Care Home: Beattyville Gardens (116)

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What the care home does well The service is small and flexible and is able to respond effectively to the needs of the people who use the service. It offers a safe, secure living environment, with well trained staff support, which enables service users to take acceptable levels of risk in their lives. The home has good staff retention and this reflects in the care being provided, as the staff are very aware of the service users` needs. The manager and staff work with the service users to enable them to retain a level of independence and to express their wishes and needs. Staff are knowledgeable about the cultural aspects of Judaism and can confidently support service users to embrace/practice their faith. All of the service users have comprehensive care plans together with any associated risk assessments. Some of the people who use the service require a high level of support in meeting some of their health needs and every effort has been made by staff to ensure their needs are being met by working closely with health professionals.All of the people who use the service are encouraged to participate in daily activities within the home and leisure activities within the community. Contact with families is seen as a priority and service users visit their families regularly and are also encouraged to keep in contact with their friends and families via phone calls. The following comment was received from the family of one of the service users, "Very pleased with the care given to our son, staff very helpful and caring." Service user forums have been established by the organisation in order to involve service users in all aspects of running the home, as well as staff recruitment and service users from Beattyville Gardens attend the forums. Both the service users and relatives were complimentary of the care being provided at Beattyville Gardens. People who use the service comments were "I like living here", "the staff are good to me" "I am happy with my key worker". As far as possible all people who use the service are supported to contribute towards the daily running of the home, primarily through service user meetings, informal discussions and key worker sessions. Staff training is given a high priority and 90% of the staff team have achieved NVQ Level 2 & 3 qualification. There was evidence that the management and staff continue to provide for the diverse needs of people who use the service, particularly in relation to their particular (Jewish) cultural, nutritional and religious needs. What has improved since the last inspection? The requirements set at the last inspection have been met. Regulation 26, monthly monitoring visits by the responsible individual are taking place. Quality monitoring is taking place and a formal organisational system is being developed in order to monitor the service`s success in achieving the home`s aims, objectives and Statement of Purpose. There is an on-going programme of refurbishment of the home. Two members of staff are undertaking Person Centred Care training to become facilitators and the majority of the staff have attained their NVQ 2/3. What the care home could do better: The manager and staff team continue to work to provide a good service for the residents and to meet each person`s needs. The requirements from the previous inspection have been met. There are no requirements made from this inspection. Two recommendations have been made as follows.The manager should develop `End of Life` care plans for all service users, which should include information on their wishes choices and decisions. The staff to ensure that the daily logs reflect how service users` individual aims and objectives are being met rather than logging routine day to day tasks completed. It was suggested to the manager that she uses the Key Lines of Regulatory Assessment (KLORA) to assist and continue to identify and evidence the excellent quality of the service provided. CARE HOME ADULTS 18-65 Beattyville Gardens (116) Diamond Lodge 116 Beattyville Gardens Ilford Essex IG6 1JZ Lead Inspector Ms Harina Morzeria Key Unannounced Inspection 23rd September 2008 09:00 Beattyville Gardens (116) DS0000025887.V372523.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 Beattyville Gardens (116) DS0000025887.V372523.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. Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beattyville Gardens (116) Address Diamond Lodge 116 Beattyville Gardens Ilford Essex IG6 1JZ 0208 503 9411 020 8550 4511 Beattyville.Gardens@norwood.org.uk 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) Norwood Ravenswood Ms Johannah Diffley Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 23rd May 2006 Date of last inspection Brief Description of the Service: Diamond Lodge is a care home registered to look after six younger adults with learning and physical disabilities. It is run by Norwood, a not for profit Jewish organisation. Hence, the ethos of the home is based around Jewish beliefs, customs and faith. All staff have attended training in the Jewish Way of Life to be able to meet the cultural and religious needs of the service users. The home is situated in a residential location, close to a local shopping area, providing easy access to all local amenities, nearby leisure facilities and transport services. Service users have mild to moderate dependency needs. They are cared for in suitably adapted premises and all service users occupy their own single rooms, which are well furnished and decorated. There is a small, well maintained garden at the rear of the house. Appropriate communal space is provided. All service users are supported by the manager and staff to maintain their independent living skills, attend college for various courses as well as accessing community facilities locally and at the Leonard Seiner Centre (Jewish Community Centre) in Barkingside. Personal care is provided on a 24-hour basis, and healthcare needs are met by staff supporting service users to attend appointments with health professionals. The fees range from £960 to £1,671 per week. A Statement of Purpose and Service Users Guide are available to the service users and their representatives. A copy of the inspection report is available upon request from the manager. Beattyville Gardens (116) DS0000025887.V372523.