Care Home: 4a Geales Crescent

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What the care home does well Enabling the service users to communicate is a high priority at the home and all the service users take part in communication sessions each day on a one to one basis with the staff. A communications room provides a private space where the service users and staff can work uninterrupted. To enable the service users to access the community, and to enjoy trips to places of interest, the company provides a people carrier, which is adapted for use by wheelchair users. Creative work completed by the service users was displayed throughout the home, encouraging and valuing the service users` creativity and stamping their individuality and sense of belonging onto the home. Training is incorporated into the work schedule for all the staff, ensuring they can easily access the necessary courses to support them in their role. Many compliments had been received by the home including, `I just want to thank you and all the staff, who made the Christmas cocktail party such a success. All the service users looked wonderful`, `thank you for the wonderful party, enjoyed by everyone and congratulations to you all on what you have made Geales Close into over the last two years. It was always a nice home, but you have turned it into a wonderful home for its residents, the effects on whom, are clear for all to see`, `the home and garden provide a great amount for the residents to enjoy themselves, but the staff provide warmth, fun and a sense of `home``, and `the food was delicious, and the fact that the residents had been so involved in preparing the food and drinks, made it rather special.` What has improved since the last inspection? Since the previous site visit a service user guide had been produced, which was illustrated with photographs, descriptions were in short sentences and large print, and symbols were used to promote prospective service users` understanding. Service users aspirations had been recorded and person centred plans in their preferred communication style had been created and service users had been involved in the process. Relevant records of staff recruitment checks were available in the home to be inspected, for the safety and protection of the service users. What the care home could do better: The special arrangements put in place, prior to the previous site visit, continued to be in place. This involves a male staff member providing personal care to female service users at certain times due to the make up of the staff team. This is not a satisfactory long term plan. Using agency staff to make up the staff team is also not a satisfactory long term solution to providing consistency and continuity of care to the service users. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 4a Geales Crescent 4a Geales Crescent Alton Hampshire GU34 2ND     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: Christine Bowman     Date: 2 3 0 1 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 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: 4a Geales Crescent 4a Geales Crescent Alton Hampshire GU34 2ND 01420542447 01420549511 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): People Potential (UK) Ltd Name of registered manager (if applicable) Mrs Susan Jones 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 to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only (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 (LD). Date of last inspection Brief description of the care home 4a Geales Crescent provides accommodation, personal care and support for up to five adults with a learning disability. The layout of the home is modern, spacious and well equipped and service users are encouraged and supported to develop their communication skills. The current range of fees is #1, 700.00 to #3,100.00 per week. 5 Over 65 0 care home 5 Care Homes for Adults (18-65 years) Page 4 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: 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: This inspection report includes information gathered about the service since the previous site visit on 5th February 2007 under the Commissions Inspecting for Better Lives (ILB) process. The registered manager completed an Annual Quality Assurance Assessment (AQAA) giving up to date factual evidence about the running of the home and informing us of what they think they are doing well, how they have improved the service and of their plans for further improvements. Two staff completed and returned surveys, giving their views on the service. An unannounced site visit was conducted on 23rd January 2009, to assess the outcomes of the key inspection standards for younger adults with respect to the service users living at the home. The registered manager, Mrs Susan Jones, was interviewed and provided support for the inspection process by making service user and staff files and other documents available to be Care Homes for Adults (18-65 years) Page 5 of 29 sampled. A tour of the premises was undertaken and communal areas and some of the service users bedrooms were viewed. A number of staff and service users were spoken with throughout the day and observations were made of the service users and of staff as they carried out their duties. Service user and staff records, maintenance certificates and complaints and compliments records were sampled and the Statement of Purpose, the Service User Guide and some policies and procedures were viewed. 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 Care Homes for Adults (18-65 years) Page 7 of 29 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 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users have accessible information to enable them to make an informed decision about living at the home and a full assessment of their needs is carried out so the home can make a decision about meeting their needs an offering a placement. Evidence: The service user guide was illustrated with photographs, descriptions were in short sentences and large print, and symbols were used to promote prospective service users understanding. In addition to photographs of the communal areas of the home, the guide included photographs of places in the community, which the prospective service user would have access to. Local shops, pubs, the leisure centre and a variety of places of worship were all included. Since the last site visit, there had been one new admission to the home. A full transition process had been put into operation to ensure that the prospective service user and the current service users were compatible. An