Care Home: 428-430 Gillott Road

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What the care home does well The home has good admission procedures in place that ensure peoples needs are fully assessed before they move in so they know the home can meet their needs. The home is clean and well decorated so it is a nice place to live. Each person has a care plan so that staff know how to support them to meet their needs. There are lots of different activities on offer so that people lead an active lifestyle that they enjoy. The staff were seen to have excellent relationships with the people living there supporting them as they wish. This gives people a sense of wellbeing. People are supported to keep in touch with their families and friends so that they do not lose relationships that are important to them. A choice of food is offered to people and they have a healthy diet to help them keep well. The health needs of the people living there are met and people get the care from other professionals they need. There are good procedures to listen to people and keep them safe from possible harm. Staff are recruited and selected in ways that ensure safe skilled individuals are employed. Staff have the training they need so they know how to support the people living there. The home has in place a quality monitoring system based on seeking the views of the people living there so they decide how improvements are made. What has improved since the last inspection? A copy of the complaints procedure is on display in the home so that people know how to make a complaint if they need to. Some areas of the home have been repainted and new floor covering fitted so that the home is a nice environment for people to live in. The fire risk assessment has been reviewed to make sure fire precautions in the home have been assessed and the risks of fire reduced. Individual fire evacuation plans have been completed so that staff have the information they need on how people should be supported to stay safe should a fire occur. What the care home could do better: Information about the fees to live at the home should be updated so that people have all the information they need to make a decision about living there. Damaged kitchen units and worktops should be replaced so that the kitchen can be properly cleaned and infection control improved. Evidence that the electrical installations in the home are safe must be available to show that people are not at risk of harm. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Gillott Road, 428-430 Gillott Road, 428-430 Edgbaston Birmingham West Midlands B16 9LP     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: Kerry Coulter     Date: 0 9 1 2 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 29 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Gillott Road, 428-430 Gillott Road, 428-430 Edgbaston Birmingham West Midlands B16 9LP 01214549293 01214558256 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Deborah Holt Type of registration: Number of places registered: Sense, The National Deafblind and Rubella Association care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: Residents must be aged under 65 years Date of last inspection Brief description of the care home 428-430 Gillott Road is registered to provide personal care and support to 8 adults with a visual impairment/ learning disability, who have been assessed as requiring full assistance with daily living tasks. The premises are divided into two homes, each with its own team of staff. Each has its own front door but is also internally interlinked. The home is staffed 24 hours a day including waking night and a sleeping in member of staff. People would be admitted to the home following a full assessment that would determine the level of support they require. A number of adaptations have taken place within the home in order to meet the assessed needs of people who live there. The home is situated in Edgbaston, a residential area of Birmingham and has ready access Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 8 8 Brief description of the care home to local amenities and public transport. The home also has its own vehicle. People who live at the home have information about how much their fees are in their own personal service user guide. However informationabout the range of fees to live at the home is not included in the guide. Previous reports about the home are available to read in the home, on request. Care Homes for Adults (18-65 years) Page 5 of 29 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: This inspection was carried out over one day, the home did not know we were going to visit. This was the homes key inspection for the inspection year 2008 to 2009. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and the Annual Quality Assurance Assessment (AQAA) completed by the manager. This provides information about the home and how Care Homes for Adults (18-65 years) Page 6 of 29 they think it meets the needs of the people living there. We sent out surveys to care professionals but none were returned to us. Surveys were sent to the home for staff to complete but unfortunately discussion with the manager indicate these were not received. Three of the people living in the home were case tracked. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked at parts of the home, and a sample of care, staff and health and safety records were looked at. Due to peoples limited communication we were unable to ask them for their views of the home but we did observe some care practice to see what it was like to live there. The manager and staff on duty at the time were spoken with. What the care home does well: What has improved since the last inspection? A copy of the complaints procedure is on display in the home so that people know how to make a complaint if they need to. Some areas of the home have been repainted and new floor covering fitted so that the home is a nice environment for people to live in. The fire risk assessment has been reviewed to make sure fire precautions in the home have been assessed and the risks of fire reduced. Individual fire evacuation plans have been completed so that staff have the information they need on how people should be supported to stay safe should a fire occur. Care Homes for Adults (18-65 years) Page 8 of 29 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.