Care Home: 61 - 63 King Street

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What the care home does well What has improved since the last inspection? A volunteer coordinator has been in post since March this year and they are currently in the process of matching the service users with the volunteers that can support them in the activities they wish to do. Service user meetings are now lead by the service users themselves and some service users have been involved with a lottery funded project enabling those with communication difficulties to express (with a variety of methods) their views and have much more control over their lives. What the care home could do better: Ensure that the service user care plans are kept up to date and accurate. Support workers need to have up to date information to enable them to care properly for the service users in their care. Ensure that risk assessments are carried out on all the risks presented to the service users living at the home. Support workers need to be aware of all the current risks to the service users and the actions they need to take to minimise those risks. Ensure that there are appropriate numbers of support workers on duty at all times. Support workers must be given the time to provide the necessary care and support to meet the needs of the residents living in the home.Develop a formal assessment form and complete before a service user moves in to the home. This will ensure that all the relevant information is obtained and the assessment document can be used to inform the decision making process. CARE HOME ADULTS 18-65 61 - 63 King Street Leonard Cheshire 61 and 63 King Street Sileby Leicestershire LE12 7LZ Lead Inspector Diane Butler Unannounced Inspection 17th June 2008 09:00 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 61 - 63 King Street Address Leonard Cheshire 61 and 63 King Street Sileby Leicestershire LE12 7LZ 01509 817750 01509 817751 carole.porter@LCDisability.org www.leonard-cheshire.org.uk Leonard Cheshire Disability Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Robert Edwards Care Home 17 Category(ies) of Physical disability (17) registration, with number of places 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2006 Brief Description of the Service: 61 – 63 King Street is a care home providing personal care and support for up to 17 service users with a physical disability. The home was purpose built in 2002 and is owned and managed by Leonard Cheshire Disability. The home is situated in Sileby, a village in the county of Leicestershire and is within walking distance to the local amenities including shops, library and the local pubs. Communal areas included four lounges, dining room/kitchens, and a number of assisted bathrooms. There are well-maintained garden areas around the home for the service users and their visitors to enjoy. These include paved walkways and raised flowerbeds and a large care park is available at the front of the home for visitors use. All the bedrooms are single and offer ensuite facilities, which include a toilet, washbasin and shower area. The charges for living at the home vary depending on individuals assessed needs. Current charges range from £746.49 per week to £1020.17 per week. Details of what is included in the charges can be found in the Service User Guide (a document which provides relevant information about the home), which is given to all service users on arrival at the home. A copy of the latest Inspection report is available at the home, or it can be accessed via the CSCI website: www.csci.org.uk. Further information about the home is available from the acting manager. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good outcomes. This was an unannounced visit, which took place over a 7 1/2 hour period in June 2008. When undertaking key inspections the Commission for Social Care Inspection (CSCI) focuses upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they received through looking at their records, speaking with them and discussion with staff on duty at the time of the visit. Where communication was difficult observation was used to evidence whether care needs were being met. A further three service users and two visitors were also spoken with to gain their views of the home and the service they provide. Further planning for this visit included checking the service history of the home and the last Inspection report. Surveys were also sent to the service users currently living at the home and a selection of support workers to gain their views of 61–63 King Street. Two service user surveys and five support worker surveys had been returned at the time of this inspection visit taking place. Comments received include: “The home provides excellent care and support to service users and staff alike”. “We need to arrange more activities for the service users, days out”. What the service does well: 61–63 King Street is a purpose-built home providing accommodation for up to seventeen service users with a physical disability. It is designed to be easily accessible to wheelchair users with wide corridors and doorways. The home is well maintained both internally and externally and the decoration and furnishings throughout the home are both of a very good standard and are presented in a comfortable and homely way. