Care Home: 85 Drove Road

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What the care home does well There was a statement of purpose and a service user guide. Each person had a copy of the service user guide, which was in an easy to read format. People had information about the service to help them to decide whether it would meet their needs. People`s needs had been assessed before they moved into the home to ensure that their needs would be met. Each person had a written contract with the home so that they knew what to expect from the service. Each person helped to develop their own person centred plan and care plan. This meant that they knew that their assessed and changing needs were reflected in their individual plans and that their needs would be met. People made decisions about their lives with assistance as needed. They were involved in all the routines of the home such as cleaning and shopping. People were encouraged to take risks as part of an independent lifestyle People had opportunities for personal development. They could attend church if they chose. One person had attended several college courses. They had opportunities to participate in their local community and used the shops, leisure centre, pubs and theatres. They kept in contact with their family and friends. People were involved in the routines of the home such as cleaning, cooking and shopping. They were offered a varied diet and enjoyed their food. People were supported to manage their personal care. Their physical and emotional health needs were being met. The arrangements for managing and recording medication ensured people were protected.People were safeguarded by the home`s policies and procedures for complaints and protection. People were protected from abuse, neglect and self harm. People lived in a comfortable and clean environment suited to their needs. There was a large open plan lounge and dining room. There was also a large kitchen, which had recently been refitted. People had constant access to the kitchen to make drinks and snacks. A new dining table and chairs had been provided in the kitchen. Each person had their own bedroom, which was individually decorated and furnished and contained personal items. Bedroom doors had locks and each person had a key to their room. People were supported by competent, trained and qualified staff. Three out of five staff had a national Vocational Qualification (NVQ) at level 2 or above and one was working towards NVQ level 2. There were enough staff on duty to meet people`s needs. There was at least one member of staff on duty at all times and two were on duty at busy times of the day, for example when people needed support to go out. Staff had regular supervision with the manager or deputy so that people benefited from staff who supported and supervised. There was a recruitment process and new staff had all the checks needed before they started work so that people were protected from being cared for by unsuitable staff. The manager was appropriately qualified and experienced. Staff felt that they were well supported by the management and people were benefiting from a well run home. There was a quality assurance process and there was an annual development plan, which identified areas for improvement. There was a common sense approach to health and safety and the necessary checks and safeguards were in place. People`s health safety and welfare were generally promoted. What has improved since the last inspection? All staff had been given a copy of the General Social Care Councils code of conduct so that they knew what was expected of them. The house had been redecorated and a new shower had been installed. This had addressed a requirement from the last inspection to paint and repair some parts of the house. A recommendation was made that a cleaning company should conduct a thorough clean of the home. This had been done and the manager planned to have an annual clean by a cleaning company to help keep the house clean. In response to a requirement at the previous inspection new staff were receiving Learning Disability Award induction and foundation training. This would ensure that they had training, which met the Skills for Care standards and obtained the necessary basic skills. What the care home could do better: The area under the radiator in one person`s bedroom needs to be painted and a piece of the wooden trim around their door needs to be replaced to improve their bedroom. A record of all the recruitment checks that have been made for each member of staff should be kept in the home for ease of reference. This will make it easier to check whether all the necessary checks have been done and new staff members are suitable to work with people. Further work is needed on the quality assurance process to ensure that people`s views underpin all self-monitoring, review and development by the home. The fire door to the kitchen must not be held open so that it can work properly if there is a fire and people are protected. CARE HOME ADULTS 18-65 Drove Road (85) 85 Drove Road Swindon Wiltshire SN1 3AE Lead Inspector Elaine Barber Key Unannounced Inspection 3rd December 2007 10:35 Drove Road (85) DS0000063428.V354695.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 Drove Road (85) DS0000063428.V354695.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. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Drove Road (85) Address 85 Drove Road Swindon Wiltshire SN1 3AE 01793 635560 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) Community Access Network Mrs Tracey Lynne Parker Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered manager must work a minimum of 64 hours per 4 weeks in the home except when absent due to sickness, training or annual leave. 