Care Home: Bells Court

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What the care home does well Information is available about what the service has to offer, to help people make a decision about whether or not to use it. People`s needs are assessed to make sure that they can get the support they want. They are able to visit the home first, to help them make an informed choice. Residents` care plans are kept under regular review each month by a named worker. 1:1 staff support means that residents enjoy a wide range of opportunities to do the things that they want to do. They enjoy a good level of basic personal care and staff support them to keep appointments with doctors and other health professionals. They are helped to keep in touch with their families and other people who are important to them. The small size of the home makes it easy to provide a wide range of food choices, and residents say they enjoy their food and can have what they want. Staff try hard to promote people`s independence and to support their inclusion in the local community. All of the staff are either qualified or working towards gaining qualifications, so that they can support residents better. People enjoy the benefit of living in a house that is comfortable and homely, and safe. What has improved since the last inspection? The Manager and staff have worked hard since the last inspection to meet requirements and to improve the service. Efforts have been made to make care plans more "person-centred", through the introduction of "Me and My Life" books. There have been some improvements in the records kept about people`s activities, so that this information can be used to help future planning. Residents have been supported to take individual holidays if they wish, instead of having to go away together as a group. Each person now has a health action plan, specialist support from a dietician has been arranged, and protocols put in place for PRN ("as required") medication, so that the support residents now get to stay healthy and well has improved. Repairs and maintenance required at the last inspection have been carried out, and improvements to the home (including new furniture in the main lounge and development of the garden) continued, to make it more comfortable for the residents` benefit. Practice relating to the selection and recruitment of staff has improved, including checks with the Criminal Records Bureau, to make sure that staff are fit for the job. Fire training required at the last inspection has been given and the Manager has put a training plan in place to make sure that staff can get the training they need to do their jobs well. What the care home could do better: Care plans and risk assessments could be better organised, so that it is easier to find important information quickly and easily. Some plans could be more detailed, to make sure that staff have all the information they need to support people in the ways they like. Residents` goals would work better if they all had outcomes that could be measured, so that it is possible to see what has worked and what might need to be changed. New health action plans need further work, so that clear targets are set and it is possible to see if these have been reached. Information about people`s health should be better organised, to make sure that they get the support or treatment that they need. The staff training and development plan could be improved by including the dates that training needs to be "refreshed". This could help the Manager plan for meeting staff training needs more effectively. Providing additional staff training in adult protection, person-centred planning, autism and working with people with challenging behaviour could give them new skills to help them do their jobs better. Some more work is needed on monitoring the quality of the service provided. The goal should be to show how the views of the people who use the service underpin its future development. CARE HOME ADULTS 18-65 Bells Court 231 Bells Lane Druids Heath Birmingham West Midlands B14 5QH Lead Inspector Gerard Hammond Unannounced Inspection 6th December 2007 09:35 Bells Court DS0000059595.V353164.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 Bells Court DS0000059595.V353164.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. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bells Court Address 231 Bells Lane Druids Heath Birmingham West Midlands B14 5QH 0121 459 1883 0121 459 2249 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) Care Through The Millennium Mr Gregory M Zhuwao Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents must be aged under 65 with a learning disability. In addition to the manager a minimum of one other suitably qualified and experienced member of staff must be provided throughout the waking day, that is 7:30 till 22.00. During the night there must be 2 awake night staff on duty. Date of last inspection 24th April 2006 Brief Description of the Service: Bells Court is a three bedroom detached property lying back off Bells Lane in the Druids Heath area of Birmingham. The service is registered to provide accommodation and support for up to three adults with learning disabilities. Bells Court is close to local bus routes for Birmingham, Shirley and Solihull. It is also close to local amenities including the Maypole Shopping Centre. The premises consist of three single bedrooms with en-suite shower, toilet and wash hand basins, located on the first floor. On the same level there is a laundry room that has a washing machine with a sluice programme. The ground floor has two comfortable lounges, one of which is used as a quiet room. There is a spacious kitchen/dining area that is fully equipped. A bathroom with toilet and hand wash facilities is situated on the ground floor that has handrails fitted to assist with access. An office is also situated on the ground floor. The property is accessed via a service road that is sheltered by high fencing, shrubs and ornamental trees providing security and privacy. There is a gate (accessed by an electronic keypad) leading onto a driveway at the front of the property. There is limited additional off-road parking in front of the gate. At the rear of the property is a private enclosed garden. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and is the first inspection of the home during the current year 2007-8. This report also reflects the findings of a random inspection visit completed in October 2006, following last year’s key inspection. Information was collected from a number of sources to inform the judgements made in this report. Before a visit was made to the home, the Manager completed the Annual Quality Assurance Assessment (AQAA) and written (“easy read” version) surveys were sent to residents. During the visit, other documents were looked at, including care plans, personal files, health records, staff files and health and safety records. The Inspector was able to meet all three residents. The Manager and members of staff were spoken to, and feedback was received from relatives and other people involved with the residents. A tour of the building was also made. What the service does well: What has improved since the last inspection? The Manager and staff have worked hard since the last inspection to meet requirements and to improve the service. Efforts have been made to make care plans more “person-centred”, through the introduction of “Me and My Life” books. There have been some improvements in the records kept about people’s activities, so that this information can be used to help future planning. Residents have been supported to take individual holidays if they wish, instead of having to go away together as a group. Each person now has a health action Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 6 plan, specialist support from a dietician has been arranged, and protocols put in place for PRN (“as required”) medication, so that the support residents now get to stay healthy and well has improved. Repairs and maintenance required at the last inspection have been carried out, and improvements to the home (including new furniture in the main lounge and development of the garden) continued, to make it more comfortable for the residents’ benefit. Practice relating to the selection and recruitment of staff has improved, including checks with the Criminal Records Bureau, to make sure that staff are fit for the job. Fire training required at the last inspection has been given and the Manager has put a training plan in place to make sure that staff can get the training they need to do their jobs well. 