Care Home: 63 & 65 Whipton Barton Road

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What the care home does well The home provides a safe and comfortable environment in which people can live and work. People are encouraged to participate in a range of activities in the home and the local community. There is a good care planning system that ensures emphasis is placed on treating everyone as an individual. Much care is taken to discover what each person likes/dislikes/needs and wants are whilst promoting their independence. There is a clear social history record for each person gathered from various sources, which helps staff to understand peoples` needs despite the limited communication abilities of people living there.There is a knowledgeable and stable staff team who know the people at the Home well and create a homely and happy environment. What has improved since the last inspection? Measures have been put in place to ensure that people`s dignity is respected at all times: clothing protectors are no longer worn by people at the Home for extended periods. Carpets in the lounge and the hallways have improved the environment and ensure that there are no hazards to the health and safety of people at the home. What the care home could do better: Changing a kitchen and laundry room to an office and a sleep-in room would ensure that the dining rooms were not used as an office and a sleep-in room. It is not conducive to a homely environment to have a bed in the dining room. Automatic closures on the fire doors of the laundries would ensure that staff working in there could hear what was happening in the rest of the home. A clear system for recording any concerns and/or complaints should be followed to ensure that actions are taken appropriately and timely. Care planning records need to be reviewed to ensure that the staff knowledge of peoples` needs is reflected clearly in the plans. Identified issues should be expanded upon to show the exact issue and what action needs to be taken by staff without using abbreviations. The use of behavioural management monitoring also should be much clearer about trigger points and details of how agitation presents. The use of the front garden needs to be risk assessed for each individual and to ensure that it is secure and safe. Some medication was out of date and this needs to be monitored to ensure that people are safe. Better staffing levels in the evenings would ensure that people are able to enjoy evening outings more spontaneously. CARE HOME ADULTS 18-65 63 & 65 Whipton Barton Road Exeter Devon EX1 3NE Lead Inspector Rachel Doyle Key Unannounced Inspection 3rd June 2008 10:00 63 & 65 Whipton Barton Road DS0000071099.V364067.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 63 & 65 Whipton Barton Road DS0000071099.V364067.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. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 63 & 65 Whipton Barton Road Address Exeter Devon EX1 3NE 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) 01392 462515 whipton.barton@guinness.org.uk Guinness Care and Support Ltd Mrs Christine Oakes Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 6. Date of last inspection New service Brief Description of the Service: 63 and 65 Whipton Barton Road are registered as one care home for six adults with a learning disability. There are three residents living in each adjoining bungalow. The homes are a mirror image of each other and each has a living room, a dining room, a laundry, kitchen, 3 single bedrooms and a WC and an assisted bathroom. There is no internal access between the bungalows. There is a large enclosed garden to the rear of each bungalow separated by a hedge. The average cost of care is currently £773.62 per week. Additional costs, not covered in the fees, include hairdressing and personal items such as toiletries, petrol for the lease car (clear guidelines accompany costings for each individual) and entrance cost for some outings. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at http:/www.oft.gov.uk/ Current information about the service, including CSCI reports are displayed in each of the two lounges. 63 & 65 Whipton Barton Road DS0000071099.V364067.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 this service experience good quality outcomes. This unannounced inspection took place on Tuesday June 3rd 2008. We were able to talk with the manager and two staff members. Three people living at the Home were case-tracked which allows us to form a better picture of their experiences at the Home. This involves looking at peoples’ individual plans of care, and speaking with the person and staff who care for them. As part of the inspection process CSCI likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to the 6 people living at the home, 6 representatives and 10 staff. At the time of writing the report, responses had been received from the 6 people living at the home (all required assistance from staff to complete these bearing in mind their limited communication abilities), 1 representative and 5 staff. Their comments and views have been included in this report and helped us to make a judgement about the service provided. All responses were positive. The people living at the home have limited verbal communication skills, and as we were not skilled in their other methods of communication it was difficult for us to have any meaningful communication with these individuals. However, the interaction between those living and working at the home was closely observed. A tour of the building was made and a sample of records was looked at, including medications, care plans, the fire log book and staff files. On arrival people were finishing breakfast and four people were getting ready to go out to a club with one travelling with a staff member on the bus. What the service does well: The home provides a safe and comfortable environment in which people can live and work. People are encouraged to participate in a range of activities in the home and the local community. There is a good care planning system that ensures emphasis is placed on treating everyone as an individual. Much care is taken to discover what each person likes/dislikes/needs and wants are whilst promoting their independence. There is a clear social history record for each person gathered from various sources, which helps staff to understand peoples’ needs despite the limited communication abilities of people living there. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 6 There is a knowledgeable and stable staff team who know the people at the Home well and create a homely and happy environment. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People thinking of moving into the home would receive relevant information and be assured that their care needs can be met. EVIDENCE: There have been no new admissions for 16 years. Admission procedures were discussed with the manager that indicated the home will ensure they will only admit people whose needs they will be able to meet. The admission procedure and the related forms are attached at the back of the home’s Statement of Purpose. The Home does not expect a vacancy for some time. People living at the home were unable to discuss their admission procedure due to our limited understanding of their communication skills. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection indicates that in order to improve the service the home intends to ensure that all relevant documents are available in Widget format and that they are hoping to lease a larger vehicle with better adaptations for wheelchair users. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally there is a good care planning system that provides staff with the information they need in order to meet the needs of the individuals although records could be improved to reflect staff knowledge. People are encouraged to make choices and decisions about their daily lives, and staff ensure that any potential risks are minimised. EVIDENCE: Three care plans were looked at in detail and time was spent with these three people at the Home. Staff said that care plans are working documents and that they write in them. They were able to discuss issues in the plans and were knowledgeable about peoples’ care needs. Care plans include clear decision making processes including the use of objects of reference, consent for medication and likes and dislikes. There are good personal objectives and reviews. There were excellent records about 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 10 discussions on individual topics. There is a separate folder with excellent, clear social history records for each person gathered from various sources, which helps staff to understand peoples’ backgrounds and needs despite the limited communication abilities of people living there. This is also very useful when agency staff need to be used at the home. However, although the details of identified problems are known by staff, some records are brief and do not clearly describe the problem and actions to be taken with titles such as ‘leaning’, ‘obesity’, ‘walking’, bizarre behaviour’ and ‘continual bedrest’. These. Some care issues need disregarding and reviewing, as they are no longer a problem. The identified issues need to be expanded upon to show the exact issue and what action needs to be taken by staff without using abbreviations use of behavioural management monitoring also should be much clearer about trigger points and details of how agitation presents. Actions had been taken appropriately for all identified issues such as physiotherapy referral but should be clearer in the records. Daily notes should link to the care plan. People at the Home are encouraged to be independent and prompted to do tasks themselves such as get ready for clubs. Staff clearly told people what was happening next such as we are waiting for staff to load the car. Staff were able to describe how people show that they would like to go to bed or have a lie down and this choice was facilitated by staff. The front gate is unlocked and leads onto a road but the manager said that most people living at the Home would not go out to the front and that two people who might go in the front garden on a rare occurrence, would be seen by staff in the Home. There is also an alarm system on the front door for evenings and night-time. This should be clearly risk assessed; the current risk assessment says to keep the gates locked. There are problems at the moment with school children using the front garden as a short cut and this needs to be addressed. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection indicates that in order to improve the service the home intends to complete widget plans for everyone living at the home so that they can be more involved. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good range of opportunities for people to take part in social and leisure opportunities both in the home and in the local community. Families and friends are encouraged to maintain contact. Meals are nutritious and balanced and offer a healthy and varied diet for everyone. EVIDENCE: There are lots of activities to do in the Home when people are not at clubs or on outings. There are games, toys suited to abilities and preferences, musical instruments and films to watch. Each room has a new digital television and people indicated that they were happy with this purchase. People like to watch the birds at the bird table and help to put food out. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 12 Staff were attentive to peoples’ needs, offering them cups of tea during the morning. Staff are always thinking of outings and activities to do that people at the Home would like and try to facilitate them and involve families. People are aided to have the correct adaptations that enable friends and family to take them out and friends and family visits are encouraged. The week of the inspection a birthday party was being planned and invitations had been sent to ensure that it was celebrated with friends and family and staff who were all involved in choosing birthday presents. Detailed records are kept of any individual’s activities in their care files. The manager and staff were able to describe various activities, which had occurred recently including trips to restaurants, coffee time with peers, decoration making, shopping, hydrotherapy and reflexology. There is going to be a summer Ball in July and a barbecue. An activity board shows people what activities and clubs are happening everyday and was up to date. Meals are flexible and people are able to indicate what they like to eat. Staff were able to describe how they would know if someone did not like something. People are able to be involved in the shopping and cooking process if they are able to do so safely with support. Fresh fruit and vegetables are on offer although these are sometimes kept open in the laundry room near the washing machine, which is not good practice. Meal times were seen to be a sociable event and can be a packed lunch of they are out or in town. The Home has a lease car, which enables staff to take people out on a regular basis. There are many photographs around the home that show everyone living and working at the home having a good time. However, there are limited opportunities for spontaneous outings in the evenings due to staffing levels (see also Standard 35). 