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 29 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 29 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 have most of the information they need so they can make a choice as to whether or not they want to live there. A full assessment of peoples needs is completing before they move in so they can be sure that the home can meet their needs. Evidence: We looked at the information available for people wishing to move into the home to see if they would be able to make a decision based on the information provided. The information is available ranging from, written; CD Roms audiotape, and picture form to ensure people identified needs have been accounted for. The service users guide tells people what service is provided and by whom, what qualifications the staff hold, the history of the organisation and what the person moving in to the home can expect. Some information about our new address needed to be updated so that people know how to contact us, should they wish to. People have their own copy of the guide that has information personal to them regarding how Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: much it costs to live at the home. However information on the range of fees to live at the home should be included in the general guide so that people thinking of moving to the home have a general idea of how much it costs to live there. One person has moved into the home since we last visited the home. Records and discussions with staff showed that a full assessment of the persons needs had been completed before they moved to the home. The assessment was very detailed and person centred, taking into account their personal preferences and cultural needs. As the person has communication difficulties and would not be able to verbally give their views on the home they were supported to visit the home for a period of two weeks before moving in. During this time they participated in activities and meal times with people who already lived there. This gave staff the opportunity to observe through body language if the person seemed happy at the home. Before they moved in to the home transition meetings were held so that the move was well planned. It is good that it was identified that the person preferred baths to showers and that arrangements were made to install a bath in the shower room close to their bedroom. Care Homes for Adults (18-65 years) Page 12 of 29 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. Staff have the information they need so they can support people in the way that the individual chooses so ensuring their safety and well being. Evidence: The records of three of the people living there were looked at. These included an individual care plan that stated how staff are to support the person to meet their needs and help them achieve their goals. There was excellent information in care plans giving good details about the person needs and how the choice of each person was to be met by staff. There was good information about what the person likes and dislikes which is important as the people living in the home have difficulty with communicating their needs. Pro-active strategies (meaning taking action before problems occur) were in place for challenging behaviour, this meant that reactive strategies to challenging behaviour were reduced (things staff need to do when the person becomes upset). Daily records gave information about the person daily activities, such as going out, Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: what activity they had completed during the day and most importantly how they had been in themselves. Each person has a core team of staff who meet on a monthly basis to review the well being of the person and ensure their care plans are up to date. People living at the home are generally unable to communicate verbally and so staff have to use alternative methods of communication with people. Staff spoken with had a good understanding of peoples communication methods. We saw staff assisting people to make choices for themselves during our visit. One staff told us they had been out that day assisting one person to choose a new sofa. They said that as the person was unable to verbally tell them which sofas they liked they had tried sitting on lots of sofas and used body language to see if the person looked comfortable on the sofas. Records included individual risk assessments that stated how staff are to support individuals to take risks in their day -to-day lives whilst ensuring that they can be as safe as possible. Risk assessments had been completed for activities such as swimming and rock climbing and for areas of risk such as choking, challenging behaviour, the use of physical intervention, accessing the kitchen, health needs, accessing the community and travel in the homes vehicle. Care Homes for Adults (18-65 years) Page 14 of 29 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. Arrangements ensure that people living there experience a meaningful lifestyle that ensures their self-esteem and well being. People are offered a healthy diet and enjoy their meals. Evidence: Care plans sampled stated the leisure and social activities that people enjoyed and how much staff support they need to be able to do these. Records sampled and discussion with the staff confirmed that the people living in the home participate in a broad range of valued and fulfilling activities that reflect their preferences and are appropriate to their needs. These included going out for meals, rock climbing, swimming, shopping, visits to parks, use of a hot tub, ice skating and drawing. One person was being supported by staff to do some drawing during our