19th October 2006 Date of last inspection Brief Description of the Service: 85 Drove Road is a small sized care home for up to 3 people, who have a learning disability, aged between 18 and 65 years of age. A company called Community Access Network (C.A.N.) operates the home. C.A.N. have 3 other similar services in Swindon and North Wiltshire. The home opened at the end of 2005 after the company decided to sell an existing nearby home that at the time did not meet the relevant National Minimum Standards (NMS). All the people who lived there and the staff transferred to this house. All the people were involved in choosing the accommodation and deciding the decoration and furnishings. The house is a 3 bedroom, two-storey semi detached property and is located on a busy main road, within a 10 minute walk of Swindon town centre. It provides each person with a spacious bedroom. There is a large L-shaped lounge/ dining room and a spacious kitchen that has been recently refurbished as well as two bathrooms. Parking is very limited. There is usually one member of staff on duty with an additional person at busy times. A member of staff sleeps in at night. Sleep in staff are expected to meet any night time needs as they arise. The main service aims are to provide high quality care within the community, where people are supported to take informed risks and to promote opportunity. Information about the service is provided in a statement of purpose and a service user guide. Inspection reports are available in the home and can also be downloaded from the CSCI website, www.csci.org. The fees range between £897.29 and £940.96 Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit to the home on 3rd December 2007. During the visit information was gathered using: • • • • • Observation Speaking to three people who lived in the home Discussion with the manager. Discussion with three members of staff. Reading records including care records. Comment cards were received from three people who lived in the home, one relative, a GP and two members of staff The judgements contained in this report have been made from all this evidence gathered during the inspection. What the service does well: There was a statement of purpose and a service user guide. Each person had a copy of the service user guide, which was in an easy to read format. People had information about the service to help them to decide whether it would meet their needs. People’s needs had been assessed before they moved into the home to ensure that their needs would be met. Each person had a written contract with the home so that they knew what to expect from the service. Each person helped to develop their own person centred plan and care plan. This meant that they knew that their assessed and changing needs were reflected in their individual plans and that their needs would be met. People made decisions about their lives with assistance as needed. They were involved in all the routines of the home such as cleaning and shopping. People were encouraged to take risks as part of an independent lifestyle People had opportunities for personal development. They could attend church if they chose. One person had attended several college courses. They had opportunities to participate in their local community and used the shops, leisure centre, pubs and theatres. They kept in contact with their family and friends. People were involved in the routines of the home such as cleaning, cooking and shopping. They were offered a varied diet and enjoyed their food. People were supported to manage their personal care. Their physical and emotional health needs were being met. The arrangements for managing and recording medication ensured people were protected. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 6 People were safeguarded by the home’s policies and procedures for complaints and protection. People were protected from abuse, neglect and self harm. People lived in a comfortable and clean environment suited to their needs. There was a large open plan lounge and dining room. There was also a large kitchen, which had recently been refitted. People had constant access to the kitchen to make drinks and snacks. A new dining table and chairs had been provided in the kitchen. Each person had their own bedroom, which was individually decorated and furnished and contained personal items. Bedroom doors had locks and each person had a key to their room. People were supported by competent, trained and qualified staff. Three out of five staff had a national Vocational Qualification (NVQ) at level 2 or above and one was working towards NVQ level 2. There were enough staff on duty to meet people’s needs. There was at least one member of staff on duty at all times and two were on duty at busy times of the day, for example when people needed support to go out. Staff had regular supervision with the manager or deputy so that people benefited from staff who supported and supervised. There was a recruitment process and new staff had all the checks needed before they started work so that people were protected from being cared for by unsuitable staff. The manager was appropriately qualified and experienced. Staff felt that they were well supported by the management and people were benefiting from a well run home. There was a quality assurance process and there was an annual development plan, which identified areas for improvement. There was a common sense approach to health and safety and the necessary checks and safeguards were in place. People’s health safety and welfare were generally promoted. What has improved since the last inspection? All staff had been given a copy of the General Social Care Councils code of conduct so that they knew what was expected of them. The house had been redecorated and a new shower had been installed. This had addressed a requirement from the last inspection to paint and repair some parts of the house. A recommendation was made that a cleaning company should conduct a thorough clean of the home. This had been done and the manager planned to have an annual clean by a cleaning company to help keep the house clean. In response to a requirement at the previous inspection new staff were receiving Learning Disability Award induction and foundation training. This would ensure that they had training, which met the Skills for Care standards and obtained the necessary basic skills. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 7 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. Drove Road (85) DS0000063428.V354695.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 Drove Road (85) DS0000063428.V354695.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, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had information about the service to help them to decide whether it would meet their needs. People’s needs had been assessed before they moved into the home to ensure that their needs would be met. Each person had a written contract with the home so that they knew what to expect from the service. EVIDENCE: There was a statement of purpose and a service user guide, which provided information about the service. These were kept up to date. The service user guide was a mixture of words and pictures to make it easier to understand. Each of the three people who lived at Drive Road had a copy of the service user guide. The three people who lived in the home and been living together for several years. Their needs had been assessed before they moved into the home. Each person had a statement of their terms and conditions which they had signed Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 10 There were policies about antidiscrimination and equal opportunities. Drove Road (85) DS0000063428.V354695.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, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People knew that their assessed and changing needs were reflected in their individual plans so that their needs would be met. People made decisions about their lives with assistance as needed. People were encouraged to take risks as part of an independent lifestyle. EVIDENCE: Each person had a person centred plan. This was an ongoing record of their likes, dislikes, wishes and needs for support. Staff supported people to develop their plans and record things that were important to them. A service user plan was developed from all this information. These plans recorded each person’s need for staff support in all areas of their lives. These included accommodation, communication, domestic arrangements, faith and culture, family life, money management, health care, personal hygiene, personal support, social life, work and specialist support. The plans were signed by the Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 12 person, their social worker and the manager. The manager reported that the plans were reviewed at least once a year and they were amended as needs changed. The GP stated in their comment card that if they gave any specialist advice this was incorporated into the support plan. Each person had a series of risk assessments. These focused on promoting independence and the benefits of participating in activities, which may pose a risk. Care planning and risk assessment information for all three people was kept together in one folder. It would be good practice to keep information about each person separately so that they can access their own records without seeing information about other people. People were fully involved in developing their person centred plans and their care plans. They wrote in their daily records and contributed their views about their experiences. People made their own decisions about their lives. For example, one person had decided not to work and then recently decided they would like to work part time in a charity shop. Staff were encouraging them to apply for a job at a charity shop. Each person had a key to their bedroom and could lock their room when they chose. Staff respected people’s privacy and did not go into the bedrooms without permission. People were fully involved in the routines of the home. They were expected to share in the cleaning of the shared rooms and to keep their bedrooms clean. People took turns to plan the meals for the forthcoming week and to do the shopping. During the inspection one person was vacuuming the living room. Another person went to the local supermarket with a member of staff to do the weekly shop. This person out the shopping away when they returned. The care plans showed when people did things independently, for example, going to a day service. During the inspection one person returned from their day service independently. There was a quality assurance report, which referred briefly to people being involved in making decisions about their home. However, it did not specifically state how people were involved in decision making or how people’s views had been gathered and contributed to the report or service development. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 13 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): 11, 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. People had opportunities for personal development. They had opportunities to participate in their local community and kept in contact with their family and friends. People were involved in the routines of the home. They were offered a varied diet and enjoyed their food. EVIDENCE: Two people had a section in their care plans about faith and culture. This showed that they had opted not to attend church but they had the opportunity if they wished. One person had attended several courses at college but were no longer attending college. A recommendation was made at the last inspection that people should be supported to access job coaches so that they could Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 14 participate in more meaningful activities outside