Care Home: 93 Ings Road

Similar services:

• Larch Avenue
• Alderson Road 12
• Cranworth Close Registered Care Home
• The Cornerstone
• John Street Nursing Home
• Pennine Camphill
• Whitwood House
• Whitwood Hall

What the care home does well Avocet Trust provides accommodation and personal care support and is a good service for adults with a learning disability and other needs. Their aim is to enable people to develop and maintain as much independence as possible, whilst helping them to be more confident and access community facilities. People and their relatives are given enough information about the home to enable than to make a choice about whether it will be suitable for them or not. People are encouraged to visit the home first and to meet everyone before they decide to have stays there. The house is located in the local community and is on a bus route making all leisure facilities and shops easy to get to. Everyone has a single room that meets their needs, in a house for no more than five people. This provides people with a home from home and private areas to their liking where they can spend private time or receive visitors. Families are encouraged to be involved as much as they wish to and are made to feel welcome when visiting their relative. The staff makes sure that peoples health needs are met and their medication is managed well for them. People are able to continue with all of their planned activities and are supported by the staff team to do so whilst staying at the home. People receive a healthy diet and their likes and dislikes are taken into account. Some people like to go shopping for their evening meal and staff support this. The home is clean and tidy with a ramp access for people who use wheelchairs. New staff members have all the checks completed on them before they start and they receive good training from the company. This means that they have the skills needed to look after vulnerable people. What has improved since the last inspection? Parts of the home have been redecorated and new carpets have been provided in the hallway, stairs, lounge and second sitting room. The upstairs shower room has a new floor and new tiles and part of the kitchen has had a new floor. Part of the staircase has been improved so its safer and the external guttering and pipe work have been repainted. The home is now fully staffed and the manager is able to spend more time in the home, as he does not have to manage two places at once. The way the home recruit new staff has improved so that full checks are carried out before they start work. The way the home records medication has improved and staff receive medication training. They have their skills assessed to make sure they are safe to administer medication. Staff training is more organised, the training plan has improved and covers more areas. What the care home could do better: One persons support plan had some parts that needed completing more fully so staff were aware of all their needs. One person had a plan of all the activities they liked to do but the notes written by staff were different. Staff need to talk to the person and check out what they really want to do. They need to make sure they help the person do the things they want to do. Each member of staff at the home must have a regular meeting with the manager to discuss the training they may need, support and other things. This has not been happening as often as it should. The manager needs to be registered with the Commission. This is where they are checked out to make sure they are the right person to manage the home. The home could purchase a small medication fridge so they can store medicines in it safely when required. The home could make sure that important information is given to people in ways that they easily understand. For example the complaints procedure should be easier for people to read. The manager carries out checks in the home and asks people that stay there questions about how they are helped by staff. When they get the replies they need to check them out and make plans to put things right if its needed. The manager needs to check the support plans put in place to help people. This should be done regularly so the manager is sure they continue to be correct. CARE HOME ADULTS 18-65 93 Ings Road 93 Ings Road Hull HU8 0LS Lead Inspector Bev Hill Key Unannounced Inspection 13th March 2008 09:00 93 Ings Road DS0000065523.V360858.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 93 Ings Road DS0000065523.V360858.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. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 93 Ings Road Address 93 Ings Road Hull HU8 0LS 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) 01482 329226 01482 329337 Avocet Trust Position Vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2007 Brief Description of the Service: The service at 93 Ings Rd is managed by Avocet Trust, which is a registered charity. The service is a detached house registered to provide respite care for up to five service users, admitted at any one time. The home is situated on Ings Rd to the east of the city of Hull. Communal areas consist of a hall, a lounge with a dining table at one end, a second sitting room, a kitchen and a small utility room. The house had a shower room upstairs for more physically able people and a walk-in wet room downstairs. There were five single bedrooms all but one of these being upstairs. One of the upstairs bedrooms has an en-suite shower room and is currently utilised as an office and staff sleep-in room. The house has a private garden to the rear of the property and space for two cars at the front. The home is accessible via a ramp. There are a variety of shops, pubs, GP surgeries and post office all within walking distance. Public transport to various parts of the city is easily accessible. Weekly fees range from £735 - £2578.94 per person per week. Additional charges are made for the following: newspapers/magazines, hairdressing, chiropody, transport for social activities and sweets. Information about the service is made available to current service users via the statement of purpose, service user guide and inspection report, which are all available in the home. 93 Ings Road DS0000065523.V360858.