initial assessment had been Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: carried out and the prospective service user had spent time at the home, staying to tea, attending a birthday party and staying overnight, before the decision was made to stay at the home. The staff from the home had also spent time at their home and at their further education placement getting to know them. Before the prospective service user had moved in, the manager stated, they had chosen the whole colour scheme for their bedroom from samples. They had chosen the furniture, the carpets and the soft furnishings and brought familiar objects to make their new bedroom feel homely. Assessment documentation sampled, covered all aspects of service users daily living skills and abilities and covered personal care, health, social, emotional, communication and behavioural needs. Risk factors in fulfilling the service users support needs, were explored and identified, and detailed information had been gathered to enable the service to decide if their mission statement of enabling all service users to reach their maximum potential and to live a valued and fulfilling life in their community could be achieved. Care Homes for Adults (18-65 years) Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Person-centred planning promotes the involvement of the service users in decisionmaking about their lives with appropriate support and independence is promoted. They are supported to take risks to enable them to be as independent as their individual abilities allow. Evidence: Service users files sampled showed that care plans had been collated using the information gathered during the assessment process. The service users personal support needs had been identified and guidance for the staff to follow to support the service users in maintaining their independence had been recorded. Each care need was fully described with the level of dependency on the staff and the associated risks had been identified. The two staff, who had completed surveys, confirmed they were always given up to date information about the people they support in the care plan and one commented, all the individual care plan reviews are made clear to all the staff and we implement them accordingly. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Since the previous site visit, the staff had accessed person-centred care planning training, and person-centred care plans had been developed, in symbolic format according to the individual service users communication needs. The care plans sampled documented the service users likes, dislikes and preferences. One service user liked dancing, music, walking, cycling, cooking and being read to, but didnt like being ignored, being told what to do instead of being asked and didnt like drinking cold fizzy drinks or eating crisps. It was clear that service users had been consulted about their preferences with respect to the activities of daily living and how their support was provided. The manager confirmed that relatives and representatives were involved in the review process. Enabling the service users to communicate was a high priority at the home and the manager stated that all the service users took part in communication sessions each day on a one to one basis with the staff. This work took place in the communication room, where they would not be disturbed. Each service user had their individual communication aids, which varied from objects of reference to MAKETON and other signs and symbols. Some service users were able to put together symbols to indicate their choices. The manager was very enthusiastic about this development, which enabled service users to make their wishes known and promoted their ability to make their own decisions. Risk factors and actions to reduce risks were included in the service users care plans for their safety and protection and to inform the staff. The manager stated that new risk assessments were in the process of being introduced. A sample showed that the hazard or task being assessed was described; control measures listed, the impact (actual or potential) was recorded with levels of severity, and the likelihood of occurrence, with levels of probability. Scores indicated the risk rating and the level of action required. Care Homes for Adults (18-65 years) Page 13 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. Service users take part in appropriate activities that take account of their needs and preferences, they are supported to maintain personal relationships and to be part of the local community. Service users rights are recognised and they are offered a healthy diet that reflects their individual tastes and dietary needs. Evidence: On the day of the site visit, a member of staff was working with some of the service users on a creative arts project, making small decorative boxes, which the service users were proud to show. One to one communications sessions took place throughout the day, and in the afternoon, a minibus trip was undertaken, to walk in a local park. The company to enable the service users to access the community, and to enjoy trips to places of interest further afield had provided a people carrier, specially adapted for use by wheelchair users. Tokens were also used on public transport, the manager Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: stated, and one service user liked to spend time on the Watercress Line steam railway. Service users had their own schedules and a sample confirmed they engaged in a variety of activities including, swimming, food shopping, gymnastics, trampolining, dance class, cooking, bowling, arts and crafts, video, meals and coffee in town and attending the leisure centre which provided a choice of activities such as archery, zip wire, sailing, canoeing, and climbing. One service user regularly attended a further education course at a local educational establishment. Some of the service users enjoyed attending bible class and a social group in the area. Individual care plans showed that service users aspirations were recorded and the steps to achieving them illustrated in photographs. One service user, who loves music, wanted to attend an Abba concert and photographs showed how they planned the trip, went to the bank for money, paid for the ticket and enjoyed the show. Another service users dream was to go to Disneyland Paris and everything had been done to enable this. Another service user enjoyed gardening and had grown vegetables, such as tomatoes and runner beans to use in the kitchen and plants for the hanging baskets. This service user had their name on a waiting