Care Home: Albany House

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What the care home does well Albany House is well furnished and homely which means that people have a comfortable place to live. Bedrooms were decorated and furnished to a good standard; they contained personal possessions, photographs and other effects. People living at the home see it as their own and are very relaxed in all areas of the home. The environment is welcoming and the home is clean and tidy. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. There are person centred assessments and care plans in place. Any risks to people have been assessed and the assessments are clear and easy to follow. The staff have a good understanding of person centred care. People are supported to gain access to advice from health professionals where they need it so their health needs can be met. The home has both a complaints policy and an adult protection policy in place. At the time of this inspection we had received no complaints and there have been no safeguarding matters since the last inspection. The home has a good system in place with regard to the appointment of staff. Records seen show that references are always obtained, and staff are not appointed prior to safety checks being undertaken. People are supported to keep in touch with their families and friends so that they do not lose relationships that are important to them. People independently go out places and are very much part of the local community. They are able to live independent lifestyles with support from Albany when needed. The home is well managed so the people living there benefit from a well run service. A proactive management and staff team involve people in all aspects of the running their home. What has improved since the last inspection? Work has been undertaken to redecorate areas of the home, the hallways, stairs and landing have been redecorated as recommended at the last inspection. Additionally further work has been done in the bathrooms and new flooring in the dining room. The service is in the process of implementing a new approach in assessing ten core areas of people lives to replace the existing care planning approach. This is called `Recovery Star`. The Recovery Star helps to identify any difficulties people using services are experiencing in each of these areas and how far they are towards addressing them and moving on. The approach requires both staff and people who use the service to work together to aid the process of recovery from mental illness. The home has complied with all requirements made at the last inspection. What the care home could do better: The home has plans in place to replace the carpets in different areas of the building. It was not necessary for us to make any requirements that the service must comply with. We made a recommendation for good practice that arrangements should be made to make sure medicines are stored at the correct temperature so they remain stable. The service needs to continue to reviewed and updated the Statement of Purpose and ensure this document is accessible to the people who live there. CARE HOME ADULTS 18-65 Albany House 16/18 Albany Road Stratford On Avon Warwickshire CV37 6PG Lead Inspector Julie McGarry Key Unannounced Inspection 11th September 2008 08:30 Albany House DS0000004382.V371725.R02.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 Albany House DS0000004382.V371725.R02.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. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albany House Address 16/18 Albany Road Stratford On Avon Warwickshire CV37 6PG 01789 261191 01789 296359 albanyhouse@rethink.org www.rethink.org Rethink 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) Mrs Deborah Susan Thrussell Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. In addition to undertaking the corporate induction programme, a structured induction programme specific to the role and responsibilities of Registered Manager be completed within 3 months of registration. A programme of monthly (minimum) supervision meetings by senior manager be put into place. Supervision meetings should be structured to encompass all aspects of the manager’s role and responsibilities as well as specific issues arising within the home. Successful completion of National Vocational Qualification in Management within 12 months. Albany House may also care for the person named in the application for variation of registration dated 6 March 2006. 28th September 2007 2. 3. 4. Date of last inspection Brief Description of the Service: Albany House is a Home owned by Rethink (previously The National Schizophrenia Fellowship). It is an 8-bedded nursing home for people with mental health needs. It is situated within walking distance of Stratford town centre and local parks. The home aims to provide a supportive residence in which 8 people with enduring mental health needs can have a sense of belonging, be treated with respect and exercise choice in their daily lives. Each individual is encouraged to participate in activities suited to their own needs and wishes, to access local resources and facilities and to manage social and familial relationships beyond the home. Through the long term development of trust between residents and staff, the fostering of hope and focus on the strengths, the home endeavours to enable people to approach their potential and to achieve some recovery in the quality of their lives. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by us is upon outcomes for people who live at the home and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. This report uses information and evidence gathered during the key inspection process, which involves a visit to the home and looking at a range of information. This includes the service history for the home and inspection activity, notifications made by the home, information shared from other agencies and the general public and a number of case files. The manager supplied the commission with an AQAA (Annual Quality Assurance Assessment). Information from this has been used to make judgements about the service, and have been included in this report. Surveys were sent to people who live at the home. The findings of these surveys have been included in the report. The inspection visit was unannounced (we did not let the home know that we were coming) and took place on 11th September between 8.30 am and 5.00 pm. The inspection involved; • • Observations of and talking with the people who live at the home and the staff on duty and the manager. Two people were identified for close examination by reading their care plan, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’, where evidence is matched to outcomes for people. A tour of the environment was undertaken, and home records were sampled, including staff training and recruitment, health and safety, and staff rotas. • We would like to thank the people who live at the home, the manager and staff for their hospitality and cooperation during the inspection visit. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 6 What the service does well: Albany House is well furnished and homely which means that people have a comfortable place to live. Bedrooms were decorated and furnished to a good standard; they contained personal possessions, photographs and other effects. People living at the home see it as their own and are very relaxed in all areas of the home. The environment is welcoming and the home is clean and tidy. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. There are person centred assessments and care plans in place. Any risks to people have been assessed and the assessments are clear and easy to follow. The staff have a good understanding of person centred care. People are supported to gain access to advice from health professionals where they need it so their health needs can be met. The home has both a complaints policy and an adult protection policy in place. At the time of this inspection we had received no complaints and there have been no safeguarding matters since the last inspection. The home has a good system in place with regard to the appointment of staff. Records seen show that references are always obtained, and staff are not appointed prior to safety checks being undertaken. People are supported to keep in touch with their families and friends so that they do not lose relationships that are important to them. People independently go out places and are very much part of the local community. They are able to live independent lifestyles with support from Albany when needed. The home is well managed so the people living there benefit from a well run service. A proactive management and staff team involve people in all aspects of the running their home. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Albany House DS0000004382.V371725.R02.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 Albany House DS0000004382.V371725.R02.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, 3, 4, 5 Quality in this outcome area is Good. People can be confident the service can support them because they have had a full assessment of their needs before moving there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service assesses people’s needs in a detailed way prior to admission to the home. One person’s file shows that an experienced member of staff carried out a pre admission assessment. Records reflect the opportunities for the person to visit the home prior to moving in, and relevant assessments are used from professionals to inform staff if they are able to meet that individual’s needs and aspirations. Four surveys returned to us said that they all had enough information before they moved to Albany House. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 10 The manager is very clear about the assessment of people’s needs to ensure it is the right service for them. One person’s individual wishes for this service to be ‘stepping stone’ to independent living is noted and plans are in place to support this person to work towards achieving this goal. Staff are very clear about people’s needs and staff files show that they are well trained to meet people’s needs. The home is in the process of implementing the ‘Recovery Star’ approach as a replacement to the current care planning process. The service has a statement of purpose and a service user guide in place, which was available to view during our visit. The service is in the process of reviewing these documents to ensure all information is correct and update. The manager told us that they are currently waiting for information to be supplied by the Primary Care Trust to complete the documents. Contracts for all those who live at this service were in place on people’s records, and details of fees were recorded on the contract of the person who most recently moved to the home. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, Quality in this outcome area is Good. People are involved in as many aspects of daily life as possible and they are given opportunity to express their opinions. People’s needs and goals are met and they are supported to take risks to help them stay independent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two people’s care records were seen. Care plans and risk assessments have recently been reviewed and include the care and support they need. The service is currently implementing the ‘Recovery Star’ approach of assessment at the home. The Recovery Star is a tool used to support and measure progress made by people who use the service. This is a recognised tool developed by The Mental Health Providers Forum. One person’s recovery star Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 12 tool was looked at, it identified ten cores areas of this person’s life and reflected the joint assessment of where the person is at in achieving goals they have identified in each of the areas. An example of cores areas measured are, work, social networks, living skills and managing mental health. One goal identified reflects this person’s aim to develop skills in independent living. A plan is in place to show the steps agreed to be taken to help achieve this aim. Records reflect the steps achieved in the plan and when we spoke with this person they told us that they have played their part in the development and implementation of the recovery plan. All plans seen are signed by the person. This person also told us that they are able to “make decisions about the day” and “can do what I want to do”. We spoke to staff, they were very clear about the importance of helping people to take risks and being supportive of this, as well as maintaining their confidentiality. The daily notes by staff support this view. This person’s recovery plan contains full risk assessments about key areas of their life, which are completed and reviewed monthly by the key worker and every three months by the people who use the service with their key worker. Recovery Plans have not been fully implemented for all of those who live at the service. We looked at other care plans, which show us that the information recorded is based on the assessment information. There are detailed care plans focusing on health and social care needs, which uses positive language like “I can”, and “you can help me by”. Most of the information in the care plans are clear for staff, however further work in implementing the Recovery Stars should ensure that records about people’s mental health needs are in plain English and easy for staff who are not trained mental health professionals to understand. The home offers support from male and female care staff. This means that the people who live there do not have the option of having care provided by either a male or female. Staff spoke to were able to talk about the person’s care needs knowledgeably. Albany House DS0000004382.V371725.R02.