adults procedures. She had also received training in supporting residents that display aggressive behaviour. The manager said that 1 incident of abuse had been recorded since the last inspection. This involved 2 of the residents. The local Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: authority and the CSCI (the previous regulatory authority) were notified of this at the time, under the staff guarding procedure. An investigation took place and guidelines were drawn up for supporting the residents. We saw these on the case files. We noted that the companys training plan identifies protection of vulnerable adults training as a key training course. When asked on the survey form if the carer knew what to do if someone had concerns about the home they all ticked yes. Care Homes for Adults (18-65 years) Page 19 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. Residents enjoy a comfortable and homely environment with pleasant communal facilities although some minor redecoration is needed. Residents live in a home where standards of cleanliness are good and where bathing and toilet facilities are appropriately sited. Evidence: During an inspection a site visit was carried out. We noted on arrival that the road now had parking bays to be used by residents only when events were taking place in Wembley Stadium. The home does have a residents pass and there is off street parking to the side of the house, along a private driveway leading to a garage. We saw that the overall upkeep of the home was good and that it was decorated and furnished so that it provided residents with a homely environment. There was new carpet in the home. This had been a requirement that had been identified during the previous key inspection and so this requirement has been met. Some of the paintwork in the dining area was scuffed and the paintwork on a wall in one of the bedrooms needed making good where the resident had picked at it. The rooms in the home are of a good size and there are bathing and toilet facilities on both levels. The building was bright and airy and ventilation was appropriate for the time of year. Local shops and amenities, including transport routes, are within walking distance. The outside of the home is in keeping with its neighbours and the front garden provides a good first Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: impression of the home. There is a large attractively laid out garden at the rear of the property. This property was originally registered as a small care home as it accommodates a maximum of 3 residents. Laundry facilities are domestic and consist of a washing machine and separate tumble drier in the large sized kitchen. The home was clean and tidy and was free from any offensive odours. We noted when we looked at staff training profiles that members of staff receive training in regard to infection control procedures. Care Homes for Adults (18-65 years) Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. NVQ training enhances the quality of care provided to residents and the home has met the target of 50 per cent of its carers having achieved an NVQ level 2 or 3 qualification. The rota demonstrated that there were sufficient staff on duty to support the residents and to meet their needs. Recruitment practices, which include checks and references, protect the welfare and safety of residents. Residents benefit from support given by carers that are skilled and trained. Evidence: We reviewed the NVQ training programme for the home with the manager. Eight names appear on the staff rota, including the deputy manager but excluding the manager. Of these eight people, 1 person has an NVQ level 4 award, 1 person has completed level 3 and is currently studying for level 4, 2 people have completed level 2 and 1 person is currently studying for level 2. A new member of staff is currently doing their foundation training. An experienced member of staff has undertaken numerous short training courses but has not commenced NVQ training. The home has met the guideline that a minimum of 50 per cent of the staff team hold an NVQ level 2 or 3 qualification. We spoke with the remaining person who was the member of staff on duty during the inspection. She confirmed that she had completed the City and Guilds Preparing for Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: Caring in the Care Sector and was hoping to commence NVQ level 2 training in September. We talked about communication and were told that although one resident has limited speech that at times can be difficult to understand he supplements this with signs e.g. he refers to a male member of staff by making a sign for a beard. We were shown a serious of cards that have been developed for use in the home to assist communication and to help offer choice. The other resident communicates by making noises not by speech. However, the member of staff and the manager told us about reading facial expressions and interpreting body language. We noted that the residents and the manager and member of staff appeared to be relaxed in each others company and that there was a friendly rapport. A copy of the current rota was on display in the kitchen. We noted that the manager and deputy managers hours were recorded on the rota from 9am to 5pm from Monday to Friday. Recording the managers hours on the rota had been identified as a requirement during the previous key inspection and this has now been met. The manager confirmed that these hours could be spent either in College Road or at the companys head office, as residents went to a day centre during the day. We saw the manager and the deputy manager at College Road during the inspection, before the residents went out in the morning. When looking at the rota we noted that there was a member of staff on duty during the hours when residents were present in the home. The manager confirmed that telephone contact is provided when the home is empty so that if a resident needs to return during the day staffing arrangements can be put in place to cover this. The member of staff on duty in the evening also undertakes the sleeping in duties and the person on duty during the inspection confirmed to us that residents were able to choose when they were ready to go to bed. She said that 1 of the residents that usually likes an early night decided to go to bed later the night before because they had wanted to watch a programme about a celebrity that had recently died. We saw that the manager was programmed to do a shift, including a sleep over, at the weekend. She told us that this was part of monitoring standards in the home. A resident was aware of who was on duty and told us the name of the member of staff that would be working in the home later in the day. When carers were asked on the survey form whether there are enough staff on duty to meet the individual needs of the residents using the service, 2 carers ticked always and 1 carer ticked usually. We selected the names of 3 members of staff and examined their personnel files. The