the home. The manager said that they had tried several things but one person had made a decision not to work for some time. This person stated that they were now looking for a part time job and were trying to get work one day a week at a charity shop. Another person worked one morning a week at the organisation’s offices and went to a music therapy session on another day. However, these two people did not have structured day time activities. The daily diaries showed that they both spent a lot of time at home. The diary showed that the first person went out several times a day independently to town and to the shops. It also showed that they did jobs around the house. During the inspection visit they were vacuuming the living room. The second person had a structured support programme to help them go out independently. They went into town without staff support for an hour at a time. They also went out independently during the inspection visit. The third person had a structured day programme and went to a drop in centre five mornings and two afternoons a week. They went there and back independently. In the afternoon a member of staff supported them with doing their ironing. The daily records showed that people went to the shop for clothes and food. One person went to the shop independently during the inspection visit. Another person wet shopping for food with a member of staff. People also went swimming, to football matches, to the pub, speedway and to shows. One person had been to an Elvis show and another had recently been to see Status Quo. People attended a local barber and hairdresser. Recently people had been to Old Town to see the Christmas lights switched on. Two people attended a disco every other Monday and one person went to a club on Wednesdays. At home people listened to music, watched television and used the computer. Staff supported people to see their families. One person saw their father and another had regular visits from their mother. Each person had contact with their friends. Two people saw friends at clubs they attended. One person had a friend whom they visited regularly. There was a varied menu. Staff said that people took turns to plan the menu for the forthcoming week. During the inspection visit one person was being supported by a member of staff to plan a menu using the computer. Another person went shopping with a member of staff to buy the food for the next week. When thy returned home they put the shopping away. The contents of the shopping showed that a varied diet was being provided with plenty of fresh fruit and vegetables. People were observed preparing drinks and snacks during the course of the visit. People said that they enjoyed the food. A recommendation was made at the last inspection that arrangements are made to store bread in the kitchen area. Some bread was seen in the kitchen and this looked fresh. The manager stated that bread was stored in a cool box in Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 15 the office to keep it fresh. This ensured that the amount of bread could be monitored and no-one had more than their share. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 16 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. People were supported to manage their personal care. Their physical and emotional health needs were being met. The arrangements for managing and recording medication ensured people were protected. EVIDENCE: The support that each person required with healthcare needs was recorded in their care plan. Staff supported people to manage their personal care and healthcare and attend appointments. The records showed that people had appointments with health care professionals. Dates of appointments and the outcome of the visits were recorded. People had access to the GP, district nurse, podiatrist, optician and dentist. Specialist support was provided by the community team for people with learning disabilities (CTPLD). The GP stated in their comment card that they were satisfied with the overall care provided to people. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 17 There was a policy about medication. Staff had received training about medication. Records were kept of medicines received into the home and administered. Only one person had prescribed medication. This was transferred from the packets in which it was dispensed into a compliance aid by a member of staff. Another member of staff checked that this was correct and both members of staff signed a record to show that this had been done correctly. People also had over the counter medication and records were kept when people took this. Consent to take medication was recorded. The GP stated in their comment card that medication was appropriately managed in the home. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 18 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 were safeguarded by the home’s policies and procedures for complaints and protection. People were protected from abuse, neglect and self harm. EVIDENCE: There was a complaints procedure in an easy to read format with words and pictures. Three people who completed surveys knew how to make a complaint. There had been no complaints since the last inspection. Information about ‘No Secrets’, the government guidance about protection from abuse, was available. The home’s policy about protection of vulnerable adults had been updated in January 2007. There was information about the local safeguarding adults procedures. The manager said that she would refer any allegations of abuse according to these procedures. Staff had been given copies of the General Social Care Council code of conduct and practice. The records showed that staff had received training about prevention from abuse. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 19 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, 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People lived in a comfortable and clean environment suited to their needs. EVIDENCE: The home was a normal house, in a residential street, near the centre of Swindon. The shops were within walking distance. There was a large open plan lounge and dining room. There was also a large kitchen, which had recently been refitted. People had constant access to the kitchen to make drinks and snacks. A new dining table and chairs had been provided in the kitchen. Each person had their own bedroom, which was individually decorated and furnished and contained personal items. One person aid that they liked the new décor of their room and had chosen the colour. It was noted that the area under their radiator had not been painted and a piece of the wooden trim Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 20 around their door was missing. There were locks on the doors and each person had a key to their room. There was a large bathroom with toilet and a separate shower room with toilet. At the last inspection a requirement was made that work must be carried out to ensure all replaced or repaired skirting boards are painted with gloss paint, to paint or varnish or stain all bedroom doors, to investigate and eliminate where possible the cause of the mould growth around the shower tray and to provide curtains or blinds in the dining room casement window. The house had been redecorated and a new shower had been installed so most aspects of the requirement had been addressed. The manager said that people had been asked about the curtains or blind and said they did not want any more curtains. There were infection control guidelines. People did the cleaning of the shared rooms and their own rooms. The washing machine was in the kitchen. A requirement was made at the last inspection that the following work must be carried out;-Clean hidden areas such a pipe work from radiators, behind toilets and skirting boards and further assess any possible risk of cross contamination and infection control measures that may be needed to eliminate cross infection when undertaking laundry tasks and ensure that support workers are issued with relevant guidance and know the procedure they must follow to reduce any potential risks. The manager had bought more cleaning equipment, which made it easier fro people to clean hard to reach places. The washing machine area had been changed. The staff and the people who lived in the home had been told that they must not do the washing when meals were being prepared. A recommendation was made that a cleaning company should conduct a thorough clean of the home. This had been done and the manager planned to have an annual clean by a cleaning company. A further requirement was made that the existing lean to by the kitchen must be made good. This had not yet been addressed. The manager said that people were no longer using this and there was a plan to replace it. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 21 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, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were supported by competent, trained and qualified staff. There were enough staff on duty to meet people’s needs. People benefited from staff who supported and supervised. People were protected from being cared for by unsuitable staff. EVIDENCE: The staffing rotas showed that there was always one person on duty. There was a second member of staff so that people could be supported at busy times. A member of staff slept in at night. There were five care staff altogether. One member of staff had a National Vocational Qualification (NVQ) in care at level 3 and was working towards NVQ level 3 in management. Two care staff had NVQ level 2 in care and one was working towards NVQ level 2. The fifth member of staff did not yet have an NVQ. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 22 The training records showed that staff had induction training, fire safety, first aid, sexuality, disability equality, medication, infection control and protection from abuse. A requirement was made at the last inspection that new staff must receive an induction, which meets the Skills for Care standards. The home was using its own induction and Learning Disability Award induction and foundation training which meets these standards. One member of staff who was spoken to had not completed the Learning Disability Award training because they had an NVQ level 2 from a previous job and did not need this training. Two staff who completed comment cards said that their induction covered everything they needed to know to do the job. One said that they felt the support was brilliant. They both also said that they had training relevant to their role. They also said that the training helped them to meet people’s different needs and kept them up to date with new ways of working. A supervision rota was seen on the office wall. Supervision sessions for staff were planned in for the forthcoming months. One member of staff said that they had supervision with the manager or deputy once a month. One staff member said in their comment card that the manager met with them regularly to give support and discuss how they were working. The other member of staff who completed a comment cards said that they met with their manager often, they had a supervision once a month and also on request. The supervision records showed that staff had supervision with the manager or deputy between once a month and one every two months. There was a recruitment procedure. Four new staff had been recruited since the last inspection. All had completed an application form and two written references had been obtained before they started work. Two staff who completed comment cards said that the employer carried out checks, such as Criminal Records Bureau checks and references, before they started work. Copies of certificates of previous