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, 14, 15, 16, 17 Quality in this outcome area is good. People have opportunities to develop their life skills, take part in appropriate activities, develop relationships and be part of their local community. They are treated as individuals and are as independent as they are able to be. Food is healthy and people’s choice is sought about this and other lifestyle activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The lifestyle people experience in the home matches their preferences; they are supported to maintain their independence and enduring interests, which enhances their quality of life. We spoke to the people who use this service and they told us about a variety of things that they had been doing, for example, the cinema, seeing his friends, family, Taekwondo and shopping. The weekly Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 14 timetables and the daily logs show people who live at Albany House have a lot of opportunity to access local shops, the cinema, ago out for walks, and good contact is maintained with family. Records show that Albany House enrols people into college if they are keen and are wish to attend. During the visit we observed people freely walking around in the house and staying in the their own rooms listening to music, they clearly felt comfortable and had free reign of the house. We observed good examples of people participating in daily life at Albany. Meals were discussed with someone who uses the service, and it is clear that there is a lot of choice and opportunity to be involved in preparing favourite foods. One person’s recovery plan shows that they wish to develop their independent living skills in cooking. The plan clearly sets out how this will be achieved through twice weekly shopping and cooking sessions with staff. The cupboards and fridge contain good supplies of healthy food and there is opportunity for regular treats such as takeaways to provide a balance. Due to the needs of one person who lives at the home, the kitchen cupboards, fridge and freezer are kept locked. Some of the people who live there have their own key to access the cupboards, but not all residents. One person, who does not have key to the cupboards, told us that he was happy with these arrangements and did not mind having to ask staff for a key to get food when he wanted to. Staff told us that there are plans to supply all people with a key to the cupboards with the exception of one identified person. A range of food had been offered including Sunday roasts and other traditional English dishes that reflect the cultural needs of people living in the home. There are staff in the home from different nationalities and special meals are also cooked to reflect different staff cultures at the home. Some of the people maintain links with their family, the nature and extent of contact is varied. There was evidence in care plans that people’s needs with regard to keeping in touch with friends and relatives had been recorded. Staff have recorded individuals religious preferences. Two people who live at the home are supported to practice their chosen faith. On the day of the inspection, one person was heard having a discussion with staff about their faith, other faiths and how this linked into their own mental health and wellbeing. Another person’s files shows trips to London where they were able to pray with other people who share their chosen faith. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 15 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): Standards 18, 19, and 20 were assessed. Quality in this outcome area is good. People living in the home are treated respectfully and are protected from harm by the safe management of medicines. Each person has a plan of care and access to health care services so that their health and personal care needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were positive relationships and interactions observed between staff and the people who live at the home. The staff and manager encouraged and supported people in a relaxed way. All of the people living in the house said that they like and get on well with the staff. A person using the service told us he gets all the help he needs and is happy with the help from the staff. The approaches to care for each individual reflect the aims of the admission, the needs and aspirations of the individual and the needs of other people who use the service. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 16 People who live at Albany House receive personal support in the way they prefer and require as evidenced through observations during the inspection, discussions with staff and examination of records. For example, on each morning of the visits not all residents were up and dressed. Residents arose at varying times and ate breakfast when they felt ready. People’s health records and care plans showed that their right to good-quality physical and mental health care is being promoted. The records show that as part of promoting their health, people make regular visits to a dentist, optician, specific health consultants, their GP and a chiropodist when needed. People’s records are kept up to date and reflect people’s current needs. For example, one person has been identified as being at risk whilst in the community on their own. A plan and risk assessment are in place to guide staff on how to support this individual to access the community, whilst remaining safe. From discussions with staff and records kept, there is a focus on promoting people’s independence and positive risk taking. For example, one person has recently left the service and move into more independent living. Enabling them to achieve their goals of independent living whilst living closer to their family. Medication records seen were correct. The manager and staff actively monitor the completion of the medication records. There was one recording omission