files contained an application form and a photograph of the member of staff. Files contained 2 satisfactory references. Proof of identity was in the form of passport details and files contained evidence of a satisfactory enhanced CRB disclosure being obtained and a pova first, where applicable. Where necessary the right to reside or to Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: work in the UK had been established. They also contained a contract and certificates of attendance or achievement for training courses. The manager provided a copy of the companys Training Plan for 2009-10. It was comprehensive and the format included the business objectives, training needs, costs, timescales, outcomes and performance indicators. The training review included the NVQ programme, courses for managers, courses in safe working practices and courses to meet the particular needs of residents. The home has training profiles for individual members of staff and staff appraisals are carried out. When asked on the survey form whether their induction had covered everything that they needed to do the job when they started 2 carers ticked very well and 1 carer ticked mostly. They all agreed that since then the training that they have been given is relevant to their role, helps them to understand and met the individual needs of the residents and keeps them up to date with new ways of working. Care Homes for Adults (18-65 years) Page 24 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. Continuing to undertake further training enables the manager to develop her knowledge, skills and understanding and to provide a service that is responsive to the needs of residents. Although feedback from residents on the quality of the service provided in the home is limited their views are sought and respected. Training for staff in safe working practice topics promotes the health and safety of residents, staff and visitors to the home although training in manual handling needs to be added. Certificates for the checking or servicing of equipment and systems in the home demonstrate that they continue to be safe to use. Evidence: The manager has been in post since the initial registration of College Road in 1994. She has completed her NVQ level 4 management training. She has continued to undertake periodic training to update her skills and knowledge and said that recently she has undertaken safe guarding adults training and attended management seminars. She has not yet undertaken Mental Capacity Act training although hopes to be allocated a place on the training course being run by the local authority. The manager is assisted by a deputy manager. He confirmed that he has achieved an NVQ Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: level 4 qualification. When asked on the survey form about whether the manager gives carers enough support and whether she meets with them to discuss how they are working, 2 of the carers ticked often and 1 carer ticked regularly. At present feedback about the quality of care in the home is obtained from residents, either during meetings, or at their reviews or more usually on a one to one basis. Only 1 of the 2 resident is able to communicate verbally and there are no family members supporting the residents so feedback is therefore limited. However, we saw that the manager spends time with each resident to gauge their well being and to assure the resident of her interest and support. Feedback from members of staff is obtained during staff meetings, individual supervision sessions or during discussions with managers. As the manager is also the proprietor of the home it is recommended that a manager from one of the other care homes operated by SFI carries out a quality audit in the home on a regular basis. We asked to see the records of inspecting or servicing equipment and systems in the home. A requirement had been identified during the previous key inspection that these are to be available at all times. All the documents requested were produced so this has now been met. We noted that there were up to date and valid documents for the fire extinguishers, testing of the portable electrical appliances, the electrical installation in the home, the Landlords Gas Safety Record, and the fire alarms and emergency lighting systems. In addition there were up to date records of safe temperatures in the fridge and freezer, a fire risk assessment that had been completed in 2008, records of fire drills being held on a monthly basis and records of monthly fire alarm tests. There was evidence of training in safe working practices but not manual handling training, which needs to be updated on an annual basis. Care Homes for Adults (18-65 years) Page 26 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 27 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 6 13 The registered manager 01/08/2009 must draw up a manual handling risk assessment for the resident whose mobility has deteriorated. This will ensure that when the resident is assisted his safety and comfort and the safety of the member of staff is promoted. 2 17 16 The manager must check the food records to ensure that they match the menu sheet as far as possible. This will enable residents to enjoy the varied diet that is detailed on the menu. 01/08/2009 3 24 23 The maintenance programme for the home must include redecorating the dining area and making good the damaged paintwork in one of the bedrooms. 01/11/2009 Care Homes for Adults (18-65 years) Page 28 of 31 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 This will assure residents of accommodation where maintenance is carried out when necessary so that good standards continue to be enjoyed. 4 37 9 When reviewing her training needs the manager must arrange to attend Mental Capacity Act training. This will assure residents that the manager has an understanding of the new legislation and of the impact it may have on service delivery. 5 42 23 The programme of testing the fire alarms and smoke detectors in the home must be carried out on a weekly basis. This will ensure that the health and safety of everyone living in, working in or visiting the home is promoted. 6 42 13 A programme of manual handling training must be put into place for all members of staff working in the home. 01/10/2009 01/08/2009 01/11/2009 Care Homes for Adults (18-65 years) Page 29 of 31 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 This will enable members of staff to carry out their duties in a safe and careful manner. 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 6 That the home contacts the placing authority by letter to request a copy of the minutes of the review meeting that was convened by the local authority and which took place in April 2009. That the out of date food hygiene certificate is removed from display in the kitchen. That a quality audit of the home is carried out on a regular basis, and recorded, by a manager from one of the other SFI care homes. 2 3 17 39 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!