visit. Staff were communicating with them using sign language and from the persons body language it Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: was apparent they enjoyed the activity. Staff treated people with respect throughout our visit, for example making sure they said goodbye to people when they had finished their shift and were going home. Records and discussions with staff show that people who enjoy going on holiday are offered the opportunity to have one. Staff told us that one person had three holidays this year because they enjoyed them so much. The home has its own vehicle and several people went out with staff support during our visit to the home. Records are kept of the activities people participate in. These showed that sometimes planned activities do not take place because of staffing difficulties, however alternative activities are usually offered. Records and discussions with staff show that a high importance is placed on promoting and maintaining contact with peoples relatives. The annual quality assurance assessment completed by the home manager recorded that SENSE have a family liaison officer and also organise an annual family day. The week before our visit to the home the staff had a team building day, discussions included how peoples social networks could be further improved. The manager told us that for one person they were trying to improve links with his cultural community and this included arranging for them to go to the temple to see if they enjoy it. For some people, staff had arranged for them to go on holidays to places local to their relatives so they could visit. For example, one person had a break in Kent that coincided with a relatives 60th birthday. Peoples food likes and dislikes are recorded in their care plan. We looked at the menus for the home and these showed that meals are varied, culturally appropriate and nutritious. Alternative choices are available, staff told us that if people do not like the choices on offer then an alternative is always provided. The manager said that for one person some meals were brought into the home to ensure culturally appropriate choices were available. The manager said the home intends to improve the meals on offer and have arranged for someone to come into the home to teach staff how to cook meals appropriate to the persons cultural needs. Peoples records demonstrate that use has been made of the speech and language therapist to assess people for swallowing difficulties so that they can provide the correct level of support to eat safely. Care Homes for Adults (18-65 years) Page 16 of 29 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. The health and personal care needs of the people living there are met so ensuring their well being. Evidence: Care plans stated how staff are to support individuals with their personal and health care needs. The people living there were well dressed in appropriate styles to their age, gender, cultural background and the activities they were doing. Attention had been paid to individuals personal care indicating that people had the support they needed so ensuring they felt good about themselves. We looked at the health records for three people. Each person had their own health action plan so that staff know what support they need to keep healthy. Records sampled showed that health professionals are involved in peoples care where needed. Records showed and staff said that they work with other professionals to ensure individuals well being. People attend health check ups with the dentist, optician and chiropodist to ensure their health needs are met. There was a chronological record of interventions by health care professionals and outcomes were recorded. One person Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: has diabetes, clear guidance was available to staff on the support they need and records show that the person has annual health checks for their diabetes. Medications are stored securely and records maintained of medication administration. At the front of each persons Medication Administration Record (MAR) there is a photo of the person so that unfamiliar staff would know who to give the medication to. There are also clear directions on how each person likes their medication to be administered. MARs sampled had been signed when medication had been given indicating that medication had been given as prescribed. Protocols were in place for people who are prescribed medication on as as required basis. This means that staff have information about why and when this medication needs to be given. The majority of staff at the home have received training in administering medication, the registered manager told us that only staff who have had training give medication. During our visit we observed a member of staff administering lunchtime medication. The procedures they followed were safe and ensured the person received the medication they need as prescribed. Care Homes for Adults (18-65 years) Page 18 of 29 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. Suitable arrangements are in place to respond to peoples concerns and complaints and staff are trained to recognise and respond to suspicions of abuse so that people are protected form harm. Evidence: We have not received any complaints about this home in the last twelve months and the home has not received any complaints directly. At the last key inspection it was identified that there was not a copy of the complaints procedure on display in the home for visitors. At this visit we saw that this was now on display so that visitors have the information they need to make a complaint if they need to. The home has attempted to make the complaints procedure more accessible to people by providing it in picture, CD Rom and audio formats. However the registered manager said that because of peoples level of understanding and communication needs people generally relied on staff and relatives to pick up on when they were unhappy via their behaviour or body language. Discussions with staff indicate they