list for an allotment, the manager stated. The manager stated that the service users all got along together well, enjoy living together, and that three were really good friends. All maintained contact with family and friends, who were invited to the home on special occasions to join in celebrations, but were welcome to visit at any time. A cocktail party over Christmas had been a great success, with service users involved in preparing the food and drinks and entertaining their guests. In the summer, bar b cues were arranged and the service users had individual holidays on the Isle of Wight and Swanage. Pictorial menus enabled service users to choose their meals. Service users helped to prepare the lunch on the day of the site visit, peeling the potatoes and preparing the vegetables, and lunch consisted of faggots, mashed potato, cauliflower, broccoli and carrots with yoghurts and fresh fruit to follow. The four-week menu was varied and wholesome and the manager stated that the service users had chosen all the dishes. Special dietary needs and choices were recorded in service users care plans and support required to ensure safety. Care Homes for Adults (18-65 years) Page 15 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. Service users personal and healthcare needs are met according to their preferences and wishes and safe procedures are in place to promote their access to medication. Evidence: The staff observed working with the service users on the day of the site visit, did so with sensitivity and understanding and the service users appeared to be trusting, happy and relaxed with them. It was clear that the staff were aware of the needs and preferences of the service users, which were recorded in their care plans. Levels of support service users required to enable them to maintain independence, were recorded. One service user liked to have a good soak in the bath, another would, ask for help to cut up food if struggling and a third needed encouragement to chew food properly. Prior to the previous site visit the home had notified the Commission for Social Care Inspection about a change in staffing personnel, which had resulted in one of the staff teams being an all male team. This presented issues regarding the provision of personal care to female service users. In order to safeguard the service users and the staff, the home had implemented a system of 3 minute recorded checks where personal care is administered by one of the males on this team. This is mainly Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: at weekends. The homes manager is available Monday to Friday and provides personal care support on arrival in the mornings. Service users parents and care managers had been made aware of the situation and, while the management were expressly aware that it was not ideal, felt that it was being dealt with appropriately. Full records were kept to confirm there had been no problems as a result of this compromise; however, the situation should really have been resolved within the two years since the previous site visit. Service users, whose files were sampled, had symbolic health action plans, showing how they maintained a healthy lifestyle with exercise and a balanced diet. Their individual programmes included opportunities for physical activities and exercise including swimming, keep fit, walking, trampolining and bowling. A healthy lifestyle checklist was included in the service users files, confirming that their key workers had ensured that service users nails, feet, ears and skin were in good order, that oral hygiene had been completed and that any unusual marks or bruises were reported. Records confirmed that service users were registered with a General Practitioner and that a local dentist provided regular checks and treatment. A physiotherapist was involved with one service user whose file was sampled and a psychologist had been involved completing a behaviour plan for another service user. All the service users had a medication profile with a photograph, a record of all medications they had been prescribed, why they were used, possible side effects to be aware of, and how the service user liked them to be administered. Medication was blister packed by the pharmacist for safety and convenience. Medication records had been appropriately completed and a list of staff signatures, confirmed which staff member had administered the medication to the service users. The manager stated that a local college provided the medication administration training and staff training records confirmed that the manager also observed the staffing in the practise of administering medication to assess their competence. Since the previous site visit, a controlled drugs cabinet had been installed, and a controlled drug register obtained, in which to keep a running total of these drugs. The number of remaining drugs in the register matched the remaining stock in the cupboard, when counted. Care Homes for Adults (18-65 years) Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home endeavours to ensure that the communication needs of the residents are met to enable them to make their feelings, wishes and views know so they may be acted upon, and a full complaints procedure is available. Systems are in place to protect the residents from the possibility of abuse, neglect and self-harm. Evidence: The service users had been provided with a pictorial complaints procedure in their bedrooms and included in their service user guides. The communication support provided at the home, promoted the service users ability to express themselves and to make their feelings known to the staff, who worked with them on a one to one basis every day. The manager also provided one to one support throughout the week. The full complaints procedure, with a timescale for acknowledging the complaint, was included in the statement of purpose and was in need of a review to include the contact details of the CSCI, to enable relatives, representatives and staff to get in touch, should they wish to do so. A complaints and compliments log had been set up in which to record details and actions taken as a result of complaints received, but no complaints had been received since the previous site visit. Some of the many compliments received included, I just want to thank you and all the staff, who made the Christmas cocktail party such a success. All the service users looked wonderful, thank you for the wonderful party, Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: enjoyed by everyone and congratulations to you all on what you have made Geales Close into over the last two