on one person’s medication audit record, however this was from the previous night and staff had already identified this before we looked at the medication records. There was no record of temperature recording. Medication must be stored below 25°C to ensure the stability of the medicines. A medicines fridge was available with daily recordings of the temperature using a maximum-minimum thermometer. This complies with the requirement made at the last inspection. Medication plans have been developed for people who self-administer and store their medication in their rooms. One plan looked at was detailed in recording information about how and where the medication is stored and administered. A second plan looked at needs to be developed to this level of detail to ensure records accurately reflect the system in place. During the visit staff made the necessary amendments to that medication plan to ensure it provided the required information. The service has complied with the requirement made at the last inspection. One person told us that they “look all of my own tablets’, ‘ I keep them stored in a locked cupboard in my room, and staff check them regularly to make sure I have taken my tablets’. People who store their own medication were happy to show us where their medication is stored in their rooms. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 17 The manager and staff continue to be proactive at meeting the specific social, health and personal care needs of the people who live at the home. There are good systems in place for monitoring people’s physical well being. Albany House DS0000004382.V371725.R02.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 Quality in this outcome area is good. The service safeguards people from abuse and neglect through thorough recruitment, training, policies and procedures. People know how to complain and the service has a system in place that ensures complaints are acted upon quickly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The annual quality assurance assessment and records seen during this visit showed that there had been no complaints made about the home since the last inspection. There is a complaints policy in place. We spoke to staff who are aware of the complaints process as well as the meaning of safeguarding adults. From discussions with the manager it is clear that the home are taking further steps to ensure that complaints are recorded, and that there is an open culture and clear recording process for all activities at the service. Surveys received prior to the inspection show that some people who live at the service are not clear about the complaints process. Minutes from resident meetings however show that the complaints procedures is discussed and repeated in following meetings if anyone is unclear. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 19 Minutes from staff meetings also refer staff to read polices and procedures to ensure they are up to date with records. People confirmed that they know who to talk to if they are not happy with something, or want to complain either within a house meeting or individually. One person spoken with was not sure how they could make a complaint but said they were happy with their stay so far. Another said “I’ll talk to staff if I’m unhappy”. Staff records at Albany House show that staff are trained in the protection of vulnerable adults. An adult protection procedure is in place at the home to inform staff of the measures to take to report any suspicions of abuse, however guidelines are currently in two separate folders, this could lead to confusion for staff if they needed to refer to guidelines. Practices for safekeeping people’s money are appropriate. Most people manage their own finances with minimum support from staff. One person currently requires support from staff to go to a bank link to withdraw money. Due to this person’s individual needs, staff need to remember their pin number. Although good practise are in place in maintaining receipts and statements, this type of support can leave this person vulnerable to financial abuse as well as leaving staff vulnerable to accusations. The organisation has already recognised this as a concern, and the home is looking at their future role in providing support to people to manage their finances to ensure practices are safe for individuals and staff. At the time of the inspection, there had been no allegations of abuse made to the commission. From observations of staff interactions and daily records it is clear that staff and manager listen to and act on wishes of the people who use the service. Albany House DS0000004382.V371725.R02.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, 25, 27, 30 Quality in this outcome area is good. The house has been refurbished to meet the needs of people with autism. It is also a welcoming environment for young people to live and feel at home. The house is clean, comfortable and well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Improvements have been made since the last inspection to the maintenance of the house, and there are plans for further improvements to be made. Work has been carried out in the bathrooms, dining room, hallways and stairways The manager informed us that new flooring would be put down carpeted areas of the building. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 21 The house is very clean in all areas. During the course of the day staff were observed following hygienic practices. Staff interviews confirm that they are aware of infection control and hygiene and have received training, which is noted in their files. There is a clear infection control policy. The kitchen was clean and well organised. Records were kept of the fridge and freezer temperatures showing appropriate temperatures to maintain good food safety. All of the people living in the home were happy to show us their bedrooms. The bedrooms reflected their individual lifestyles, interests and tastes. Information from the surveys received told us that people feel that the home is kept fresh and clean. People at the home said that they are involved in cleaning and tidying alongside staff. During our visit, cleaning products were stored under the kitchen sink in an unlocked cupboard. Staff immediately removed these products to place them in a locked cupboard in the laundry room. The conservatory was designated as the smoking area and the people living in the home were being encouraged not to smoke in their bedrooms. Albany House DS0000004382.V371725.R02.