know how to raise their concerns. One staff told us can go to anyone with concerns, there is never a problem, things get sorted out there and then. As well as being able to report concerns directly to the managers SENSE also provides a freephone number for people Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: to use to report any concerns they may have. Systems in place to safeguard people from the risk of harm show that this is given high importance. As stated previously a national freephone number is provided to people where they can raise concerns if they wish to, as well as using the usual channels within the home. SENSE has a national team that monitors all incidents of reported abuse and there is a regional investigations officer in post. The registered manager is a qualified trainer in the protection of vulnerable adults. Records sampled show that staff have all received training and also complete an annual questionnaire about safeguarding people to make sure they know how to do this. Safeguarding is also discussed with staff during supervisions with their manager. Staff spoken with during our visit knew what to do to keep people safe if they suspected someone had been abused. The finance records of one of the people living there was looked at to ensure that their money was being looked after appropriately and was safe. Receipts were kept of all purchases, these matched the amounts stated on the individuals finance records. Staff check that peoples money is correct at the change over of each shift and regular audits are completed by the providers representative. One person at the home sometimes displays behaviour where they physically hurt themselves, often by banging their head. Training records show that staff have received training in managing peoples behaviour and the use of physical intervention. Since our last inspection staff have worked hard to try and reduce these incidents following seeking advice from their behaviour support team. Discussions with the registered manager and records show that incidents have reduced. Records show that there have been some occasions when staff have had to use physical intervention. The records and discussions with staff show this has been used as a last resort and to protect people from harm. Staff records show that recruitment procedures are robust. It is good that the home has a system of rechecking staffs criminal record bureau checks every three years. This helps to reduce the risk of abuse from having unsuitable staff working with people. Care Homes for Adults (18-65 years) Page 20 of 29 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. People live in a generally clean, well decorated and safe home that meets their individual needs. Evidence: The home is made up of two houses with interconnecting doors. Four people live in ech house where they have their own bedroom and a communal lounge, bathrooms and toilets, dining area and kitchen. We looked at all of the communal rooms during our visit and some bedrooms. The home was at a comfortable temperature and no unpleasant odors were noticed. Communal areas were homely in style and some areas had been repainted recently to make the rooms more pleasant areas to spend time in. New floor covering had also been installed in the kitchen and dining areas. The home had also looking nice with decorations in readiness for Christmas. Bedrooms were decorated and personalised according to each persons preferences and needs as recorded in their care plan. Some people had bedrooms with lots of personal effects whist others had rooms that were quite sparse. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: There are two bedrooms without wash-hand basins. In one bedroom the person would not tolerate one. They have refused a wardrobe or drawers and insist upon clothes being neatly spread on the floor area. They have also refused to have other furniture or chairs in the room. In another bedroom the wash-hand basin had to be removed for safety reasons. The person sometimes self harms with head banging and so the walls have been fitted with carpeting to reduce the risks of injury. This person prefers a room of low temperature and to accommodate this the room has been fitted with airconditioning. The home provides a physical environment that meets the specific needs of the people who live there. Tactile images are provided around the home and there are colour changes to steps and light switches making them more visible to people with sight impairment. We found that in general the home was clean and infection control procedures were in place to include satisfactory hand washing facilities. Units and worktops in the kitchens in the home are now a little tatty in appearance. Some areas of the laminate is chipped and crumbling exposing the chipboard beneath. This makes these areas difficult to fully deep clean and do not promote good infection control. Discussions with the manager indicate that the home have previously been told they will be having replacement kitchens by the landlord but that no firm dates have been set for this. Care Homes for Adults (18-65 years) Page 22 of 29 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. The arrangements for staffing, their support and development ensure that the needs of the people living there are met. The recruitment practices help to ensure that the people living there are safeguarded from abuse. Evidence: Discussions with staff were open, positive and relaxed. Staff skills and knowledge about the people they were supporting were evident throughout observations during the inspection. The annual quality assurance records that a number of staff have worked at the home in excess of five years and so know people well. However the home also has recently recruited a number of new staff who do not have an National Vocational Qualification (NVQ) in care. This has meant that the percentage of staff who have an NVQ has dropped since our last inspection, however this training will be provided to new staff once they have completed their