years. It was always a nice home, but you have turned it into a wonderful home for its residents, the effects on whom are clear for all to see, the home and garden provide a great amount for the residents to enjoy themselves, but the staff provide warmth, fun and a sense of home, and the food was delicious, and the fact that the residents had been so involved in preparing the food and drinks, made it rather special. The home had a copy of the local authority safeguarding adults policy and procedure to inform the staff of how to safeguard the residents from harm, and the staff training matrix confirmed they had received the protection of vulnerable adults training. The registered manager had completed the mental capacity act training and the home provided training in responding to challenging behaviour. The staff recruitment process also safeguarded residents by ensuring that recruitment checks including Criminal Record Bureau and the Protection of Vulnerable Adults list checks had been received, prior to the offer of employment. The AQAA recorded that, over the previous twelve months, one safeguarding referral had been made as a result of a complaint. Full details of the investigation, including the homes action plan, were recorded and stored appropriately. As a result of the investigation, a psychologist had worked with the staff team on behaviour management plans, and preventative measure to be employed. Care Homes for Adults (18-65 years) Page 19 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a home that is safe, well maintained, homely, clean and comfortable, and which provides enough space and facilities for them to lead the life they choose and to meet their needs. Evidence: The home was a large detached house located on a residential street on the outskirts of Alton and did not stand out in any way from adjacent properties. A small car park was available to the front of the building and it was also possible to park on the street. The homes vehicle was parked in the car park and a covered area, between the outer door and the front door, provided shelter for a service users wheelchair. The home was within easy reach of community facilities including a variety of shops, cafes, a small gymnasium, parks and open spaces. In the town of Alton was a large leisure centre, where the service users could access such activities as swimming, a fitness studio, badminton and football. Public transport was within easy walking distance of the home. A tour of the premises revealed that the home had a variety of communal spaces for the service users to enjoy. The large lounge had been provided with comfortable leather sofas, chairs and beanbags. The original centrepiece of the living area had Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: been a fireplace with large chimney, which had been adapted as seating. The service users had chosen the colourful material for the seating and the beanbags, the manager stated. Lighting was domestic and ornaments and potted plants gave the room a homely feel. Creative work completed by the service users was displayed, not only in this room, but also throughout the home, encouraging and valuing the service users creativity and stamping their individuality and sense of belonging onto the home. A personal computer with appropriate software was available for the service users exclusive use, and a widescreen television, video, DVD and associated videos and compact discs had been provided for their entertainment. French windows led out into the garden, which was partly laid to lawn and well maintained. In the garden were a fishpond, covered seating, a hammock and a terraced area used for playing such games as skittles and croquet, the manager stated. A sensory herb garden had been created for the service users enjoyment and for use in the kitchen, and a greenhouse enabled the service users to assist in the growing of tomatoes and runner beans for general consumption. A high hedge made the garden private and secure. The large well equipped, high quality, up to date kitchen also had a door to access the garden and had sufficient space for the service users to assist in the preparation of meals. A dining area was incorporated and a solid table and chairs were arranged at one end of the kitchen, separated by a low divider, so that those involved in the preparation of meals were able to communicate easily with anyone sitting at the table without interference in the work in hand. Other communal spaces included a sensory room, containing a music system, bubble tubes, fibre optic lights, and beanbags for relaxation, an arts and crafts room supplied with a large variety of materials for the service users creative use and an exercise bicycle, and a communication room. The communication room provided a quiet space, where the staff conducted communication sessions with the service users for ten minute sessions each day. All the service users had their own communication aids, including objects of reference and symbols to enable them to make choices and decisions about their lives. The service users bedrooms were personalised and reflected their individuality. One service user, who really liked trains, had a large picture of one on their bedroom wall and many jigsaw puzzles with the same theme. Another service user had lots of art materials, soft toys and enlarged photographs of family and friends on holiday. It was clear the service users had chosen their bedroom furniture, soft furnishings and colour schemes because all the bedrooms were so different, and the manager confirmed this. Furniture was of a high quality as were the en-suite facilities provided for all the Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: bedrooms. En suite facilities were also individualised according to the needs and preferences of the service users, the manager stated. The utility room contained domestic laundry facilities and a secure Control of Substances Hazardous to Health (COSHH), for the protection of the service users, and hand washing facilities to promote infection control. Supplies of disposable gloves, aprons and anti bacterial wipes were also provided, and the training schedule confirmed that up dated infection control training was due within the month. 