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 13 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. Staff have a good understanding of the individuals’ personal support needs, and people benefit from the positive relationships they have with staff. The systems for the storage and administration of medications are generally good. EVIDENCE: Staff were very knowledgeable about peoples’ health care needs and care plans showed good detail about health professionals visits and outcomes. Staff were seen to interact well with people living at the Home taking into account their limitations and health care needs. Staff are observant to any changes in care needs and the appropriate referrals are made in a timely way. The manager has a good relationship with local GPs and health care professionals. Staff were seen to offer personal support in a polite and discreet manner knowing when to leave people alone. Care plans also contain individual information gathered from various sources about health needs such as epilepsy, which is useful for staff. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 14 Medication is stored securely and all medication is checked at each shift handover. There are good procedures in place to ensure the risk of medication being wrongly administered is minimised. All staff who administer medication have completed appropriate training. All records relating to the administration of medicines were seen to be appropriately completed. No-one living at the home manages their own medication and one does not have any medication. There is a Homely Remedy policy and staff are clear about when to use medication for irregular events. Some medication was found to be out of date and the manager addressed this immediately. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection indicates that in order to improve the service the home intends to continue with staff training and open forums for staff, where areas of concern relating to peoples’ health care needs are discussed to ensure that the Home continues to meet peoples’ health care needs. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 15 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. People are safeguarded by well-trained staff who are able to deal with any concerns or abuse although records could be improved. EVIDENCE: Staff were able to say how they have acted upon any concerns raised by families and could describe how they would know if someone living at the Home was unhappy from body language and knowledge of their usual demeanour. However, there is not a clear record of any complaints in a record book to show exactly how and when actions were taken and timescales reflecting the complaints procedure. A record book must be started and staff made aware. There is a comprehensive complaints process and this information has been given to relatives. The relatives who responded to the survey confirmed that they were aware of these details. The manager keeps in regular contact with relatives and described incidences where concerns had been addressed well with the welfare of the person at the Home being the focus of the outcome. They said that there had not been any written complaints for a long time but agreed that concerns from families at times, which have been well addressed, should be recorded clearly. All staff have undertaken the Protection of Vulnerable Adults training and are aware of any issues that may be seen as abuse. The manager and staff were very clear about how they would deal with any abuse issues should they arise, including involving outside agencies. Excellent notes were seen of an issue that was well dealt with by staff in the past, which centred on the person’s welfare. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 16 The Home uses body maps to record any bruising noticed on individuals by whatever cause. This needs to be very clear about how the event happened and how it will be prevented in the future. For example one person is very prone to bruising but the body map just shows incidences of bruising and should have more detail to ensure that they can be explained innocently. One record said ‘the person was hit by another client’, this needs to be investigated as to what triggers there were and how this would be avoided in the future to keep all people at the Home safe. The records of financial transactions for three people were looked at. All three had their own separate accounts, and any cash is kept in separate cash boxes. All receipts were numbered and accounts were double signed. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection indicates that in order to improve the service the home intends to ensure POVA training is constantly up-dated and reviewed. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is generally good, providing everyone with a clean, safe, comfortable and homely place in which to live and work. EVIDENCE: The Home is decorated to a good, contemporary standard. Each room has been decorated with the involvement of each person to suit how they like it. One person has a covered bed bumper in their favourite colour so that they can relax and watch television in their room. Two relatives said that they were happy with the personalised approach and comfortable décor. The gardens are well maintained by the staff and have been well used this summer. New swings have been purchased for people at the Home as they like separate ones. There is a small flower-bed full of daffodils. The rear garden is enclosed and safe for people to walk around with supervision. Two relatives it might put undue pressure on staff time. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 18 The home is made up of two separate bungalows that are mirror images of each other. This means that there are two kitchens and two laundry rooms as well as two lounges, two dining rooms and two bathrooms as well as the six bedrooms. The manager feels that there is no need for two kitchens and two laundry rooms and that one of each of these rooms would be better converted for use as an office and a sleep in room. This would remove the need for the office to be in one dining room and the staff sleep-in bed in the other and help make these two rooms more homely and comfortable for residents. There were satisfactory bathing facilities in both bungalows with two new baths being installed recently. One bathroom door has a device allowing it to be opened by someone in a wheelchair. There is a range of grab rails and lifting aids around the home. Various types of lighting have been fitted in clients bedrooms for their enjoyment, new furniture in lounges, ie- TV stands, Corner units in both hallways, lounge sideboard in 65 and new carpets. Staff have received training in infection control and there are disposable gloves and aprons available around the home. Cleaning chemicals are stored appropriately in a locked cupboard to keep people safe. During the inspection all areas of the Home were clean and homely. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection indicates that in order to improve the service the home intends to purchase a Gazebo for the garden and also on order is a summer house for a client, which will enable them to enjoy the garden in safety. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a well-trained team of staff that are generally able to meet their needs effectively. The procedures for the recruitment of staff are robust and offer protection to everyone. EVIDENCE: There are 17 staff working at the Home, including two male staff who are able to give same sex care to one individual. It is a stable staff team with some staff having worked with the people living at the Home for some years. There are two staff and the manager on duty in each bungalow in the mornings and one on each side in the evenings. Staff are able to be flexible if they knew that someone wanted to go out in the evening. However, only having one staff member per bungalow does mean that there is little opportunity for spontaneous activities or outings during the evening. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 20 There is a lovely rapport between staff and people living there. Staff appeared to understand the language and body language of people at the Home for example telling them what the time is and talking about pictures that they like. Each person living at the Home has a key worker, which means that there is a named person who oversees peoples’ care and ensures that their needs are met including shopping. Staff were able to describe peoples’ characteristics such as preferring quiet time, signs that they need the toilet and positive conversations were seen. Staff said that they enjoyed working at the Home and comments included; ‘I continue to receive support and training to give the right support, experience and knowledge to ensure peoples’ well being’. Five staff members said that they could not think of anything that the Home did not fulfil and another said that it was a happy home. The files of three staff were looked at; all contained the required information including two written references and proof of identity. All files also contained a satisfactory CRB (Criminal Records Bureau) check. Staff training records were looked at and these showed that four staff have completed the National Vocational Qualification in Care to level 3 and two staff are currently training to level 2. Mandatory training including fire, manual handling, first aid and food and hygiene was up to date. The manager hopes to be able to secure places on a Total Communication course in the future and staff have just done epilepsy training. There is a full induction programme for new staff on a corporate level in line with the recommended Skills for Care standards, which showed probation interviews at 3 and 6 months. Staff had commented ‘the job suits me down to the ground and I enjoy my job’. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection indicates that in order to improve the service the home intends to continue with specific in-house training and complete the NVQ programme. The manager is keen to continue with training that relates specifically to people at the Home and has recently done a study day on hypothermia. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and this results in practices that promote and safeguard the health, safety and welfare of people living and working there. EVIDENCE: Two relative survey responses were received and both were very positive. Both were totally satisfied with the care that their relative was given. One said that ‘there is a very good manager with excellent support staff.’ Their relative’s needs were fully catered for. The manager has many years experience working with this client group. She has been registered for some time and has obtained her RMA (Registered Managers Award). She is able to show great understanding of the needs of people living at the Home and staff said that they felt well supported. There 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 22 are regular staff meetings that are well attended where staff are praised for their good work. People who live at the home are also included in these meetings. Staff work in both bungalows for continuity and staff are able to voice suggestions for implementation in the Home at the meetings. The Home is currently looking into holiday destinations for the people living at the Home. There is a corporate Quality Assurance system to ensure that people at the Home and/or their representatives can make their views known on an annual basis. These responses include health professionals and the results are collated. Comments recently included ‘staff are committed and caring’ and ‘staff take respect and dignity issues on board very positively.’ The majority of people had ticked the excellent box. So that the risk of burning from hot surfaces is minimised, all radiators within the home are covered. All windows are fitted with restrictors. All taps that people living in the home have access to are fitted with temperature control valves and weekly checks for Legionella are made. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit, provided evidence that 63/65 Whipton Barton Road complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, health and safety checks and risk assessments. The fire logbook, record of fire safety training and accident and incident records were found to be accurate and up to date. The insurance certificate for the home expires on 31st March 2008. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection indicates that in order to improve the service the home intends to fit automatic closures to the laundry doors and source other activities for clients especially in the evenings. 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 23 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X 63 & 65 Whipton Barton Road DS0000071099.V364067.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA22 Regulation 22 (8) Requirement You must ensure that a clear record is kept of all concerns or complaints showing the detail, actions taken and outcomes. Timescale for action 03/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Identified issues should be expanded upon to show the exact issue and what action needs to be taken by staff without using abbreviations. The use of behavioural management monitoring also should be much clearer about trigger points and details of how agitation presents. You should ensure that there are clear risk assessments relating to the security and safety of each individual’s use of the front garden. You should consider ways to ensure that spontaneous evening outings can take place. You should ensure that all medication is in date. You should consider replacing one kitchen and one laundry room with a sleep-in room and an office, so that the dining rooms are not used for these purposes. DS0000071099.V364067.R01.S.doc Version 5.2 Page 25 2. 3. 4. 5. YA9 YA13 YA35 YA20 YA24 63 & 65 Whipton Barton Road Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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