training were seen. It was not possible to tell from the records seen in the home whether the staff started to work after all the checks had been received. The manager provided further information about recruitment following the inspection. Two members of staff had had criminal records bureau checks including Protection of Vulnerable Adults (POVA) before they started work. Two other members of staff had had (POVA) first checks before they started work then they had worked under supervision of another member of staff until their CRB checks were received. Proof of identity had been obtained for all the staff as part of the CRB checking. Copies of this had been kept for three of the people. However, no copy of the proof of identity could be found for the fourth. Over all the recruitment records were muddled and it was difficult to work out which checks had been received for which staff. The recruitment checks were kept in the head office. A clearer record of the recruitment checks carried out should be available in the home. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 23 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 generally good. This judgement has been made using available evidence including a visit to this service. People were benefiting from a well run home. There was a quality assurance process but further work is needed to ensure that people’s views underpin all self-monitoring, review and development by the home. People’s health safety and welfare were generally promoted. EVIDENCE: The manager had the Registered Managers Award and NVQ level 4 in care. She was also an instructor with the crisis prevention institute and trained the staff to mange different levels of behaviour. She kept her own training up to date. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 24 There was a quality assurance statement and an annual report, which identified plans for future improvements. The report talked about the progress made by people who lived in the home and referred briefly to people being involved in making decisions about their home. However, did not specifically state how people’s views had been gathered to contribute to the report. The manager said that questionnaires would be sent out to people who used the service, relatives and professionals. A copy of the questionnaire to be sent to staff was seen. There was a health and safety policy. There was a gas safety certificate for 10th October 2006 and this was due to be checked again. Portable appliance checks took place annually and the last certificate was seen. The Environmental Health Officer had visited on 6th May 2005 and recommended that the washing machine was removed from the kitchen. This had not been done. Instead it had been moved to part of the kitchen away from food preparation areas and a risk assessment had been conducted. Risks were reduced by doing the laundry at times when there was no meal preparation or eating of meals. A staff member described a common sense approach to health and safety. They said that when things were not working this was noted in the maintenance log book. Arrangement s were made to repair the defect and progress with repairs was over seen in team meetings. There were risk assessments about the radiators, windows and hot water. These identified that control measures were not needed because people could mange their own safety in relation to these. There were fire prevention measures in the form of smoke alarms and fire doors. The door to the living room had an automatic hold open device but the door to the kitchen was wedged open. Checks of the fire prevention measures took place regularly and were recorded. There was a fire risk assessment and fire drills took place regularly. People said that they had fire drills and knew what to do in the event of a fire. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 25 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 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 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 4 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 X X 2 X Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 26 YES Are there any outstanding requirements from the last inspection? x 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 YA24 Regulation 22(3)(b) Requirement To ensure safety and to complete the upgrading of the home, make good the existing lean to leading from the kitchen. This had not been addressed from the last inspection although it was no longer in use. The timescale has been extended. The area under the radiator in one of the bedrooms must be painted and the trim around the door frame must be repaired and repainted. A copy must be kept, for each member of staff, of their proof of identity, including a photograph. The system for reviewing the quality of care must include collecting the views of people who use the service. The report produced must show how these have helped to identify service improvements. The fire door to the kitchen must not be held open except by a device approved by the fire officer. Timescale for action 01/05/08 2. YA26 23 (2) b and d 01/05/08 3. 4. YA34 YA39 19 (1) b Schedule 2 24 (5) 18/01/08 30/04/08 5. YA42 23 (4A) b 03/12/07 Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 27 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 YA34 Good Practice Recommendations The staff recruitment records should be reorganised for ease of reference. When staff recruitment records are kept in a central office a record of all the checks undertaken for each member of staff should be kept in the home. A proforma for doing this is available on the CSCI professional website. Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Drove Road (85) DS0000063428.V354695.R01.S.doc Version 5.2 Page 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. 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