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, 33, 34, 35, 36 Quality in this outcome area is good. There is a well-trained staff group in sufficient numbers to meet the needs of the people who use the service. The staff are competent and qualified in relevant specialist areas, and they receive excellent support from their manager, which helps them to support people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager told us that the usual staffing complement for the home is: ▪ one waking night staff who is registered nurse ▪ two staff each morning / early afternoon ▪ two staff late afternoon / evening. The home ensures at least one qualified nurse is on duty throughout the day and night. Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 23 Three weeks of the home’s duty rota between 1stth September and 21st September 2008 was examined and demonstrated that the staffing levels set by the home are consistently achieved. It was evident from the outcomes achieved for residents that there are sufficient staff on duty to meet their needs. Staff spoken to confirmed that the staffing arrangements enabled them to meet the needs of residents. Staff interviews confirm they are aware of their roles and are aware of the key policies and procedures of the service. Staff know people’s needs well and observations show that they are able to develop a relationship with people who use the service, and have the right attitudes and characteristics to work with them. Observations of someone using the service with their key worker show that staff have a rapport with people and they enjoy the time they spend together. Staff files show that they have been well trained and have the necessary skills and experience to do their jobs. Most of the staff are qualified nurses, and new staff follow a comprehensive induction program to work through. A training database is held and a log kept of staff training, and certificates held in their file. Staff report feeling well supported by the manager through regular supervision and regular staff meetings, which take place. The personnel files of two recently recruited staff were examined and both contained evidence that satisfactory pre-employment checks such as Criminal Record Bureau (CRB), Protection of Vulnerable Adult (PoVA) and satisfactory references were obtained before staff started working in the home. Robust recruitment practices safeguard people living in the home from the risk of abuse. Albany House DS0000004382.V371725.R02.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, 39, 40, 42 Quality in this outcome area is good. People have confidence that the service is managed appropriately and according to their wishes. The environment is safe, and health and safety practices are carried out. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is well qualified to manage the service and discussions with her show an open, positive and inclusive approach to management. The service is well set up with the correct policies and procedures and staff training for when Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 25 new people move in. She is a registered nurse currently working towards the registered manager’s award (NVQ level 4) and is also completing a distance learning program in coaching skills. The management structure in the home has stabilised since the last inspection providing continuity of leadership within the home. It is evident that the manager’s skills have developed since the last inspection. Staff spoken with told us that having a stable management structure has improved the way the home is run. Staff who work at the home made positive comments about the manager, saying that they felt the team “was cohesive” and that it “made a positive difference having Debbie manager in post”. During this visit the manager spent some of her time in the communal areas of the home, this indicates that the manager makes herself accessible to listen to people who live and work at Albany House. The Annual Quality Assurance Assessment (AQQA) completed by the manager was completed to a good standard. Information provided was supported by a range of evidence, and the Annual Quality Assurance Assessment (AQAA) fully informed us about changes the home has made and where improvements still need to be made. A representative of the registered provider visits Albany House on a regular basis to report on the standard of care provided of which reports are made available within the home. From looking at the most recent reports and discussions with the staff team, it was evident that the views of people who live in the home had been actively sought with regard to the way in which the service is being run. We were told that there are regular house and staff meetings so that people have an opportunity to discuss issues that are important to them, such as planning activities and menus. Staff files confirm that they have received training in protection of vulnerable adults, fire safety, first aid, food hygiene and infection control. Fire alarm testing is now standard practice, complying with the requirement made at the last inspection. A number of checks are made by staff to make sure that peoples’ health and safety is maintained. Records showed that the fire alarm system had been regularly tested and serviced to make sure that it was working properly. The home has paper towels and soap dispensers in place in the bathrooms to ensure good infection control management, complying with the requirement made at the last inspection. Evidence throughout this report demonstrates there are good outcomes for people living in the home. Albany House DS0000004382.V371725.R02.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 3 2 3 3 3 4 3 5 3 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 X 29 X 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 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 3 X 3 X Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 27 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA1 Good Practice Recommendations The registered person should review and up date the statement of purpose setting out the aims, objectives and philosophy of the home, its services and facilities and terms and conditions; and provide each service user with a service users guide to the home. Arrangements should be made to make sure the temperature in the medicine storage area is consistently within recommended limits to maintain the stability of medicines. 2 YA20 Albany House DS0000004382.V371725.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Albany House DS0000004382.V371725.R02.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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