Care Home: 40 School Road

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What the care home does well 40 School Road provides a valuable respite service to carers and individuals that use the service. People that use the service benefit from living in a homely and comfortable environment, and are able to dictate their own daily routines. "Have your Say" surveys were used to seek the views of people who use the service about the standards of care at the home. Four completed surveys were received and stated that they always make choices about their daily lives and staff treat them well. It was also stated that they know the complaints procedure and who to speak to if they are not happy. The views of relatives and friends involved in the care of people that use the service were sought through comment cards and face to face during the visit. Four responses were received and stated that they are welcome at the home, members of staff keep them informed of important matters and there is always sufficient staff on duty. What has improved since the last inspection? The statement of purpose has been reviewed and amended to include the maximum length of stay people who use the service. Individuals are now assured their safety in respect of the recruitment practices ensuring thorough checks are undertaken prior to staff being employed. Individuals assessed care needs are kept under review ensuring that the care provided is appropriate. Individuals are assured their safety through the risk assessment framework. It was evident that this does not curtail their independence. What the care home could do better: To empower people who use the service to make decisions, care plans must contain the means used by the individual with communication needs to make decisions about all aspects of their lives. Whilst some work has been completed this remains outstanding. Whilst the statement of purpose has been amended to reflect the maximum length of stay it was evident that this was not always followed. This should state unless in exceptional circumstances. Staff responsible for writing the care plan should sign and date the documentation, which would better evidence that it is current. CARE HOME ADULTS 18-65 40 School Road Brislington Bristol BS4 4NN Lead Inspector Paula Cordell Unannounced Inspection 16th January 2008 10:00 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 40 School Road Address Brislington Bristol BS4 4NN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0117 3532994 Bristol City Council Mrs Sheena Huggins Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only: -Code PC To service users of either gender whose primary care needs on admission to the home are within the following categories: 2. Learning disability- Code LD The maximum number of service users who can be accommodated is 7. Date of last inspection 21st March 2007 Brief Description of the Service: 40 School Road is operated by Bristol City Council and is registered by The Commission for Social Care Inspection to provide short-term accommodation to seven adults (male and female) with a learning disability between the age of 18 years and 64 years. The statement of purpose states that the home will not accommodate a person for a period longer than six weeks. The property is detached and is set in its own grounds. There are disabled facilities on the ground floor. There is also one double room, which would be suitable for a couple. The home is arranged over two floors, but all communal areas are on the ground floor. There is no lift facility. At the time of publishing this report the home had a standard weekly charge of £64.25 per week, but this varied depending on the financial assessment completed by the individual’s social worker. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit as part of a key inspection process the purpose was to review the requirements and recommendations from the visit in February 2006. In addition to checking on the welfare of the people who use the service, ensuring the premises are well maintained and to examine health and safety procedures. During the site visit, the records were examined, a tour of the premises conducted and feedback sought from individuals on respite care and staff. Prior to the visit some time was spent examining documentation accumulated since the previous inspection, including correspondence and notified incidences in the home (Regulation 37’s). Feedback from relatives and individuals receiving care was sought through comment cards. Four comment cards were received from families and friends and four from individuals that stay for respite at School Road. The visit was conducted over six hours. What the service does well: 40 School Road provides a valuable respite service to carers and individuals that use the service. People that use the service benefit from living in a homely and comfortable environment, and are able to dictate their own daily routines. “Have your Say” surveys were used to seek the views of people who use the service about the standards of care at the home. Four completed surveys were received and stated that they always make choices about their daily lives and staff treat them well. It was also stated that they know the complaints procedure and who to speak to if they are not happy. The views of relatives and friends involved in the care of people that use the service were sought through comment cards and face to face during the visit. Four responses were received and stated that they are welcome at the home, members of staff keep them informed of important matters and there is always sufficient staff on duty. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals have clear information available to them prior to making a decision to spend time at 40 School Road. Individuals can be confident that they needs are assessed prior to receiving a service. The home continues provide care to people for a period exceeding six weeks so therefore the home is not following the objectives within their statement of purpose. EVIDENCE: The home has a statement of purpose and a service user guide. These clearly described the service provided to the individuals using the respite service at 40 School Road. The manager stated that each person is sent a copy of the service user guide, a copy of the home’s care plan and a contract. Completed surveys from individuals and their carers confirmed that they had sufficient information prior to making a decision to using the service. The statement of purpose has been amended to include the timescale for people staying at 40 School Road which stipulates that the home will provide respite for a maximum period of six weeks. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 9 One person has exceeded this timescale. The manager stated that the person is looking for a residential care home that is suitable to their needs. It was evident this was out of the manager’s control. Social workers, the individual and a relative were looking for appropriate options. Advice was sought from a regulation manager during the visit, as this is not the first time that this has happened. It is further required that the statement of purpose is amended to state “six weeks unless exceptional circumstances”. The home should write to the Commission for Social Care Inspection where an individual’s stay exceeds the six-week timescale. The notification should include the name of the person and the reason why the stay has exceeded six weeks so that this can be closely monitored with confirmation when the person has successfully moved to an alternative placement. The fees were clearly documented in the service user guide, statement of purpose and the contract of care. Each time a person uses the service an amended contract was seen detailing the cost of the stay and the room that was to be occupied. Staff stated that where possible people have a room for their duration of stay but occasionally due to an emergency admission this can change including asking individuals/carers to cut short the respite. The manager stated that this is sometimes regrettable and only as a last resort. The home has one emergency bed. The home has a booking system and carers are sent request forms on a quarterly basis. Records were maintained of all visits including the room occupied and the length of stay. The home has an admission procedure. Evidence was provided that individuals are assessed prior to respite being agreed. This included tea visits where the individual can meet the staff and some of the other people who receive a service at 40 School Road. It was evident that relatives were involved in the process ensuring that the individuals routines continued during their stay. The home supports approximately 150 people with a learning disability aged 18 to 65. It is evidently a valuable resource both for the individuals and their carers. This was confirmed in comments from individuals and their carers. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals can be confident that the home is meeting their care needs and that they are involved in the decision process. Individual’s safety is maintained through the risk assessment process. Individual’s independence is maintained during their visit to 40 School Road. The views of individuals receiving a service are sought before and after the visit. EVIDENCE: Five care plans were looked at as a means of determining the processes the home goes through to support the individuals living at 40 School Road. Care plans detailed the support needs of the individuals focusing on life skills and personal care. It was evident that these had been devised based on the assessment and care plan drawn up by the placing social worker and the home’s assessment processes. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 11 In response to a requirement from the last visit care plans are being systematically reviewed when a person stays at the home. People who use the service and their representative had signed the home’s care plan. However, staff compiling the care plan had not dated or signed the plan of care. The home operates a key worker system (where each person is allocated a named member of staff), and in the main it is their responsibility to review and update the care documentation. Care plans covered all aspects of care ensuring that the person’s routine is maintained whilst staying at 40 School Road. The home’s care plan detailed the individuals past history, areas of need with an account of the person’s likes and dislikes. An individual confirmed that they were involved in discussions with staff on the content of the care plan. Staff compile detailed daily accounts of the individuals stay, which describes how the individual spends their time at School Road, personal care given and the outcome of the visit. Risk assessments were in place to ensure that the individual’s safety is maintained. The home has developed manual handling risk assessments, however, staff stated Bristol City Council operate a no lifting policy. Guidelines were in place in the event of a person falling. Staff stated that one of the criteria for people coming into School Road was that they did not require support with manual handling. There was a previous requirement for the home to develop plans in relation to the communication for individuals who are non-verbal. One person was staying in the home who uses makaton (a sign language for people with a learning disability). It was not clear from the plan of care how this person fully communicates detailing the makaton signs the individual could use. However, in contrast another individual has a comprehensive dictionary that clearly describes how the person communicates including pictures and makaton signs. Staff stated that this was because the speech and language therapist had supported the family and the staff in developing the tool. It was evident that the home still needs to improve in this area and the requirement remains. Three “Have your Say” surveys from people that use the service indicated that they always make decisions about what to do each day and one person stated sometimes they make decisions. Individuals are encouraged to complete a preadmission questionnaire, which is used to inform they stay at 40 School Road. This gathers information on how the person wants to spend their time. A further questionnaire is completed after the visit. This is good practice and enables the individuals to express their views about the service. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are able to continue with their planned day activities. Individuals are supported to access the community. However, this can be restricted if individuals have no money. Individuals are supported to maintain links with family and friends. Individual’s rights are respected. Meals served at the home are varied and healthy. EVIDENCE: Care plans and pen pictures included how the person liked to spend their time. This information is reviewed prior to each visit via the pre-admission questionnaire. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 13 The person in charge stated that where individuals have pre-arranged day activities this is maintained during their stay. Where there is no pre-arranged activities for individuals on respite care then activities are organised. Completed “Have your say” surveys confirmed that three out of four could do what they wanted during the day, in the evenings and at weekends. One person stated that they could not do what they wanted at weekends. The manager stated that activities are planned at the weekend but quite often individuals have no money despite this being requested which can restrict some people. The manager stated that there is no budget for social occupation and individuals are expected to fund this. Individuals spoken with stated that they have been to the cinema, bowling and trips in the mini bus. One person stated that like to spend time doing puzzles and watching and listening to music. Staff stated that if individuals can access the community independently then this is encouraged and maintained. Documentation seen confirmed the level of support the individuals require when accessing the community. The home has a mini bus to enable them to access the community. The manager stated that this is funded through the weekly charge that is payable by the individuals using the service. Four “have your say” surveys stated that visitors were always made to feel welcome. An opportunity was taken to speak with a relative during the visit who stated the staff are always welcoming, all provide a high standard of care and keep them informed of important information. It was evident from talking with a relative during the visit that there was a high level of satisfaction about all aspects of the care provided at 40 School Road. In addition it was evident from conversations with staff and completed surveys that the home ensures that individuals diverse and cultural needs are met with examples given during the visit. The home has a policy on Equalities and diversity. The menus were viewed for the month of January. These provided evidence that the individual’s preferences were catered for and a healthy and varied diet was provided. A cook is employed from Monday to Friday to assist with cooking the evening meal. Care staff complete this at the weekends. In response to comments from the last visit records were maintained in relation to the variations of the planned menu. Good systems of work were being adopted to ensure that safety is maintained in relation to the preparation and the cooking of food. One individual spoken with during the visit stated the food was good. Specialist diets are catered for with the option for individuals to bring in their own food where relevant. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual’s personal and health care needs are being met during their stay at 40 School Road. Medication systems are safe. EVIDENCE: Care documentation included how the person wanted to be supported with their personal care. A member of staff stated that Bristol City Council has a policy that care is delivered to individuals of the same gender where possible. Although it was understood that female staff do support the men. This was incorporated into the planning of the staff rota ensuring that there is a female on duty at all times. Individuals spoken with during the visit expressed positive comments about the staff working in the home. From talking with staff it was evident that people were treated as individuals and care was delivered in a sensitive manner. Staff were observed speaking with individuals in a respectful manner. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 15 The home has demonstrated compliance to a requirement from the last visit in relation to manual handling risk assessments ensuring that they clearly describe the action taken to reduce the risk. The deputy manager stated that the bedsides are no longer in place as these are not required by anyone receiving a service at present. The manager stated that the home is registered with a local GP for people using the service who are outside their GP’s catchment area. It was understood from the deputy manager that where appointments are arranged to occur during respite stays, the home would endeavour to support the person to keep the appointment. During the visit it was observed that a relative supported a person to attend a hospital appointment. The relative commended the home on identifying the health concern in the first place and their prompt response to ensure that a medical professional saw the person. The manager and the deputy manager described positive links with the community learning disability teams in the local area. Community nurses and district nurses continue their involvement with individuals during their stay at 40 School Road ensuring that their health care needs are being met. It is the policy of the home to only accept medication that is clearly labelled by the pharmacist for staff to administer. There is a system in place for recording medications received and returned to the person on respite care. It was understood from the manager that to maintain safe practices of administration, staff that administer medication attend medication administration training. However the manager stated that the person who normally delivers this training has not been available for a period of time. As an interim measure staff in-house training has been organised with their competence being assessed. Records were in place confirming The records of administration and medications held at the home crossreferenced. Records of administration also indicated that staff sign the records immediately after administering medications. Bristol City Council has adopted the practice that two senior care staff complete the medication administration with one person acting as a witness. Whilst this could be seen as minimising the risk of error it must be made clear who is ultimately responsible should an error occur? Individual medication profiles that list prescribed medication and known allergies are in place. This now includes the purpose of the medication and known side effects in response to a recommendation from the last visit. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that individuals concerns are listened and responded to. Safeguarding policies are in place. However, the decision for the home to not look after individual’s finances (where relevant) could be putting people at risk. EVIDENCE: The home’s Complaints procedure is written in a simple format with pictures to ensure that the people for whom its intended can understand it. Completed surveys confirmed that individuals were aware of the complaint procedure. Four of the completed surveys indicated that they knew who to talk to if they were not happy. It was noted that the name of the Commission, the address and telephone number is now incorporated into the procedure but since this was amended there has been a change of office and named inspector for the home. This still requires amendment. The home maintains a complaints record, which lists the name of the complainant, the nature of the complaint and the actions to be taking to address the concern. There have been no complaints in the last twelve months. The level of satisfaction is not currently included within the record of complaints as noted at the last visit. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 17 The Local Authority “No Secrets” policy is available at the home and staff have attended Safeguarding Adults training. Staff were aware of the reporting procedures where abuse is suspected. The home has a whistle blowing policy. Bristol City Council has a policy where money is not held by the home for safekeeping. Concerns are raised whilst this diminishes responsibility of the service this does not take into account individuals who are unable to take on the responsibility of looking after their finances. Each bedroom has a lockable storage. As part of the assessment process an inventory is completed of person’s belongings for each visit to the home. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals that stay at 40 School Road benefit from a homely, comfortable and safe environment. EVIDENCE: School Road is a detached property set in its own grounds. It has the appearance of a large domestic dwelling, which blends well with its immediate environment. Accommodation is arranged over two floors, with shared space on the ground floor and bedrooms on both floors. The environment is well maintained and suited to the people that use the service. The property is decorated and furnished to a good standard that creates a comfortable homely atmosphere. Bedrooms have furniture and fittings that are suitable to the needs of the people that use the service. The bedrooms of the people that are currently on respite care contained personal belongings to enhance their personal space. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 19 The bedroom on the ground floor is for people with mobility impairments. It contains low level switches, adapted en-suite facilities, an emergency call system and furniture that promote independence. Four people indicated through the “Have your Say” surveys that the home was always clean. The home employs domestic staff to complete day-to-day cleaning tasks. Schedules of cleaning tasks were being completed. The home was clean and free from odour on the day of the visit. There is a large dining/lounge area on the ground floor, which was open plan. This had recently been decorated and was homely in appearance. Sufficient seating was available for the number of people. The kitchen area was clean and well organised. Policies relating to food safety along with daily records were seen to ensure safe systems of work were being adopted. The laundry is sited away from the kitchen. This area was clean and well organised. There is an industrial washing machine with sluicing programmes and a tumble dryer. A member of staff stated that the staff normally complete the laundry. However, if people receiving respite wanted to do their own washing this would be promoted. Systems are in place to minimise the loss of personal items, as individual’s clothes are often not named when they come to 40 School Road. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient and competent staff support the individuals staying at 40 School Road. Good recruitment practices are being adopted to ensure that individuals are protected. Whilst there is a comprehensive training programme in place this would be enhanced if more staff obtain a National Vocational Qualification. EVIDENCE: The home was staffed in accordance with the statement of purpose. This was confirmed in conversation with staff and the home’s duty rota. During the day three to four staff would be working with one member of staff providing sleep in cover. Staff stated that the home is always staffed with two care officers (senior) to enable medication to be administered in accordance with the home’s medication policy. Four staff files were viewed. This provided evidence that the home completes a thorough recruitment process ensuring that all the documentation is in place. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 21 The manager stated that all staff that have been working in the home in excess of three years are completing a new criminal record bureau (CRB) check. The manager stated that all staff complete the CRB disclosure at an enhanced level to enable them to support vulnerable adults. The home has demonstrated compliance to a requirement from the last visit. Evidence was seen that a comprehensive induction was in place, which included orientation of the home, policies and procedures and care practices. All staff complete the Learning Disability Qualification, which has replaced the Learning Disability Award Framework. Staff files provided evidence that there is an ongoing training programme based on the care needs of the individuals and statutory health and safety training. The manager has planned training on epilepsy for all staff. What was not apparent was training for staff on how to support individuals who are nonverbal or who use makaton (sign language for people with a learning disability). The manager has agreed to explore how this can be delivered to the staff team. Members of the team are encouraged to undertake a National Vocational Qualification (NVQ) at either level 2,3 or 4 depending on their role in the home. The manager stated that one of the deputies has completed an NVQ 4, and the other is in the process of completing. The home has 21 staff and from conversations it was only evident that 3 staff have obtained an NVQ with a further four staff completing. The home should devise a plan to ensure that 50 of the workforce have a relevant NVQ in care as per the government’s guidelines. The manager stated that with only two assessors working in the home this has hindered progress in achieving the government target. Staff spoken to during the visit described their role clearly with high job satisfaction and a cohesive team being in place. Records provided evidence that staff receive regular supervision and support with regular monthly team meetings. Staff have an annual appraisal of their work, which identifies further training that is required. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 40 School Road continues to be a well-managed service. Individuals benefit from a safe environment. People that use the service can be assured that the quality of the care provision is kept under review. EVIDENCE: Mrs Haddow is managing 40 School Road whilst Mrs Huggins the registered manager is seconded to another area within Bristol City Council. Mrs Haddow is in the process of applying to become the registered manager with the Commission for Social Care Inspection. Mrs Haddow is a registered nurse for people with a learning disability. She has been in a management position in excess of two years. She has worked at the home since it opened four years 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 23 ago as the deputy manager. Mrs Haddow has completed a level 4 National Vocational Qualification in management. Staff spoke positively about the support the manager offers them and her open approach. The manager stated that the provider visits on a monthly basis to complete a quality monitoring visit in respect of regulation 26. Records were not viewed on this occasion. Copies are not being sent to the Commission for Social Care Inspection. Questionnaires are sent to people who use the service for them to express the views on the quality of the care provided. These are available in plain English and include pictures making them more accessible. Presently there is no formal way of seeking the views of the relatives. There is a business plan in place as seen at the last visit. Good health and safety systems were in place. There is a named health and safety representative within the team. Risk assessments were in place for fire, COSSH, manual handling and food safety. These had been kept under review and ensured safe working practices were in place. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA7 Regulation 17 (1) (a) Sch.1.l Requirement To enable people that use the service to make decisions, the means used to communicate must be incorporated into the care plans of people with communication needs. (Outstanding since 30/06/07 The statement of purpose must be amended to be clear that the maximum six week length of respite care may only be exceeded where there are exceptional circumstances. Timescale for action 16/04/08 2. YA1 4 (1) (c) 16/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA39 Good Practice Recommendations To ensure that care plans are dated and signed by the person compiling the care plan in addition to the person receiving a care service. For the home to include relatives in the quality assurance audit. 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 40 School Road DS0000053613.V353240.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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