Care Home: Alfred Minto House Care Home

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What the care home does well People have a very thorough assessment before they are admitted to the service so they know the home is right for them and the staff know they can meet their needs. The staff are given very good training to prepare them for the kinds of needs they may have to support people with. The planning of care is very good. The plans are clear, detailed, up to date and they are agreed with the person who needs the care and support. There is a good balance between allowing people to make decisions (and face the consequences) and trying to minimise the risks. The staff communicate honestly with people and involve them in decisions about their own lives and the running of the service. People have flexible lifestyles that meet their needs and their expectations. Their educational, social, cultural and emotional needs are considered and met well. People are encouraged to develop their independent living skills with a view to moving on into the community. The staff support them with areas they find more difficult. The staff understand people`s needs, and they make time for people who need to talk and who may be unwell. They help people stay well and healthy by making sure they get access to treatment if they need it. People are encouraged and supported to look after their own medication to prepare them for when they live independently. There is a clear complaints procedure and the people living at the service know how to complain and say that their concerns are heard and responded to quickly. They feel safe at the home and the staff are well trained and understand how to protect people from harm and abuse. The staff are kind, caring and well trained. They support people well. The service is well run, managed and continually strives to improve. What has improved since the last inspection? No requirements were set following our last inspection of the service. The service continues to make improvements to the environment, to care planning and risk assessment, to staff training and to information provided before admission. They are not complacent and look to improve their service further. What the care home could do better: The managers need to make sure that all parts of the home which people use are kept warm and comfortable. They must also make sure that staff understand infection control and the precautions which need to be in place to stop infection spreading between staff and other people living at the service. CARE HOME ADULTS 18-65 Alfred Minto House Care Home 26-28 Zulu Road New Basford Nottingham NG7 7DR Lead Inspector Linda Hirst Unannounced Inspection 20th October 2008 10:40 Alfred Minto House Care Home DS0000002228.V372846.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 Alfred Minto House Care Home DS0000002228.V372846.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. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alfred Minto House Care Home Address 26-28 Zulu Road New Basford Nottingham NG7 7DR 0115 978 3826 0115 978 0717 alfred.minto@turning-point.co.uk www.turning-point.co.uk Turning Point Limited 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 Dianne Field Ms Gaye Flounders Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2006 Brief Description of the Service: Alfred Minto House comprises two adapted terrace houses which have been joined together to make one home. The service is set in a busy area about three miles from Nottingham City centre. There is good access to local shops, public houses and places of worship and there are good public transport links to the area. The service caters for men only. Specialist care and support can be provided for up to nine people who have forensic histories, personality disorders and mental health needs. The service acts as a stepping stone between hospital or secure care and more independent housing in the community. It is not a secure facility but it offers close monitoring and supervision within Home Office restrictions. There are eight single rooms and one self-contained flat at the service. The communal areas comprise two lounges (one non-smoking), a kitchen/dining area and a laundry room. There is a back garden for people who live at the service to use. Every person who wants to live at the service is given an information pack before they move in which contains the service user guide. A copy of the latest inspection report is made available for people living at the service. The fees range from £905 to £1165 per week. These fees do not include food, toiletries, clothes or social activities. Alfred Minto House Care Home DS0000002228.V372846.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 3 stars. This means that the people who use this service experience excellent quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who live at the home and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the people who live there and how they can and intend to improve their service. We received this back from the manager in good time and the form was well completed and helped us to plan our visit and to decide what areas to look at. We also reviewed all of the information we have received about the home since we last visited and we considered this in planning the visit and deciding what areas to look at. We sent out surveys to every person who lives at the home before we visited, and to five visiting professionals to get their views on the service being provided. We received three back from people living at the service and three from visiting professionals. Visiting professionals were positive about the service being provided, comments included, “(The service) is good at rehabilitating patients who have been in secure institutions for variable periods. Moreover it does so with a keen eye on emerging risk issues. It has the right balance between support and supervision.” Another commented, “(the service) provides comprehensive support whilst acknowledging and managing risks. Excellent inter-agency information sharing.” People living at the service commented, “some people who come into the project are usually new and have spent some time in Hospital where things are decided for them and they lack the skills that are learnt for them (here),” and, “If I’m not happy I speak to, staff, manager, area manager.” The main method of inspection we use is called ‘case tracking’ which involves us choosing three people who live at the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. With the exception of one person, English is the first language of all of the people living at the home at the moment. We case tracked a person with Equality and Diversity needs to make sure these are being considered and met at the service. The staff team come from a wide variety of backgrounds and experiences. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 6 We spoke with two members of staff and two people who live at the service to form an opinion about the quality of the service being provided to people living at the home. We read documents as part of this visit and medication was inspected to form an opinion about the health and safety of people who live at the service. What the service does well: What has improved since the last inspection? No requirements were set following our last inspection of the service. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 7 The service continues to make improvements to the environment, to care planning and risk assessment, to staff training and to information provided before admission. They are not complacent and look to improve their service further. 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. Alfred Minto House Care Home DS0000002228.V372846.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 Alfred Minto House Care Home DS0000002228.V372846.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 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who want to live at the service are given full and detailed information on which to base their decisions. The service fully assesses their needs and considers all of the information, including the skills of the staff group to make sure their needs can be met at the service. EVIDENCE: The managers told us in their Annual Quality Assurance Assessment that they ensure good communication with the referrer and (where appropriate) the person who wants to live at the service throughout the pre admission process. They told us they ensure all delays are kept to a minimum and a large part of the induction process takes place whilst the person is on day visits and overnight stays so that they are very aware of what the service will offer them. We “case tracked” the last person to be admitted to the service and found that there is full and thorough information from a wide variety of sources held on the file to make sure staff are fully informed about the person’s needs. People we spoke with told us, “My social worker decided on Alfred Minto House, and I came to the service for an assessment and a two night stay Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 10 before moving in. I never knew there were places like this; I wish I had come here years ago. They have been brilliant.” Others commented, “I got too much information about the service, loads of it,” and, “I didn’t get a choice, my social worker decided. I was assessed and came here to visit and stay over to see if I liked it. I didn’t really want to live here, I want my own place but people say I am not ready for it yet.” Staff told us, “when we have a vacancy people complete our information pack, they send in the Care Programme Approach information, risk assessments, pre sentencing reports and two staff from here then visit the potential service user in their current setting, we complete a report with recommendations. We work very closely with the Wells Road centre for people who have drug and alcohol issues and involve outside agencies straight away. I am on courses about alcohol and dual diagnosis. We move them in using gradual transition, it can be very traumatic for some people who have been in secure care for a long time.” Alfred Minto House Care Home DS0000002228.V372846.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 excellent This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: The managers told us in their Annual Quality Assurance Assessment that they work with a person centred approach to empower people who live at the service to take control of their lives. They state they balance this against their need to work within the Care Programme Approach and any Ministry of Justice (Home Office) restrictions. We looked at the care and support plans for the people who we case tracked and found these to be well written, clear and they reflect the current needs of people living at the service. People have signed their care plans to indicate their agreement with the plans, and their wishes and aspirations form part of Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 12 the plan of care. People’s religion, issues around sexuality and any cultural needs are covered in the plans. People who live at the service told us, “I have a support plan, we sat down and talked about my needs, what help and support I need, the staff ask me what I want to happen, to the smallest detail they try to do what you want.” Another person told us, “I have a care plan which staff have talked to me about.” Staff we spoke with said, “People who live here have an allocated primary worker and they write the support plan with the service user and they sign to agree to the plan.” The managers told us in their Annual Quality Assurance Assessment that half of the staff have attended training on the Mental Capacity Act and they have done a presentation to the people living at the service about the new Law. They told us that information on advocacy services is available at the home and Speaking Up (Advocacy Service) have visited and talked to people living at the service about the project. They hold residents’ meetings once a month. We saw posters in the communal areas of the service advertising advocacy services and notifying people of the date of the next residents’ meeting. We looked at the minutes of the last meeting and found that information on budgets are shared with people living at the service so they can see what has been spent, maintenance and repair issues, activities and staff changes are also discussed with them, and they have the chance to raise any issues of concern. One of the people living at the service acts as a service user representative and he compiles a newsletter every month. He told us, “People give me contributions and tell me what they have been doing. We have regular residents’ meetings and we put notices up, but people can talk to me or raise issues anytime. The staff act on anything we say; we wanted a fence in the garden, it’s done, we wanted some lights, it’s done.” Another person told us, “I have a curfew from the Home Office and other restrictions but other than that I can do what I want.” The managers told us in their Annual Quality Assurance Assessment that they manage risk but also promote independence. Professionals commented to us in their surveys that the service, “provides comprehensive support whilst acknowledging and managing risks,” and another said, “It is good at rehabilitating patients who have been in secure institutions for variable periods. Moreover it does so with a keen eye on emerging risk issues. It has the right balance between support and supervision.” One person commented that, “at times the culture of the project is risk averse/overprotective in my opinion.” We did not find evidence on this inspection which supported this view. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 13 We found the risk assessments in place to be comprehensive, up to date and balanced in terms of weighing the risks and the advantages to people living at the service. People living at the service told us, “The staff know me drinking alcohol is a risk, I know they have to look at any risks, but they also know I have moved on. I have a curfew but if I have a good reason I can get an extension, they will talk to you about it and negotiate with you. They treat you like a human being.” Staff we spoke with told us, “Sometimes with risk, people are in denial, if I have written a plan or a risk assessment and the person does not agree with it, I will explain the reasons for the plan and these will be reiterated at Care Programme Approach reviews.” They also said, “I think there is an even balance here between decision making and risk. The restrictions in place from the Home Office at the moment are not excessive. Only a couple of people are on strict curfew times, if people ask for extended leave we will talk to them about it. We are rehabilitating them after all, and part of that is about them having a social life.” Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who live at the service have a flexible lifestyle and their social, cultural, emotional and recreational needs are considered and met. EVIDENCE: The managers told us in their Annual Quality Assurance Assessment that they encourage all people who live at the service, as part of their recovery, to have meaningful activities in their week, by supporting them to find education, training or voluntary employment in areas they are interested in. The service has recently had an Occupational Therapy student on placement and we saw her running an art session with some of the people who live at the service. We saw lots of leaflets at the home advertising places to go and things they could do with their time. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 15 The people we spoke with told us, “I go to college and am studying a course in communication and confidence, I am also the activity organiser. We had a disco last night; I got up early made all the food and ran the disco. The staff are great, they join in and have fun with us. We have been to the cinema and the Playhouse; I ask people what they want to do. Sometimes we go out together as a whole group, other times it’s just one or two of us.” Another person told us, “ I go to the gym twice a week and I would like to go to college to learn to do gardening. I did computer studies at (another placement) and I really enjoyed it, I only stopped because I left there. I went to the Playhouse the other week with (another person living at the service) and it was brilliant, I really enjoyed it. I went to the disco last night and we have a buffet about every week; it’s like Christmas every day. I like to have something to do with my day, I think it’s important.” Staff we spoke with told us, “some of the men attend gardening projects, one person goes to college, another is doing an National Vocational Qualification in catering, another in music technology. We organise trips out, walking in Derbyshire, Skegness, we go on park visits, meals out, ten pin bowling, we have a cinema group.” As the service aims to rehabilitate people back into the community, there is an expectation that people will work towards independent living, one person commented to us in a survey, “when I got to Alfred Minto House they asked me to brush up on my cooking to feed myself there so I could live independently in a flat in the future.” The people we spoke with told us, “We are responsible for all of our own cooking, cleaning, laundry, shopping and so on because this prepares us for living in the community, it’s good for us. The routines are very flexible; I get up when I want, go to bed when I want and (as long as I observe my curfew) I do what I want.” Another person told us, “I do my own washing, cleaning, shopping and cooking. I would say the washing machines are too small and people have to queue to do their laundry, they should buy a bigger one. I think I will raise it at the residents’ meeting. I get some help with budgeting, it’s an area I need help with.” The staff we spoke with confirmed, “people are pretty much self caring; the odd one may need some support but we encourage them to try and do things. We sometimes have to work on budgeting skills, people’s diet or their hygiene.” People shop for and cook their own meals and the managers told us in their Annual Quality Assurance Assessment that they could improve by promoting healthy living, to include diet, exercise, general health issues and lifestyle. Staff we spoke with told us this is an area of concern for them, “We have issues with obesity at the service. We try and encourage healthy eating and to join the gym. A lot of the medication they are prescribed can lead to increased Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 16 appetite and weight gain. We are trying to get some people referred on for advice. None of the people we spoke with are currently in relationships, but they told us, “The staff encourage us to form relationships and friendships. If I wanted someone to come and stay over they could. I also think it’s good to have a mix of male and female workers here.” Another commented that he finds communal living difficult for a variety of reasons, and these concerns have been passed on to the manager for action. The staff we spoke with told us, “the people living here at the moment are single. We talk about the emotional side of relationships with service users and about safe sex.” Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People’s health and personal care needs are fully assessed and met with sensitivity and their privacy and dignity are maintained. EVIDENCE: The managers told us in their Annual Quality Assurance Assessment that they encourage and support people to make their own choices. Monitor their mental and physical health whilst respecting their privacy, dignity, independence, giving them control over their lives. We found that the care plans cover issues where people need support to maintain personal hygiene and their physical and mental health are well written and regularly reviewed. The care plans clearly highlight the signs that people may be becoming unwell and all of the documentation is kept up to date and gives a well rounded picture of the person. One person living at the service has Diabetes, the staff accompany him to his appointments, and they try and promote his physical health by encouraging healthy eating. Another Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 18 person has high levels of cholesterol and attends the lipid clinic; another has been referred for attendance at a clinic to look at his weight. People who live at the service told us, “my physical health is good and I’ve just come back out of (Hospital), it was a relief to come back to be honest. I don’t like it there.” Another person said, “I don’t need any help with personal care and I am healthy. I slipped my disc and staff were really worried and they got me referred to the Hospital. If people are not well they always take the time to chat to them, to give them time and support.” Staff told us, “during their first week here we register them with a dentist, doctor and optician if they need it. If they refuse their medication we speak with their Psychiatrist and we monitor their mental health closely.” We looked at the arrangements for medication. Most of the people in the service self medicate following a risk assessment, they have secure and lockable facilities to store their medication in their own rooms. Their medication is logged in and supplies checked periodically. The staff store some people’s medication in the office. These are in separate bags and the person is observed taking the medication. The staff we spoke with told us that they have received training on medication from Boots. They told us, “We do not administer any medication, we witness and observe those whose tablets are kept in the office. I think the system we have in place is fine.” People we spoke with told us, “I look after my own tablets and I have a box in my room to store them in. The side effects of my medication are not bad, they suit me.” Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People have access to a robust complaints procedure and their concerns are heard and responded to. They are safeguarded at the service by well trained and supportive staff who take steps to protect them from harm or abuse. EVIDENCE: The managers told us in their Annual Quality Assurance Assessment that people living at the service are encouraged and supported to use the complaints procedure. They told us that there is information on local advocacy services in the service user guide and on display in the service. The majority of people who live at the service have their own solicitors. We looked at the record of complaints and found that there have been two complaints since our Annual Service Review, one about the provision of security lights which has been resolved and one about the inappropriate behaviour of a staff member which was withdrawn. There is a clear record of complaints, their investigation and outcome. We saw information about advocacy displayed in communal areas of the service. The people we spoke with know how to complain, “The procedure is up there (on the notice board) and we fill in a form, but I wouldn’t wait, I would raise it directly. They (the staff) listen to your concerns and they take action. The managers are really good, they talk to the service users, they get involved.” Another person said, “I know how to complain and I would tell them if I wasn’t Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 20 happy.” People also commented in their surveys, “if you are not happy it is best you talk to your keyworker and if not happy after that, talk to the manager.” The staff we spoke with told us, “the complaints procedure is displayed, leaflets are also around for service users. The managers are very prompt at responding to complaints, very good.” The managers told us in their Annual Quality Assurance Assessment that staff are aware of their role to uphold people’s rights and responsibilities and safeguard them against various forms of abuse. They told us they intend to improve by putting together an information pack for people living at the service about safeguarding issues. There have been two safeguarding referrals made since our last annual service review, both about financial abuse by people in the community, these matters were appropriately referred under the safeguarding procedure and investigated. The service has its own safeguarding policy and a copy of the local procedures which they follow. People who live at the service told us, “I feel really safe here, physically and mentally. I have never seen the staff behave badly and I would report them if I did.” Staff we spoke with said, “I have had training on safeguarding. With people with mental health problems there is always a risk and sometimes from people in the community who have taken advantage. If we have any concerns we contact the social worker and make a safeguarding referral, strategy meetings are held. If I saw any member of staff behaving inappropriately I would report them to the manager.” Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is well maintained and clean but is not maintained at a comfortable temperature for the people living there. EVIDENCE: The managers told us in their Annual Quality Assurance Assessment that they keep well maintained premises that are safe, homely, comfortable, clean and hygienic having adequate light and heat and are accessible to local amenities and transport. They state they have improved the environment in response to people’s requests by decorating the lounge, installing an electric fire in the lounge, by having temporary membership of Setanta sports channel, and they have decorated some bedrooms and the flat. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 22 We did a partial tour of the home and found the service to be clean and well maintained. The communal areas are comfortable and personalised as are the bedrooms we saw. People who live at the service told us, “The home is comfortable and homely, it is in the community but supportive, a good stepping stone. We keep it clean ourselves,” another commented, “My room is a bit small, but I’ve coped for ten months. It’s better than Hospital.” The staff commented, “I find the house cold sometimes, the rooms are badly built and the toilets are small but the service is well maintained and repairs are done quickly.” The staff member told us that they are not aware of some precautions to be taken if people have transmissible infections. This information was passed to the manager for action. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported by caring and trained staff who have been safely recruited. EVIDENCE: The managers told us in their Annual Quality Assurance Assessment that they encourage staff to take on further training opportunities, and they state they have improved their assessments of staff training needs. They told us that 33 of staff have achieved their National Vocational Qualification level 2 at the moment but they want to encourage all staff to achieve their National Vocational Qualification level 3. We looked at the training records and found staff have undertaken training on Health and Safety, person centred approaches, working with diversity, managing challenging behaviour, substance misuse awareness, Protection Of Vulnerable Adults and on people with a Personality Disorder. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 24 The staff we spoke with confirmed that they have done training on Health and Safety, Basic Food Hygiene, managing challenging behaviour, fire safety, working with diversity, person centred approaches, Coroner’s court training. “I am also due to start alcohol awareness and dual diagnosis training. The training is fantastic and Diane (one of the managers) is very supportive at making sure staff get good access to training.” The managers told us in their Annual Quality Assurance Assessment that they have a comprehensive recruitment process. We looked at the staff files of three people working at the service and found they have all of the information and documentation required by Law in their files. Staff we spoke to confirm they have to provide references, a Criminal Records Bureau check and complete an application form before working at the service. People who live at the service told us, “The staff are really wonderful, if I could I’d nominate them all for awards. They are always here for us. My keyworker is brilliant. If anyone is unwell they are so good, they chat to us, help us and work with us. My only criticism would be that staff spend too much time doing paperwork, it takes them away from us.” Others commented, “the staff are good, they know you, they help you. I get on well with them all, they are great human beings,” “If you have a problem the staff are good and they listen to you about your problem over a cup of tea and they sort it out.” Staff members commented, “The staff group are very competent with backgrounds in mental health. We have a wide variety of experiences we bring.” Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 25 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 excellent This judgement has been made using available evidence including a visit to this service. The service is well managed and runs in the best interests of the people who live there. EVIDENCE: The managers told us in their Annual Quality Assurance Assessment that they exceed the requirements for Registered Manager hours as both the Service Manager and the Team Leader share the role of Registered Manager. People who live at the service and staff told us the service is well run, “the service is very well managed, the managers are brilliant, really good. They get involved, they don’t just sit in the office.” “The home is good overall, I like it, Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 26 but would prefer my own place,” “I love the manager, she really supports the staff, they are both really supportive, the service runs well.” The service undertakes full audits of the service and we saw action plans developed where areas requiring improvements are highlighted. The results of the latest surveys completed by people living at the service are published in the service user guide. Their last audit raise issues around recruitment to vacant posts, improving activities, cleanliness and the culture at the service. The evidence we found on this inspection shows that steps have been taken to address all of these issues. Staff and people living at the service confirmed that they have questionnaires sent to them to let them comment on the quality of the service being provided. Staff told us, “questionnaires are sent out and there are regular audits done on the service.” We found that all of the Health and Safety testing and servicing has been completed at the required intervals and staff told us their health and safety is properly protected. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 27 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 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 4 X 4 X 4 X X 3 X Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 28 N/A 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. 2. 3. Refer to Standard *RCN YA32 YA30 Good Practice Recommendations There must be evidence that all parts of the home used by people living at the service are maintained at a comfortable temperature. 50 of staff should be qualified to National Vocational Qualification Level 2 Staff must be given information about precautions to be taken when supporting people with transmissible infections before they come to live at the service to prevent infections passing between staff and other people living at the service. Alfred Minto House Care Home DS0000002228.V372846.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Alfred Minto House Care Home DS0000002228.V372846.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. 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