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 that the people who use this service experience good quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key inspection of the home on 8th March 2007, including information gathered during a site visit to the home, which took place over one day. Throughout the day we spoke with one service user and two staff members to gain a picture of what life was like for people who have short stays at 93 Ings Road. Most of the service users that stay at the respite service have complicated needs and are not able to tell us their views therefore in this report comments from relatives and staff have been used to help to form a view about whether service users needs are met or not. We received some surveys from relatives and two from social services care managers. We also had discussions with the manager. We looked at assessments of need made before people were admitted to the home, and the home’s care plans to see how those needs were met whilst they were staying there. Also examined were medication practices, activities provided, nutrition, complaints management, staffing levels, staff training, induction and supervision, how the home monitored the quality of the service it provided and how the home was managed overall. We observed the way staff spoke to service users and supported them, and checked out with them their understanding of how to maintain privacy, dignity and choice. We also checked that people were supported and protected in a safe and clean environment. What the service does well: Avocet Trust provides accommodation and personal care support and is a good service for adults with a learning disability and other needs. Their aim is to enable people to develop and maintain as much independence as possible, whilst helping them to be more confident and access community facilities. People and their relatives are given enough information about the home to enable than to make a choice about whether it will be suitable for them or not. People are encouraged to visit the home first and to meet everyone before they decide to have stays there. The house is located in the local community and is on a bus route making all leisure facilities and shops easy to get to. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 6 Everyone has a single room that meets their needs, in a house for no more than five people. This provides people with a home from home and private areas to their liking where they can spend private time or receive visitors. Families are encouraged to be involved as much as they wish to and are made to feel welcome when visiting their relative. The staff makes sure that peoples health needs are met and their medication is managed well for them. People are able to continue with all of their planned activities and are supported by the staff team to do so whilst staying at the home. People receive a healthy diet and their likes and dislikes are taken into account. Some people like to go shopping for their evening meal and staff support this. The home is clean and tidy with a ramp access for people who use wheelchairs. New staff members have all the checks completed on them before they start and they receive good training from the company. This means that they have the skills needed to look after vulnerable people. What has improved since the last inspection? What they could do better: 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 7 One persons support plan had some parts that needed completing more fully so staff were aware of all their needs. One person had a plan of all the activities they liked to do but the notes written by staff were different. Staff need to talk to the person and check out what they really want to do. They need to make sure they help the person do the things they want to do. Each member of staff at the home must have a regular meeting with the manager to discuss the training they may need, support and other things. This has not been happening as often as it should. The manager needs to be registered with the Commission. This is where they are checked out to make sure they are the right person to manage the home. The home could purchase a small medication fridge so they can store medicines in it safely when required. The home could make sure that important information is given to people in ways that they easily understand. For example the complaints procedure should be easier for people to read. The manager carries out checks in the home and asks people that stay there questions about how they are helped by staff. When they get the replies they need to check them out and make plans to put things right if its needed. The manager needs to check the support plans put in place to help people. This should be done regularly so the manager is sure they continue to be correct. 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. 93 Ings Road DS0000065523.V360858.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 93 Ings Road DS0000065523.V360858.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): 2 and 4. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed prior to admission which means the home is able to determine whether they are able to meet needs. EVIDENCE: The manager confirmed that service users needs were assessed prior to admission to the home and assessments completed by care management were seen in the files. This information was crucial in the decision making process as to whether the home was able to meet peoples’ needs and also used when formulating support plans. Three care files were examined in detail. Documentation confirmed that service users were only admitted to the home after professionals have assessed their needs. There was also evidence in one of the files that the manager had reviewed and updated information available in the care management assessment, as this had been completed several years ago. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 10 One care manager stated in a survey, ‘the service always ensures that they have received a copy of the assessment and care plan prior to the placement commencing’. For any new service users using the respite service the manager needs to routinely write to them or their representatives following the pre-admission assessment formally stating their ability to meet identified needs. The manager stated the company wrote to the local authority following receipt of the assessment completed by them, stating they could meet the persons’ needs. Correspondence needs to be maintained on file. One survey received from a relative and completed on behalf of the service user stated that they were able to visit the home before the first respite admission, ‘I was slowly introduced to Ings Road, and I got to know staff and the building before I felt ok about staying there to sleep’. They also commented on family supporting and preparing them for the initial respite stay. 93 Ings Road DS0000065523.V360858.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 and 9. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users had their needs planned for and met in their preferred way. These were detailed in individual support plans, which were reviewed at intervals. EVIDENCE: Three care files were examined and all contained support plans that had been completed with the service user at the centre of planning. The care files had lots of information regarding the needs of the service users, including life histories, preference lists, risk assessments, moving and handling assessments, epilepsy management and treatment plans, reviews and various monitoring charts for behaviour, bowel care and nutritional intake. There were separate files for finances and health. The individual care plans consisted of support plans and management plans. The management plans were added information for particular tasks and the 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 12 manager confirmed these were usually put in place when some element of risk has been identified. The support plans were written in a person centred way and contained clear tasks for staff in how they were to support people. They also contained service user preferences and how staff could enable the person to maintain their independence to varying degrees. Behaviour Management plans were in place that gave staff clear instruction in how to deal with issues as they arose. Two of care plans examined covered the full range of needs identified at the assessment stage, whilst the third could be expanded in areas of communication, mobility, the provision of activities and the management of continence. There was evidence that reviews of care plans were held with family members and professional present. The support plans were signed by staff to evidence they had read and understood it. Staff members spoken with were aware of service users needs and confirmed they had time to read support plans and update themselves with new information. Risk assessments were in place in the files examined for falls, epilepsy management, swallowing and particular behaviours. One service user spoken with during the day told us they continued to be independent whilst in respite by attending to their personal care needs, had a key to their bedroom door and was able to make choices about aspects of their life. Some people managed their own money during their stay, whilst staff supported others with this task. One survey received from a relative and completed on behalf of the service user stated, ‘staff always allow me to have a choice so long as I don’t upset anyone or myself’. 93 Ings Road DS0000065523.V360858.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): 12, 13, 15, 16 and 17. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff supported people to attend places and events of their choice and to participate in daily living activities. The home provided a range of nutritional meals which offered choices and alternatives to service users. EVIDENCE: There was evidence on care files examined that service users continued with their planned activities whilst staying at the home for respite care. On the day of the site visit one service user was due to attend a ‘speak out’ group in the community and another was awaiting transport home. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 14 Service users care files examined contained an activity timetable, which covered a range of activities and interests. One person spoken with confirmed they liked to go bowling and to the pub and did not like to watch television all the time. This was also detailed in their assessment information but when cross-referenced with daily recording of what actually happened, watching the television did appear to be the activity they had participated in the most. Between the end of January 08 and the date of the visit, 13th March it was documented they had been bowling twice, community club once and a car ride once. The rest of the evenings were documented as, ‘watched television’ or ‘interacted with staff’. This was mentioned to the manager to look into and ensure the service user had a more varied range of activities. The service user did tell us that when they were in respite they went to the shops most afternoons with staff to buy the food they wanted for tea and they enjoyed this. Service users were able to access Avocets own day service whilst receiving respite care. One relative stated in a survey, ‘the respite team have opened up and extended the world for our son, beyond our expectations’. Another person writing on behalf of their relative stated, ‘’I am happy with the things I do in respite’, but also wrote, ‘sometimes the staff are very busy at the weekends – so I may have to do more things in the house, but it’s a nice place and I have a choice of activities’. The house is