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 6 Service users are fully involved in life at the home, regular meetings chaired by one of the service users are held and service users are involved in the recruitment of new support workers when ever possible. There is a relaxed and friendly atmosphere throughout the home and the support workers go about their daily work in relaxed and friendly manner. Support workers are well aware of the current care and support needs of the service users and ensure that these needs are met on a daily basis. A training coordinator is employed to ensure that all required and relevant training is provided. A healthy balanced diet is offered, service users are able to choose what to eat on a daily basis and mealtimes are flexible and unrushed. Service users feel safe and are aware of whom to speak to if they have a concern of any kind. All service users spoken with were most satisfied with the care and support provided. What has improved since the last inspection? What they could do better: Ensure that the service user care plans are kept up to date and accurate. Support workers need to have up to date information to enable them to care properly for the service users in their care. Ensure that risk assessments are carried out on all the risks presented to the service users living at the home. Support workers need to be aware of all the current risks to the service users and the actions they need to take to minimise those risks. Ensure that there are appropriate numbers of support workers on duty at all times. Support workers must be given the time to provide the necessary care and support to meet the needs of the residents living in the home. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 7 Develop a formal assessment form and complete before a service user moves in to the home. This will ensure that all the relevant information is obtained and the assessment document can be used to inform the decision making process. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are able to visit the home before moving in to see whether it is the right place for them. EVIDENCE: The acting manager explained that an assessment of need is obtained from the service users social worker for all prospective service users, this is looked at carefully to ensure that the staff working at the home can meet their identified needs. For service users who are privately funded the prospective service user completes an application form in order that all the relevant information is obtained. The acting manager explained that the home doesn’t currently have it’s own assessment documentation but this is something that she intends to develop before any new service users are admitted. Prospective service users are invited to look around the home before they move in. This enables them to get a feel of the home and to decide whether it is the right place for them. They are encouraged to meet with the staff and the service users already living at the home and are invited to stay for a meal; this 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 10 gives them an opportunity to get a feel of the home and what services it can offer. Service users and relatives spoken with confirmed that they were able to look around the home before deciding whether to move in or not. Comments received included: “I came and had a look around before I moved in”. “I just looked around downstairs and fell in love with it”. “I came to have a look around and they came and visited me in hospital as well”. “We visited first”. Written information about the home is also available so that the prospective service user can make an informed choice about living at the home. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users make decisions about their lives and are consulted on and participate in all aspects of life in the home. Improvements in individual service plans and risk assessments would ensure that staff have all the information they require. EVIDENCE: Individual service plans are in place, these cover the health, personal and social care needs of the service users and include their likes and dislikes within daily living. Quick reference care plans are also in place. These give the reader a quick snap shot of the help and support the service user requires and is used to inform relevant parties of the needs of the service user if they have to attend hospital etc. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 12 On checking three of the service plans it was noted that these did not include all of the actions the support workers carry out to meet the individual needs of the service users, this included the actions to be taken to support service users with their catheter care and for one service user who had recently been prescribed Warfarin, this was not included in their medication care plan. There was also no evidence within the service plans of these being reviewed on a regular basis. This was discussed with the acting manager during the visit who acknowledged these shortfalls. The acting manager explained that she was in the process of reviewing all the documentation currently being used and it was her intention to address these issues. The regional manager who was at the home during the visit explained that he had arranged a meeting the previous week to look at the current service plans but this had had to be cancelled. A further meeting has been booked for the week following this visit. Support workers enable the service users to take responsible risks on a daily basis both in the home and in the local community. On checking the risk assessment documentation for three service users it was noted that whilst all had a moving and handling assessment, environmental risk assessment and financial risk assessment in place, risk assessments for more individual risks were lacking. These include the risks posed to service users who suffer with swallowing difficulties and the risks associated with taking the medication Warfarin. It was also noted that not all support workers were aware of those service users who currently take Warfarin. This was discussed with the acting manager who stated that these shortfalls would be addressed. All service users living in the home are able to make decisions on a daily basis, these include when to get up, what to wear, what to eat and where to eat it, and what activity they wish to complete in their free time. Evidence was seen throughout the inspection of the service users making their own decisions. Comments received included: “You can make choices, I’ve been out today, and I’m out Mondays, Tuesdays, Thursdays and Sundays”. “You can breakfast upstairs or downstairs” “They let you do what you want when you want, it feels like home”. Service users are fully involved in life at the home. Issues that arise are discussed on a daily basis and service user meetings are held regularly. Minutes of the last meeting held on 13th March 2008 were seen. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 13 The team leader explained that whenever possible service users would be involved in the recruitment process for new support workers, this was confirmed whilst talking to one of the service users in the home at the time of the visit. Service users are enabled to live an independent life style within the home and support workers support the service users to meet their individual goals and objectives. One service users stated: “I’m more independent than the rest of them, the staff encourage me but I have help with bathing and showering”. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are encouraged and supported to live fulfilled and independent life styles. EVIDENCE: Service users are encouraged and supported to attend local colleges and day services. One service user spoken with showed us their weekly schedule, which included attending Lonsdale College in Birstall, Charnwood Day Centre and Rawlins College. Other facilities such as Douglas Bader Day Centre in Leicester and St Peters Church in Loughborough are also accessed. Service users are supported to access appropriate community and leisure activities; this includes supporting them on shopping trips, swimming at the local leisure centre, going out to pubs and restaurants and attending the local church. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 15 A volunteer coordinator has been in post since March this year. On speaking with them we were informed that they have now met with all the service users at King Street to discuss what they would like to do and they are now in the process of matching the service users with the volunteers that can support them in the activities they wish to do. Comments received included: “The first year I was here we seemed to do a lot more, bowling, trips to Rutland Water etc but we haven’t done so much since. We have a new lady [volunteer coordinator] and I think we will get more of this now”. “xxxx [the volunteer] is priceless”. “I’m going shopping tomorrow”. “A bonus would be if we could get out a bit more”. The volunteer coordinator informed us that three volunteers have recently requested training in minibus driving. This will enable the volunteers to take the service users and they supporters out and about more. Service users have a key worker who supports them within the home. Those spoken with said that they knew whom their key worker was and that they helped them if they needed anything. On talking with the key workers it was evident that they spend time with the service users (including in their own time) to ensure that the service users have access to activities and trips out. Visiting and maintaining contact with family and friends is strongly encouraged. Relatives and visitors spoken with during the visit stated that they were made most welcome and were able to visit at any time. Strong links with the local community are in place with many volunteers visiting the home and assisting the service users to access the local facilities. Daily routines within the home promote privacy, independence and choice. Service users can choose whether to be alone or join the other service users and can choose what and to do in their free time A healthy balanced diet is offered, choices are provided at every mealtime and mealtimes are relaxed, flexible and unrushed. Comments received included: “If you want to you can do things and go on trips but they don’t make you, you don’t have to do it if you don’t want to”. “The staff meet with me occasionally and ask me what I want to do”. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 16 “Mum visits me at weekends”. “The food is good and you can have what you want”. “There is always something I like, I had lamb hotpot today it was lovely”. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are looked after well in respect of their health and personal care. EVIDENCE: Service users are encouraged to be as independent as possible, for those less able to care for themselves, care and support is offered in a sensitive and supportive manner. Preferences regarding the delivery of care are included in the care plan documentation and all service users spoken with confirmed that they were treated with respect and care and support was provided in a dignified manner. On checking a selection of daily records it was evident that service users are assisted to access healthcare services when needed. Services contacted on the service users behalf included the local GP’s, community nurse, dentist, optician’s, speech and language specialists and physiotherapists with the community nurse and the physiotherapist visiting two of the service users spoken with during the visit. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 18 Medication records were checked. Medication had been appropriately signed into the home and medication had been signed for when given to the service users. All medication was being stored appropriately and accurate records were being kept for controlled medicines. All support workers involved in the administration of medicines have completed accredited medication training. All service users spoken with stated that the support workers treated them with respect and offered support in a relaxed and friendly manner. Comments received included: “The staff know us”. “The staff are really good, they let me go at my pace”. “They look after you”. “They treat me as a person, they are very helpful”. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users feel safe living at the home and feel confident that any concerns would be dealt with appropriately. EVIDENCE: A complaints procedure is in place and copies of this are displayed within the home. Details of how to make a complaint are also included in the service user guide, which is given to each service user on moving into the home. All service users spoken with during the visit were aware of whom to speak to if they had any concerns and all were confident that any concern would be taken seriously and appropriately dealt with. One service user stated: “I would talk to xxx [team leader] or xxxx [acting manager] they are very approachable”. A second service user stated: “I have a key worker who I would talk to if I was unhappy but I’ve not been unhappy”. All support workers attend training in the protection of vulnerable adults during their induction period and regular updates are also provided. The acting manager is aware of the procedures to follow to ensure that the service users in her care are protected and all support workers spoken with during the visit were aware of the actions to take, should they suspect any form of abuse. Following a recent safeguarding referral, it was evident that the homes safeguarding procedures were not fully followed. This included the immediate reporting of the incident and the involvement of relevant professionals. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 20 The acting manager acknowledged this and steps have been taken since this incidence to ensure that all senior staff are aware of the procedures to follow under safeguarding adults. Social services have been working closely with the staff in the home and further training in safeguarding adults is being provided for all senior staff and acting seniors on 26th June 2008. Leonard Cheshire is providing further safeguarding training throughout the year for all staff working at the home. All service users spoken with said that they felt safe living in the home. Comments received included: “I feel very safe” “They look after you and make you feel safe”. “They look after her really well, I can go home and know she is in safe hands”. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The standard of accommodation within the home is very good, providing the service users with a comfortable place to live. EVIDENCE: 61–63 King Street is a purpose-built home providing accommodation for up to seventeen service users with a physical disability. It is designed to be easily accessible to wheelchair users. Corridors and doorways are wide and rooms are large and free of obstacles. There is a good range of equipment for service users with limited mobility. The home is appropriately maintained and suited to the service users needs. The decoration and furnishings throughout the home are of a good standard and are presented in a comfortable and homely way. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 22 All bedrooms are single and offer ensuite facilities. These include a toilet, sink and shower area. All bedrooms, ensuite areas and communal bathrooms have ceiling hoists and a manual hoist is kept for use in emergencies. The rooms belonging to four service users were seen during the visit. All were highly personalised and furnished appropriately. The bedrooms on the ground floor also have french doors leading to the garden area outside. Service users spoken with were most satisfied with the accommodation provided, though one did mention that in one shower room when sitting in front of the sink area it was difficult to see themselves in the mirror. The kitchen areas are equipped with adjustable tops and sink area, which enables the service users easier access. There are well maintained garden areas around the home for the service users and their visitors to enjoy and a large care park is available at the front of the home. All areas of the home seen on this occasion were clean, fresh and tidy. One service user stated: “Its always clean and tidy”. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are supported by competent and qualified staff. EVIDENCE: A thorough recruitment procedure is in place, application forms are completed, references are collected and a CRB (Criminal Records Bureau) and POVA 1st (Protection of Vulnerable Adults) check are obtained. On checking three support workers files it was evident that all the necessary checks were in place. A face to face interview is carried out in the home and service users are involved in the recruitment of new support workers when ever possible. A period of induction is provided to all new support workers, this involves spending one week learning about policies and procedures of the organisation, completing training, including fire awareness, basic food hygiene, infection 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 24 control and moving and handling and shadowing an experienced member of staff at the home so that new staff are aware of the support workers role. An Induction and personal development pack is also completed within the first twelve weeks of employment to ensure that the support workers have the skills and knowledge they need to carry out their role competently. A training coordinator is employed to ensure that all required and relevant training is provided to the staff working at King Street and on checking the training records it was evident that an ongoing training programme is in place. Training provided so far this year includes: Disability and the Law Swallowing Disorders Bereavement training Medication training Peg Feed training First aid Protection of Vulnerable Adults Challenging Behaviour Multiple Sclerosis workshop On checking the staffing levels in the home it was noted that there are currently six support workers rotared on each morning shift and five support workers rotared on each evening shift to support the sixteen service users currently living in the home. Additional one to one support is also provided for part of the day for some of the service users living in the home. Support workers spoken with during the visit felt that on the whole the staffing levels were sufficient and that they could meet the needs of the service users without feeling rushed. It was stated however that when the extra one to one support wasn’t provided for individual service users, the support workers were required to provide this support, which meant that less staff were available for the rest of the service users. At these times it was stated that it could be quite difficult to complete all the tasks required of them. The acting manager acknowledged this and explained that this was being looked into. The acting manager must monitor staffing levels to ensure that enough support workers are on duty at all times to meet the individual needs of the service users. Service users spoken with felt that on the whole there were enough staff available to meet their current support needs. Comments received included: “They come when I need them”. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 25 “I ring the bell and they come alright”. “They’re not bad but when you want something urgent you can wait up to ten minutes”. “They always come when needed, they are very good and come within five minutes”. “They have been short staffed in the past due to sickness, at those times it’s been a bit rushed though it seems better know”. Supervision sessions are provided on a regular basis to provide ongoing support to all staff and staff meetings are also held. Minutes of the last meeting held on 13th March 2008 were seen. All spoken with during the visit stated that they felt supported by the management team and there was always someone they could talk too if they had any concerns or issues of any kind. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41,42, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from the relaxed and friendly atmosphere, which is evident throughout the home. EVIDENCE: The day to day running of the home is carried out by the acting manager with the support of the team leader, volunteer coordinator, training coordinator and administrator. The acting manager has been managing care services for the last 10 years and is in the process of completing her Registered Managers Award. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 27 All service users and visitors spoken with during the visit stated that the acting manager was approachable and would have no hesitation to talk to her should they need to. Support workers spoken with felt supported by the management team and all spoken with stated someone was always available to talk to should they need to discuss any issue or concern. Policies and procedures for the health, safety and welfare of the service users are in place and all support workers are made aware of these during the induction process. Service user meetings, which are chaired by one of the service users are held on a regular basis, this enables the service users to share their views on the service provided. Staff meetings are also held to enable the acting manager to gain the staffs view of the service they currently provide. The regional manager visits the home once a month to carry out a quality monitoring audit. Service users have full access to their records with the choice of keeping their care plan in their room or in the office. One service user spoken with explained that they had theirs on their computer, though it had yet to be completed. Risk assessments were in place for safe working practices, though it was noted that not all individual risks presented to the service users had been included in the risk assessment documentation. The acting manager stated that this would be addressed. Appropriate records for the safe keeping of service users money are in place, two signatures are obtained for any transaction carried out on the service users behalf to ensure that their finances are safeguarded. Training in Health and safety is provided to all staff during their induction period and training in fire safety, food hygiene, first aid and moving and handling are provided on a regular basis. It was evident during the visit that the service users benefit from the ethos and management that is provided by the acting manager and her team. There was a relaxed and friendly atmosphere throughout the visit and the interactions between support workers, visitors and service users were positive, informal and inclusive. 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 X 27 4 28 X 29 4 30 4 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 3 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 X 3 2 3 X 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 29 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15(2)(b) Requirement The registered person shallKeep the service user’s plan under review. Where appropriate and unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his revise the service users plan. The registered person must ensure that the residents care plans and associated documents are reviewed and are kept up to date and accurate. Support workers need to have up to date information to enable them to care properly for the service users 2 YA9 13(4)(c) The registered person shall ensure that: Unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. 04/07/08 Timescale for action 04/07/08 15(2)(c) 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 30 The registered person must ensure that risk assessments carried out are kept up to date and accurate at all times. Support workers need to be aware of all the current and ongoing risks to the service users and the actions to take to minimise those risks. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA2 Good Practice Recommendations The registered person should develop a formal assessment form and complete before a service user moves in to the home. This will ensure that all the relevant information is obtained and the assessment document can be used to inform the decision making process. The registered provider should ensure that at all times suitably qualified, competent and experienced persons are working in the home in such numbers as are appropriate for the health and welfare of service users. Care workers must be given the time to provide the necessary care and support to meet the needs of the residents living in the home. 2 YA33 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 61 - 63 King Street DS0000061710.V366743.R01.S.doc Version 5.2 Page 32 - 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. 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