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 people who use the service experience good quality outcomes. This inspection was unannounced and was carried out as part of the inspection programme for 2008/09. The inspector spoke to the deputy manager and staff as well as people who use the service present at the time of the inspection. The manager was asked to complete the Annual Quality Assurance Assessment. Some of the information provided in the assessment has been incorporated into this inspection report. Care staff were asked about the care that people who use the service receive and were also observed carrying out their duties. A tour of the home was undertaken and the rooms seen were clean and tidy. Service users’ files were case tracked; including risk assessments and care plans, together with the examination of medication records, staff rotas, menus, accident/incident forms, staff records and health & safety records. The inspector had a discussion with the deputy manager on the broad spectrum of equality & diversity issues and he was able to demonstrate an understanding of the varied needs of the service users around religion, sexuality, culture, disability and gender. Positive feedback was received from the London Borough of Redbridge Commissioners. What the service does well: The service is small and flexible and is able to respond effectively to the needs of the people who use the service. It offers a safe, secure living environment, with well trained staff support, which enables service users to take acceptable levels of risk in their lives. The home has good staff retention and this reflects in the care being provided, as the staff are very aware of the service users’ needs. The manager and staff work with the service users to enable them to retain a level of independence and to express their wishes and needs. Staff are knowledgeable about the cultural aspects of Judaism and can confidently support service users to embrace/practice their faith. All of the service users have comprehensive care plans together with any associated risk assessments. Some of the people who use the service require a high level of support in meeting some of their health needs and every effort has been made by staff to ensure their needs are being met by working closely with health professionals. Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 6 All of the people who use the service are encouraged to participate in daily activities within the home and leisure activities within the community. Contact with families is seen as a priority and service users visit their families regularly and are also encouraged to keep in contact with their friends and families via phone calls. The following comment was received from the family of one of the service users, “Very pleased with the care given to our son, staff very helpful and caring.” Service user forums have been established by the organisation in order to involve service users in all aspects of running the home, as well as staff recruitment and service users from Beattyville Gardens attend the forums. Both the service users and relatives were complimentary of the care being provided at Beattyville Gardens. People who use the service comments were “I like living here”, “the staff are good to me” “I am happy with my key worker”. As far as possible all people who use the service are supported to contribute towards the daily running of the home, primarily through service user meetings, informal discussions and key worker sessions. Staff training is given a high priority and 90 of the staff team have achieved NVQ Level 2 & 3 qualification. There was evidence that the management and staff continue to provide for the diverse needs of people who use the service, particularly in relation to their particular (Jewish) cultural, nutritional and religious needs. What has improved since the last inspection? What they could do better: The manager and staff team continue to work to provide a good service for the residents and to meet each person’s needs. The requirements from the previous inspection have been met. There are no requirements made from this inspection. Two recommendations have been made as follows. Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 7 The manager should develop ‘End of Life’ care plans for all service users, which should include information on their wishes choices and decisions. The staff to ensure that the daily logs reflect how service users’ individual aims and objectives are being met rather than logging routine day to day tasks completed. It was suggested to the manager that she uses the Key Lines of Regulatory Assessment (KLORA) to assist and continue to identify and evidence the excellent quality of the service provided. 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. Beattyville Gardens (116) DS0000025887.V372523.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 Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 3,4 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Prospective service users and their relatives have the information they need to be able to make an informed choice about moving into the home. The assessment of needs and other information received from health and social care professionals means that staff have detailed information to enable them to determine whether or not they can meet the needs of prospective service users. Prospective service users know that the home can meet their needs. EVIDENCE: A Statement of Purpose is available and the Service User Guide is comprehensive and in a pictorial format, which enables prospective service users to know what the home is like and what services they can offer. This is explained to the service users in the presence of their families/ representatives by the key workers. The Statement of Purpose and Service User Guide have been reviewed and updated. The current service users have been living at the home for some considerable time; most of them since the home opened. There have been no new admissions to the home since the last inspection. Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 10 It would be the procedure of the home to ensure that any new service users are appropriately assessed prior to admission. A detailed pre admission assessment is undertaken by the Organisation’s admissions officer and the manager of the home to ensure the home is able to meet the needs of the prospective service user and staff have the skills and ability to meet the assessed needs through the service delivered. The funding authority and health professionals would also provide assessments. Further information will also be gathered from the prospective service user, their families and an advocate where required. The admission process would be designed around the needs of the prospective service user. The prospective service user may make several visits to the home and possibly an overnight stay to ensure that they like the home and to meet the other service users. This transition period would also allow staff to get to know the prospective service user and to know whether they can meet the their needs. Beattyville Gardens (116) DS0000025887.V372523.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): 6,7,8 and 9 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. All of the service users’ identified needs are reflected in up to date care plans and risk assessments. This ensures that service users’ needs are being appropriately met and that service users and others are safeguarded. Staff provide the service users with assistance and support so that they are able to participate in all aspects of life in the home and to make independent decisions about their lives within a risk assessment framework. EVIDENCE: The manager and staff have ensured that the service users are involved in all decisions about their lives. There is a care planning system in place that is clear and concise. Each service user has an individual person centred care plan. Relatives and advocates are also involved with the service users’ permission and assist them in decision- making within the home. The care Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 12 plans include reference to equality and diversity issues and address any needs identified in a person centred way. For example, the service identify and promote the practices and values of Judaism which is clearly reflected in the service users’ care plans. For example, in one person’s care plan under the heading “Culture” the care plan states that staff should encourage the service user to be aware of his cultural identity aiming to encourage him to attend cultural events and participate in celebrating Jewish festivals and events. This was also noted in other care plans examined. Care plans examined evidence that the service users are involved in regular meetings with their key workers. The care plans are used as working documents, reviewed monthly and updated as required. A member of staff, when asked if they are given up to date information about the needs of the people they support or care for said, “care plans are updated monthly. Information discussed at team meetings.” For example, evidence was seen of an updated care plan for one person who is now diabetic, which is reflected in the relevant section of the care plan. It states how staff should support the person in terms of taking him to the diabetic clinic regularly as well as monitoring his blood sugar levels and diet. An appropriate risk assessment is also in place. It was clear that staff have completed diabetes awareness training. Each service user has an individual daily log sheet, which is completed. These daily records reflect the assistance that has been given on a day-to-day basis and how service users are prompted and assisted to carry out individual tasks according to their capabilities. However, a recommendation has been made that the daily logs reflect how individual aims and objectives are being met rather than logging routine day to day tasks completed. The service users are also involved in menu planning, shopping trips, cooking, gardening, cleaning, laundry tasks and external activities in the community. The service users, all with assistance are able to take part in varying degrees with daily life activities within the home, for example, helping to prepare lunch and dinner, watering the garden and to put the laundry in the washing machine. All of the service users have a moderate learning disability and some physical disabilities. Each care plan includes a comprehensive risk assessment, which is reviewed regularly. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. Service users are encouraged to take reasonable risks and there were detailed risk assessments that had been regularly reviewed. Assessments showed areas identified such as, tasks and activities within the home and in the community, health risks and medication and what action to be taken. These risk assessments have been forwarded to the service user’s care plans. The home ensures that the service users are consulted regularly to gather information about their satisfaction with the home. Staff were observed interacting with the service users, their relationship was easy going and friendly but in a professional manner. Staff were seen to ask Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 13 service users what they wanted encouraging them to make independent choices. All staff are trained to enable them to communicate with service users, using makaton. The service is aware of current policy issues and good practice developments, and tries where possible to transfer this thinking into their daily work. Beattyville Gardens (116) DS0000025887.V372523.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): 11,12,13,14,15,16 and 17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Opportunities for social and leisure pursuits and personal development are actively promoted and supported by staff for all people who use the service to enable them to participate in the wider community in which they live. People who use the service are provided with culturally appropriate, varied and nutritious meals, staff promote healthy eating and individual preferences are catered for. Visitors are made to feel welcome in the home and people who use the service are supported to maintain and establish family links and friendships. EVIDENCE: The service has a strong commitment to enabling service users to develop and maintain their skills, including social, emotional, communication and independent living skills. Service users’ care plans identify lifestyle choice, such as local leisure activities, activities within the home and family contact. The Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 15 service users have ample opportunities for personal development and service users’ leisure activities are individualised and varied. The care plans identify lifestyle choices, such as going to college, day centre, shopping, going to synagogue, clubs , local leisure activities and visiting families. The daily log sheets record whether these activities have taken place and who has participated. All of the people who use the service have opportunities for personal development and have a varied activity programme, which takes into account their preferences and interests. People who use the service attend day centres and participate in meaningful daytime activities of their choice according to their individual interests and capability. Where appropriate, education and occupational opportunities are encouraged, supported and promoted. One person goes to a daycentre and two other people go to college. The service users also enjoy a variety of activities within the community; such as swimming, hydrotherapy, trips to the local cinema, going to the local leisure centre, accessing library services and days out for example, going to the proms, Southend, going to the park, group holiday to Spain, theatre, music lessons (drums) and massage therapy. They also participate in activities at the local Jewish community centre at the Leonard Seiner Centre in Barkingside. The service users also go out individually with their key workers to pursue individual activities and staff re-arrange their rotas to accomodate this. People who use the service are encouraged and assisted to stay in contact with friends and relatives. Most of the service users’ families/representatives visit them regularly and staff also help people to remain in contact with their families via phone calls. All the service users are Jewish and follow the Jewish way of life. All staff working at the home have received extensive training regarding the “Jewish Way of Life” and encourage the service users to observe all the Jewish traditions. Hence, following the Jewish faith and beliefs, practices and values of Judaism underpin all aspects of the service users’ lives. For example, they are supported by staff to observe Shul. Some service users attend the synagogue on Saturdays and all the Jewish festivals are celebrated. Weekly sabbath is encouraged in ways that are meaningful to residents. The staff encourage the service users to build links with the mainstream Jewish community. A Rabbi monitors compliance with the laws of Kashrut on site and Norwood’s cultural advisor is available to support staff in enabling service users to explore and celebrate their faith. The Rabbi attends some team meetings to discuss cultural issues and Kosher foods. Service users attend weekly cultural sessions at the local community centre. Service users’ individual dietary needs are fully catered for, whilst adhering to a Kosher diet. People who use the service are involved with planning the weekly menus; these take into consideration people’s likes and dislikes, as well as dietary and cultural (Kosher) requirements and alternative choices would be cooked if they chose not to eat what was on the menu. Some of the service users are involved in cooking the meals with staff. The staff encourage them to choose healthy options and encourage them to try new and sometimes Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 16 unfamiliar food. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals including those requiring special diets e.g diabetic or food sensitivity. A nutritionist came to talk to staff and service users about healthy eating. A sports coach has been employed by the organisation to discuss with the service users about an active lifestyle. Staff have the overall responsibility for the cleaning of the home, however most of the service users are able to participate in this at varying levels, such as, dusting their bedrooms, putting their clothes away, helping with putting their laundry in the washing machine and putting the rubbish out. This was observed on the day of the inspection. Beattyville Gardens (116) DS0000025887.V372523.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): 18,19,20,21 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People who use the service are prompted and encouraged to take responsibility for their own personal care. Service users’ physical and emotional health care needs are monitored and this ensures that their needs are recognised and met. The medication policies and procedures are clear. Staff have undertaken medication training in order to ensure the safety of the service users. EVIDENCE: People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Personal health care needs including specialist health, and dietary requirements are recorded is each person centred plan or health action plan. Care plans and daily records were examined and discussed with the manager. The care plans clearly identify health and personal care needs and how these needs should be met. Most of the service users require Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 18 encouragement and prompting rather than physical assistance. The delivery of personal care is individual and flexible, consistent, reliable and person centred. Service users were dressed in clothes that were appropriate for the time of year and which they choose. Records inspected showed that service users have very comprehensive personal health records and health action plans; all of these have been reviewed within the past six months. All service users are supported to access dental care, opticians, chiropody, the community nurse and psychological support is accessed via out patient appointments or home visits by these professionals. Reviews are held on a quarterly basis, the Individual plan (IP) is reviewed annually. Family, advocates and the placing authorities are invited to attend if the service users choose to invite them. Staff have access to training in health care matters, for example diabetes awareness training. The aims and objectives of the home reinforce the importance of treating individuals with respect and dignity. Allergies are noted in the folders for each individual if applicable. There are policies and procedures for the handling and recording of medication within the home. Staff have received medication training and there is a list of staff (with their signatures) that are competent in the administration of medication. Medication Administration Records (MAR) charts and the medication cupboard were checked and found to be correct. The manager regularly undertakes medication audits to ensure that staff are administering medication appropriately. Refresher medication administration training is provided to staff on a rolling basis. Care plans that were examined had details of people’s preferred wishes regarding their funeral arrangements. It would be a recommendation that staff now discuss with service users and relatives (if appropriate) Preferred Place of Care Plan (PPC). PPC would detail the service users’ thoughts about their care and the choices they would like to make, including saying where they would want to be when they die. Information about the family can also be recorded so that care staff can read about who’s who and what matters to them. Beattyville Gardens (116) DS0000025887.V372523.