situated in the local community and blends in well with its surroundings. All service users have an individual bedroom where they can spend private time and they have unrestricted access to all areas of the house. Bedrooms have privacy locks and one person spoken with confirmed they locked their bedroom when they went out for the day. The home has good links with families and they are made welcome at the home and are able to visit whenever they wish, however the very nature of the service (respite care) means that they do not take up this offer very often as they are taking a well-earned break. One relative did write, ‘we maintain contact twice daily when our son is in respite. We are always given accurate accounts of how he is, what he has done and if he wishes he sometimes comes to the phone to speak’. The manager and staff promote a healthy eating menu but try to balance this with service users likes/dislikes and special treats on occasions. The manager confirmed that Saturday was ‘own choice’ night, where whoever was in for respite would choose what was for the evening meal. Care files contained information on likes, dislikes and preferences and the menu plan was presented in a pictorial format. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 15 The choice of meals has not changed since the last inspection. Breakfast consists of a variety of cereals, toast, tea, coffee and juice. Lunch is a choice of sandwiches, soup, beans or egg on toast, omelette or jacket potatoes with a choice of fillings. Options on the menu for dinner included chicken, mince, pasta, fish, all served with fresh vegetables and the manager confirmed that there is always plenty of fresh fruit and yogurts available. Some service users enjoyed shopping for food at local supermarkets. Staff confirmed that currently there was no service user on a specialist diet although one person had their meals liquidised and their intake was monitored. This was confirmed in care plan documentation. The staff members generally prepare the main meals but occasionally service users like to assist. The kitchen was clean, tidy and well stocked. 93 Ings Road DS0000065523.V360858.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 and 20. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of service users were met whilst they were in respite. EVIDENCE: The nature of the service (respite care) means that relatives managed the majority of the service users health needs when they are living at home, but care staff will support service users to attend any appointments whilst staying at the home. Three care files were examined during the visit. Daily records were maintained and there was evidence that a range of professionals continued to support service users with their health care needs whilst in respite care. One care manager stated in a survey, ‘I feel all aspects of health is monitored closely and in my experience staff have contacted relevant health professional as needed, I have always been informed of any concerns’. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 17 Comments from relatives were, ‘I feel they look after my son very well, they treat him as we all do at home, therefore he is happy’, ‘they provide support as agreed in care plans’ and ‘physical and other disabilities all appear to receive an efficient and thoughtful service’. There were positive comments throughout surveys about the support provided by care staff. Support plans had been produced that covered health and personal care needs. Some monitoring charts, for example behaviour monitoring, epileptic seizure activity, bowel and nutrition were in place. Documentation was completed when accidents or incidents occurred that affected the wellbeing of the service users and these were forwarded to the Commission as appropriate. The management of medication was assessed as part of this visit and we discussed the systems with the manager and examined recording tools. Service users bring in their stock of medication with them on admission. The medication is entered onto the stock control sheet and then transcribed by staff onto the medication administration sheets. There had been an improvement in recording of medication since the last inspection. The medication file contains information leaflets and a procedure was in place for the use of homely remedies, which tended to be paracetamol for pain relief. The home did not have a designated medication fridge and those items requiring refrigeration would be held in a separate container in the main fridge. The manager must ensure that should this happens the items are secure and inaccessible to service users. Staff members completed a one-day medication awareness course in addition to three competency checks by the manager and they also complete training in how to administer epilepsy medication in an emergency. 93 Ings Road DS0000065523.V360858.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 and 23. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff awareness of the safeguarding adults, and complaints policies and procedures means that any issues are dealt with quickly and people are protected from abuse. EVIDENCE: Neither the home nor the CSCI had received any formal complaints about the home since the last inspection. The home had a complaints procedure that was displayed in the home. Staff members were aware of the procedure and the documentation used to record complaints. The procedure could be produced in a format more easily understood by service users and the complaints form used could contain an outcome section to evidence complainant satisfaction. The home had policies and procedures to cover safeguarding adults from abuse, whistle blowing, aggression, physical intervention and restraint and management of service users money and financial affairs. The manager and staff had received training in how to safeguard vulnerable adults from abuse and had completed training in how to manage behaviours that could be challenging to others. The staff on duty displayed a good understanding of how to safeguard vulnerable adults from abuse and they were confident about reporting any concerns. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 19 Since the last inspection there had been an incident between two service users that was reported by the manager to the Commission and to the company’s health and safety officer. Some confusion had arisen regarding whose role it was to refer the incident to the local authority, which is the lead agency for investigating any allegations. This has been addressed and the manager is fully aware of their responsibilities regarding the referral and investigation procedures. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 20 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 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home continues to provide a safe, clean, homely and comfortable environment for service users. EVIDENCE: 93 Ings Rd is a semi-detached house registered to provide respite care for up to five service users, although it has been decided that four people should be the maximum amount at any one time. The home is situated on Ings Rd to the east of the city of Hull. Since the last inspection there have been some changes to the environment to allow more communal space for service users. The lounge now doubles as a dining room and the previous dining room, which was also used as a staff sleep-in room, has been made into a sitting room for service users. Both rooms, as well as the hallway, have been redecorated and new carpets 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 21 provided. A new settee is to be purchased to replace the current bed settee in the small sitting room. New carpets have been fitted to the stairs and landing, and alterations made to the banister frame to improve safety. The home had four single bedrooms for service users to occupy, one of which was on the ground floor. A fifth bedroom was now used as an office and sleepin room for staff. There was minor redecoration required to some of the bedrooms and curtains required repair in one of them. Apart from one or two pictures the bedroom walls looked quite sparse, however the bedrooms were used for short stays and service users do not bring in large amounts of items. However this was mentioned to the manager to look into to see if a discussion with regular service users could lead to suggestions for wall decoration to make the rooms look more appealing when occupied. All bedroom doors had privacy locks but not lockable facilities to store personal items. Some of the bed linen was looking a little jaded due to the frequency it was changed as people came in and out. The home had a shower room upstairs for more physically able people and a walk-in wet room downstairs. New flooring and tiles have upgraded the upstairs shower. The house had a private garden to the rear of the property, which required some attention, and space for two cars at the front. There was a ramp to the patio doors at the side of the house for wheelchair users. This led into the main lounge. On the day of the visit the house was found to be clean, tidy and provided a homely and comfortable environment for service users to stay in. All the required equipment was in place to meet service users needs. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 22 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 and 36. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home operates good recruitment, induction and staff training systems to ensure service users are supported, in sufficient numbers, by a competent and consistent staff team. EVIDENCE: There are currently eight service users that regularly use the service at 93 Ings Rd for respite care and the home is registered for a maximum of five people. However the manager advised us that the size of the building coupled with the fact that some service users need to have one to one staff support, realistically means four service users can be adequately supported at any one time. Service users were now receiving rolling respite in a structured way and this enabled the manager to plan more effectively. The home had a core team of six permanent staff and access to three bank staff when service users required extra funded support. Staff members spoken with advised that they were now 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 23 fully staffed but had lacked key personnel in the past. They felt supported in their roles and a new staff member to the team stated they felt welcomed. Surveys from relatives were complimentary about the staff team, ‘the regular staff are all suitably experienced to care for our son’s complex needs’ and ‘the team create a welcoming, relaxed milieu’. One person spoken with on the day said, ‘the staff are alright, its nice here’. The company’s headquarters formulated the training plan that included mandatory and a range of service specific training that had been devised following an audit of the training needs of the staff and the needs of the service users. These included a non-verbal communication course, Makaton, eating and swallowing, PICA disorder, autism, bipolar disorder, epilepsy, intensive interaction and continence management. All staff had completed training in how to deal with behaviours that may be difficult to manage. Individual training records were examined and evidenced that mandatory training had been undertaken or booked and updates recorded when required. The training records were maintained and forwarded to HQ for continual planning. The records enabled training requirements to be tracked and mandatory updates recorded and addressed. The company provided a two-week induction when mandatory training was completed and staff members were enrolled on the common induction standards. This entailed completion of a booklet that was sent for verification by an assessor. Staff members were expected to work through the booklet within four weeks. All of the six, permanent staff team had completed NVQ to level 2 