probationary period. Observation of care practice and discussion with the managers of the home and staff indicate that there are usually enough staff on duty to meet peoples needs. One staff told us that it was very rare to be short staffed.The home is not fully staffed but additional staff have been recruited, pending satisfactory recruitment checks. There has been some use of agency staff to cover staffing shortages, staff told us that the Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: home tries to use regular agency staff for consistency. The records of three of the staff who work there were looked at. These included the required recruitment records including evidence that a satisfactory Criminal Records Bureau (CRB) check had been completed to help ensure that people are not put at risk of having unsuitable staff working with them. Training records showed that staff had receive training that includes health and safety, first aid, protecting vulnerable adults, food hygiene, physical intervention, challenging behaviour, moving & handling, fire, medication, infection control and working with deaf blind people. This ensures that they know how to meet the needs of the people living there. Staff we spoke with said that training provided is good, their comments included had lots of induction and training is very extensive and ongoing. Records and discussions with staff show that regular staff meetings and supervisions take place to ensure safe working practice and staff personal development. One staff said supervision is very regular, is every month and we have an appraisal. They allow you to have your say, never frightenend to say what you want. Care Homes for Adults (18-65 years) Page 24 of 29 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 management arrangements ensure that the home is generally well run and in the best interests of people living there. Evidence: The home comprises 428 & 430 Gillott Road but there is access internally between the adjoining houses. The houses are run and staffed separately although they are registered as one home There are in fact two managers, one is approved as the registered manager. Both managers share an office on the ground floor that allows direct involvement and management in the daily running of the home. Both managers were observed to work well together during our visit. Discussions indicated they have a good knowledge of the needs of people living at the home. We received the homes annual quality assurance assessment when we asked for it and this was completed to a good standard, recording where the home intended to make improvements. Requirements that we made at the last key inspection had been met. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: A representative of the provider visits the home, usually on a monthly basis to assess the quality of the service provided. There had been some gaps in the visits during a change of representative but visits are now happening monthly. Reports made following each visit were very detailed and showed consultation with staff and observation of care practice in the home. An internal quality assurance assessment had been completed where staff views had been sought via questionnaires. Audits had also been completed regarding medication, fire, care planning, the environment and physical intervention. These showed that the home is continually assessing its own practice and identifying where things can improve for the benefit of people living there. Requirements were made at the last key inspection regarding health and safety, to ensure the cellar door is kept locked, the fire risk assessment to be updated and individual fire evacuation plans to be completed. At this inspection we found that these issues had all been rectified. Fire records showed that staff test the fire equipment regularly to make sure it is working. Certificates were available to show the fire systems are also regularly serviced by a qualified engineer. A fire drill was due but there was evidence available to show that this was planned to take place to ensure that staff know what to do to keep people safe should a fire occur. Staff check the temperatures of the hot water in the home on a daily basis to make sure that people are not at risk of being scaled. Records showed that temperatures were safe. The home did not have evidence during our visit to show that the gas installations in the home were safe. Following our visit the registered manager contacted the landlord for the home and obtained a copy of the gas safety certificate. A copy was forwarded to us and showed gas installations were safe. The homes five year electrical installations certificate dated 2004 did not show that electrical installations in the home were safe. The manager said that the required remedial works had been carried out some years earlier, however the manager was unable to locate the paperwork for this during our visit and said she would seek copies from the landlord. Following our visit the manager has contacted us and stated that as the installations are due to be rechecked in 2009 they would be done in January to ensure electrical installations are safe. Care Homes for Adults (18-65 years) Page 26 of 29 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 29 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 42 13 Evidence that the electrical 30/01/2009 installations in the home are safe must be provided. To ensure that people are not put at risk of injury or harm. 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 1 The service user guide should be updated to make sure that people interested in moving to the home have information about the range of fees to live there. Damaged kitchen units and worktops should be replaced so that the kitchen can be properly cleaned and infection control improved. 2 30 Care Homes for Adults (18-65 years) Page 28 of 29 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. 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. 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