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The service users’ views are listened to and acted upon. Service users are protected by the home’s safeguarding adults policies and procedures and the monitoring systems within the home. EVIDENCE: The home has an open culture that allows service users to express their views and concerns in a safe and understanding environment. There is a clear complaints procedure, which is available in written and pictorial format which is easy to understand. It is available upon request in a number of formats (other languages, large print, audio). A copy of the procedure has been made available to all of the service users and is displayed in a number of areas within the home. Service users and others involved with the home understand how to make a complaint and are clear about what will happen if a complaint is made. At the time of inspection, there were no complaints were logged in the complaints book. Service users were asked individually what they would do if they were unhappy with anything at the home, responses included “I would tell J-- (the manager)”, “I would tell my keyworker”. The service users spoken to told the inspector that they were happy at the home and did not want to live anywhere else. Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 20 There are weekly service users’ meetings, this ensures their views are listened to. The service users are encouraged to participate in decision making on issues, activities and events within the home. The home has policies and procedures for the safekeeping and expenditure of service users’ money. Service users’ money, which is held in safekeeping by the home is checked at each handover at the end of the shift and monitored by the service manager during the monthly Regulation 26 visits. Service users are given support where appropriate to make purchases, receipts are kept for all expenditures and records of money held. Two staff have to sign for any money taken out. The Organisation has a comprehensive safeguarding adults policy and procedures; there was evidence that these have been read by the staff. All staff receive this training during their induction period and they complete refresher training periodically. Staff members that were spoken to were very clear on what constituted abuse and their responsibility to report any potential or actual abuse. Staff files indicated that all members of staff have attended safeguarding adults training. Any safeguarding adults allegations are appropriately dealt with by the manager following the organisation’s safeguarding adults protocol. All permanent staff working within the home have completed positive response training, which shows them how to respond appropriately to physical and verbal aggression. They fully understand that the use of physical intervention is a last resort and know what other alternatives to use. Beattyville Gardens (116) DS0000025887.V372523.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): 24,25,26,27,28, 29, 30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users live in a homely and comfortable environment. Bedrooms, living areas, toilets and bathrooms meet the service users’ needs. EVIDENCE: The home provides an environment that is appropriate to the specific needs of the people who live there. A tour of the home was undertaken including two of the service users’ bedrooms. The home is decorated and furnished in a homely fashion and all areas of the home were well-maintained, clean, tidy and odour free. The layout and design of the home allows for small clusters of people to live together in a non institutional environment including a lounge and a dining area. All of the service users’ bedrooms are of a reasonable size and one has ensuite facilities. The bedrooms were individually decorated and personalised Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 22 with their own possessions, such as, televisions, CD players, photographs, ornaments and memorabilia. The environment promotes the privacy, dignity and autonomy of the service users. There is on going refurbishment of the premises as required. The bathroom, shower room, hallway and stairs are fitted with appropriate aids and adaptations and all are adequately maintained. Adaptations and specialised equipment are obtained for service users who require this to maximise their independence. The kitchen was clean, tidy and spacious. The kitchen is suitable for the service users to carry out domestic tasks, such as, washing up, making cups of tea and preparing snacks. The laundry room was clean and tidy and with clear instructions both written and pictorial format on how to use the washing machine, as some of the service users are able to use the washing machine independently. There is a garden to the rear of the home that service users make full use of during the warmer months. Service users are able to receive their visitors in the lounge or dining room (which has a settee), their own bedroom, which have comfortable armchairs or the garden in the warmer weather. The home is well maintained and there was evidence that all repairs are dealt with promptly. The home has a robust infection control policy and would seek advise from external specialist if and when required. Beattyville Gardens (116) DS0000025887.V372523.