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. Safe recruitment practices, appropriate induction and mandatory and specialist training prepare the staff for the supportive role and to meet the service users individual needs. Evidence: The AQAA recorded that four care staff had left employment in the home over the last twelve months and that there was a total of nine staff including the manager. The manager stated that the home still had vacancies for a deputy and two other staff member, and that in the meantime, three agency staff were being employed at the home to keep the staff ratios up and to cover for sickness. The AQAA confirmed that more than 50 of the staff team had either achieved a National Vocational Training Qualification at Level 2 or above, were working towards one or had an equivalent qualification. The two staff, who completed surveys, thought there were always enough staff to meet the individual needs of the service users, and one carer commented, there are good staff numbers. Training in communication and in supporting the behavioural needs of service users was provided, and the staff training matrix confirmed that the majority of staff had accessed this training, to help them to understand and respond to the needs of the residents. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: The recruitment procedure, described by the manager, included an initial visit to the home before interview, to gain feedback from the staff team and to see how the service users responded to the prospective staff members. If the prospective candidates passed the first test, the manager and the personnel manager carried out formal interviews at the head office. Staff personnel files included application forms, interview notes and equal opportunities monitoring forms to confirm the process was carried out fairly. The records of two staff recruited since the previous site visit contained two written references, Protection of Vulnerable Adults First and Criminal Record Bureau checks to confirm safe recruitment, for the protection of the service users. The two staff, who completed surveys, confirmed that their employer had carried out checks such as CRB and references before they started work. The staff induction programme was based on the Skills for Care Common Induction Standards, which is an introduction to the caring role, which promotes the service users rights to be treated as an individual, and have their equality and diversity needs respected. Stages of completion of the full induction programme were signed off by the employee and their supervisor to confirm competence. The two staff, who completed surveys, recorded that their induction covered everything they needed to know to do the job when they started, very well, and that they were being given training which is relevant to their role, helps them to understand the service users needs with respect to equality and diversity and keeps them up to date with new ways of working. Training was incorporated into the work schedule for all the staff and a training manager was responsible for arranging the training schedule. Staff training and development files included certificates for food hygiene, safeguarding adults, fire safety, autism, SCIP, health and safety, first aid, moving and handling, communication, the administration of rectal diazepam and the administration of medication. 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. Service users benefit from living in a well managed home which is run in their best interests. Their health, safety and welfare is promoted and protected. Evidence: Since the previous site visit, the homes manager, Sue Jones, who had been in charge of the day to day running of the home, had applied to be registered, as the manager for the home, and her application had been successful. She had already achieved a National Vocational Qualification at level 3, attended the Mental Capacity Act Training, and completed the local authority train the trainer, safeguarding adults training. The staff training matrix shows that she keeps herself up to date with mandatory and specialist training with respect to the needs of the service users. However, she has yet to complete the Registered Managers Award, and is working towards this qualification. The manager had an open and inclusive management style and was very enthusiastic about making the service users lives as fulfilling as possible. A staff member commented, the manager meets regularly to give support and to discuss how I am working and meetings take place every month. The manager is always approachable Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: and gives good feedback. The completed quality assurance questionnaires were not available to be sampled as they were at Head Office, the manager stated. However there were many compliments about the service in the compliments folder including, visiting the home was akin to visiting a group of friends in their own home. We are lucky to have such wonderful residents, an excellent staff team, a great manager and a lovely house. It is quite incredible what can be achieved when this foundation is put together. I feel you should all be really proud of what you have achieved, and I would like to thank you for making our relative such a wonderful place to live, and I would like to take this opportunity to mention how much I appreciate your excellent staff at Geales Close. The team have proved to be professional, experienced and efficient in dealing with any circumstances that arise. The Annual Quality Assurance Assessment (AQAA), completed by the manager, did not contain sufficient detail to do justice to the service provided. It did, however, record that equipment had been serviced or tested as recommended by the manufacturer or other regulatory body and certificates for the electrical appliances and the gas, sampled, confirmed they had been serviced in 2008. The Control of Substances Hazardous to Health (COSHH) had been appropriately risk assessed to safeguard the residents and all the risk assessments had been signed by the staff to confirm they had read them. Policies and procedures and codes of practice in relation to Health and Safety had all been reviewed in a timely manner to ensure the staff had been kept up to date with current legislation and practice. The staff training matrix confirmed that training in moving and handling, food hygiene, first aid, fire training and health and safety had been regularly updated to inform the staff. Infection control training had been planned for January. Records were kept of accidents and other serious incidences and the home kept the Commission for Social Care Inspection appropriately informed of such events. There was an ongoing programme of maintenance and repair. 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 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 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. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!