or 3, which was a very good achievement. The company’s recruitment process was robust. Application forms were completed and references and police checks obtained. Potential applicants were selected via a solid interview process. There had been no new staff recruited to the home since the last inspection. Some staff members had transferred from other units in the company. The manager confirmed new staff would only start employment after the return of their criminal record bureau check. In exceptional circumstances they could start after the initial check of the protection of vulnerable adults register but the company’s Head of Service had to sanction this so stringent supervision arrangements could be in place. A programme of supervision has commenced in the home however this needs to be maintained to ensure staff receive a minimum of six supervision sessions in the year. On the day of the visit the staff team were observed to be very caring, considerate and respectful. There was a relaxed atmosphere in the house and people appeared to be well supported. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 24 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 and 42. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well run by a competent and qualified manager. This means the home is safe and comfortable for the people that receive respite care there. EVIDENCE: The manager was underway with his registration with the Commission. He has a variety of skills, relevant qualifications and experience and has managed care homes in the past. The manager still managed a second service, a domiciliary care services and their hours were divided between the two. However a new manager has been appointed to the domiciliary care services, which will enable the manager to 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 25 devote full time hours to this service. The manager confirmed this would enable them to concentrate on management tasks such as quality assurance, planning and staff supervision. A senior staff member has also recently been employed and will take over the majority of staff supervision. A systematic approach to quality assurance has been developed and the staff met last year to self-assess the service. Senior managers completed the same task and the two scores were evaluated. This annual service review resulted in an action plan to address identified shortfalls. Some of the target dates had been met but there were still some areas to address. The manager had also completed the annual quality assurance assessment required by the Commission. However the information provided was brief and could be expanded on. Some surveys had been completed by service users and there was evidence of one return from a relative. However these had not been collated and analysed yet. The views of other stakeholders such as professional visitors to the home and staff had not been obtained yet. Staff stated they tended to speak to people on a daily basis when they were in respite to ensure they made decisions about their lives. Smaller group discussions about service provision could be documented to evidence decision-making. The trustees of Avocet Trust usually undertake monitoring visits to the home and produce reports for the Commission. However there were none recorded since August 2007 although the manager confirmed the Head of Service had visited the home since then. The manager holds staff meetings every two months and management meetings take place monthly. Maintenance certificates were available and up to date. The manager advised that alterations had been made to the landing banister rails to make them safer and the staff team constantly monitored the environment. Any maintenance issues were sorted out straight away. 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 26 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 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 2 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 2 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 2 3 3 X X 3 X 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 Requirement The registered person must ensure that one specific support plan is expanded further in areas of communication, mobility, activities and nutrition. This will ensure all areas of need are fully addressed and care planned for. The registered person must ensure that the activity plan for one specific service user is reviewed and discussed with them to provide support for further interests. The registered person must ensure that all staff are on track to receive formal supervision at least 6 times per year. (Timescale of 31/12/06 and 30/06/07 not met) It is acknowledged that this process has re-started. The registered person must ensure that the manager completes registration with the Commission. Timescale for action 30/04/08 2 YA12 12 30/04/08 3 YA36 18 31/05/08 4 YA37 8 31/05/08 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 28 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 2 3 4 Refer to Standard YA20 YA22 YA37 YA39 Good Practice Recommendations The registered person should consider purchasing a small medication fridge. The registered person should consider providing key information in alternative formats for the people that use the service, for example the complaints process. The manager should investigate whether their current qualifications meet the requirements of NVQ level 4 in care and management. The registered person should fully embed the quality assurance system so that the service can demonstrate its commitment to internal monitoring, review and taking action to improve its service without external influence. The registered person should consider the addition of case file auditing as part of supervision or quality assurance activity to ensure that standards are maintained and peoples needs continue to be met. 5 YA39 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 93 Ings Road DS0000065523.V360858.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!