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): 31,32,33,34,35,36 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users are supported by qualified and competent staff. Staffing levels are satisfactory and there are sufficient staff on duty, who have the appropriate skills and training to meet the individual needs of the service users. The procedures for the recruitment of staff are robust and provide safeguards for service users living in the home. Staff receive regular supervision and annual appraisals, which is beneficial to the service users. EVIDENCE: Rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the people who use the service. Duty rotas were Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 24 inspected and they correlated with the staff on duty, there were sufficient staff on duty to meet the needs of the service users. There are three staff on duty on each day shift and one sleeping in night staff, as well as the manager and deputy manager during the day time. The staff work flexibly to support service users during their evening club activities on Mondays and Thursdays as well as additional weekend cover depending on activities being undertaken. There is a clear organisational recruitment policy and procedure that defines the process to be followed. This procedure is followed in practice with the organisation recognising the importance of effective recruitment procedures in the delivery of good quality services for the protection of individuals. Staff recruited confirmed that the organisation was clear about what was involved at all stages and was robust in following its procedure. Staff undertake external qualifications beyond basic requirements. The organisation encourage and enable this and recognise the benefits of a skilled, trained workforce. All staff have job descriptions and specifications clearly define the roles and responsibilities of staff. There was evidence on staff files that an induction programme had been undertaken as well as Jewish way of life, food & hygiene, health & safety, COSSH, safeguarding adults, first aid, moving & handling, infection control, administration of medication, person centred planning, behaviour and anxiety awareness, dementia awareness, diabetes awareness and positive restraint techniques. All staff have completed NVQ 2/3 qualifications. The deputy manger as well as one other senior staff have completed NVQ Level 4 qualification. Supervision sessions are regular and staff find them helpful with a focus on improving outcomes for people using the service. annual appraisals have taken place, which staff were able to confirm. Staff meetings are held fortnightly. Every staff member has a training profile where training that has been undertaken is recorded and future training needs are identified. Beattyville Gardens (116) DS0000025887.V372523.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): 37,38, 39, 41, 42 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is well managed, which means service users’ health, safety and welfare are promoted and protected. Service users can be confident that their views underpin the self-monitoring, review and development of the home. EVIDENCE: The manager has the required qualifications and experience and is competent to run the home. She has managed the home since it was registered and has completed the Registered Managers Award as well as NVQ level 4. The home is run in a way which provides a safe environment. The manager has a clear Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 26 understanding of the key principles and focus of the service, based on organisational values and priorities. They provide an increased quality of life for the service users with a strong focus on equality and diversity issues. The AQAA contains clear, relevant information that is supported by a wide range evidence. The AQAA lets us know about the changes they have made and where they still need make improvements. All records are held securely. Service users would be able to have access to their records. The home works to a clear health and safety policy and all staff are fully aware of the policy. The service users’ health, safety and welfare are met by the staff working in the home. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. All accidents are recorded and appropriate action is taken when required. Induction training for new staff is being provided with further ongoing training being offered on a regular basis. Health and safety checks and the associated records were appropriately completed in line with the Regulations. Individual risk assessments for each service user are in place. The inspector was informed that lay monitoring visits are regularly undertaken by lay monitors appointed by Norwood and one of the representatives of “relatives of the Parry group” which is a group of parent representatives. An auditor appointed by the organisation carries out regular financial audits. The Rabbi visits weekly to carry out checks. As stated earlier in the report service users’ meetings take place and all are encouraged to have an input into these meetings. Minutes are kept of all meetings held. An annual development plan will be completed reflecting the comments and views from the stakeholder surveys carried out. The standards that relate to health and safety were also well managed and information was readily available. Fridge and freezer temperatures are taken and recorded daily. Fire drills are taking place regularly. Fire extinguishers are annually checked and fire alarm call point is being tested and recorded weekly, a fire risk assessment has been carried out. The manager is aware that it is her responsibility to protect and promote the health, safety and welfare of the service users and carry out regular health & safety inspections. Beattyville Gardens (116) DS0000025887.V372523.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 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 3 3 3 3 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 x 3 3 x Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard YA21 YA7 Good Practice Recommendations It would be good practice for staff to discuss with the service users their preferred place of care or end of life care plan. The staff to ensure that the daily logs reflect how service users’ individual aims and objectives are being met rather than logging routine day to day tasks completed. Beattyville Gardens (116) DS0000025887.V372523.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Beattyville Gardens (116) DS0000025887.V372523.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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