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. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 7 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 Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 8 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that the care home will be able to support them properly. Information about what the service provides is readily available. People’s needs are assessed to make sure they get the support they want. They have the chance to visit before making a decision about whether or not to move in. EVIDENCE: An appropriate Statement of Purpose and Service Users’ Guide are in place as required. There has been one admission since the last inspection visit, so there are currently no vacancies. Residents’ personal files were sampled. Assessments of support needs were present; these were detailed and up to date. A requirement was made at the last key inspection that assessments should include individuals’ medical conditions: this has now been met. The Manager advised that staff made two visits to the newest resident in his former placement, and that he came and stayed in the home for a couple of nights before making a decision to move in. The person in question confirmed that he had had the chance to visit, and meet the other residents and staff. It Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 9 was noted that there were issues about the accuracy of some of the assessment information provided to the home before his admission. Work is ongoing with members of the multi-disciplinary team to keep this under review, so that care planning can be properly informed. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7,8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some further work is needed on people’s care plans and risk assessments. This is to make sure that they get support according to what they need and in ways that they want, and that they are helped to stay safe at all times. Residents are able to take part in all aspects of life in the home, and staff respect their rights and support them to make decisions and choices. EVIDENCE: Sampling of residents’ personal files provided some evidence that there has been continued improvement in care planning since the last key inspection. Work has been done to complete “Me and My Life” books, which follow a more person-centred format. Sampled care plans contained detailed information and were supported with risk assessments and activity plans, which showed that individuals had been directly involved in making. However, it was noted that tracking between these component parts was not easy. This was discussed Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 11 with the Manager, and it was suggested that plans and risk assessments should be numbered, indexed and cross-referenced, so that clear links were established between them. Care plans could be more detailed, so that staff reading them have clear guidance about how support should be given. One person’s plan had an entry “reminded by staff to do his laundry on set day”. It is suggested that this should make it clear what the individual can do independently, and what areas require specific support (e.g. can he sort laundry appropriately, does he know how to use the washing machine, set programmes, temperatures etc., how to get clothes dry / aired / ready for ironing?). Another plan, about money management, said “staff to encourage (X) to spend his money wisely”, without further guidance. It is suggested that this plan might make clear what the individual is already able to do (e.g. does he recognise coins and notes, understand their true value, know how much change to expect) or identify possible areas for training / learning. If the object of the exercise is to get this person to budget effectively, then what needs to be done precisely to get him to do this? Another person’s plan referred to making his own breakfast or lunch. Again, this should show what he can do independently, and identify specifically what areas require support. There should be clear links to relevant risk assessments (e.g. using kitchen appliances safely, risks of scalding, handling sharp instruments, etc.) as necessary. The plan for anger management would be better if it identified particular triggers or circumstances that provoke inappropriate responses. This could be directly linked to a person-centred plan “what works / doesn’t work for me”. It was noted that some risk assessments follow a generic format: consideration needs to be given about how to make these more personal, so that they relate clearly to each individual. There were individual risk assessments on file, but it was difficult to track them or see clear links with relevant care plans in some instances. One person’s risk assessment showed he presented a high risk to members of the public, and was at risk from others, but there were no specific risk assessments about these. Conversations with the Manager showed that appropriate consideration had been given to the relevant issues, but the records did not support this. Care plans should also include people’s agreed goals and aspirations. There was some evidence of this, particularly in activity planning. This was also discussed with the Manager. It was suggested that all goals should have outcomes that can be measured, and that these should be evaluated when the plan is reviewed. It should be acknowledged that there were examples of clear goals: good work already done in this regard should be built upon. Plans are kept under constant review by monthly “supervisions” carried out by each person’s named worker, and this practice is commended. It is suggested that developing plans (by making all goals more specific and clearly measurable) could support this process further. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 12 People’s records and direct observations provided evidence that they are directly involved in the day-to-day running of the house, according to their individual wishes and abilities. These include helping with household chores, cooking, cleaning and choosing their daily activities. (See next section “Lifestyle” also.) It is recommended that better organising care plan and risk assessment information (e.g. by indexing and cross-referencing) will make it easier to find important information and ensure that staff have clear guidance about how to support people according to their assessed needs and wishes. Good work already done to use person-centred approaches needs to be taken forward. This was also discussed with the Manager: it may be that specific training in the use of person-centred planning would be of benefit. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to pursue valued activities and to keep in touch with people who are important to them, so that they have the lifestyle they want and can be active members of the community in which they live. They can choose the food they like, and enjoy their meals. EVIDENCE: Staffing arrangements at the home provide 1:1 support for each resident. This enables each person to access a wide range of activities of their own choosing. These are planned at the beginning of each week and recorded on their activity schedules. On the day of the inspection visit, two of the residents spent most of the day out with their respective support workers doing their Christmas shopping. Plans provided evidence of variety and choice including cinema, bowling, shopping, taking exercise, cooking and playing pool. Activity records also showed that plans were not rigid, and that residents could change Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 14 their minds and do something different if they so chose. It was noted that some improvements had been made to recording of activities, showing people’s responses: these should be continued and built upon. People are encouraged to do activities in a community context, respecting their need for support due to their learning disability but promoting their equality and inclusion. Some concerns were expressed about the number of occasions one resident remains in bed until the late afternoon. In recent weeks this has been variable but frequent. A balance needs to be struck between accepting this individual’s informed lifestyle choices and supporting him appropriately to take part in purposeful activities in accordance with his assessed needs and agreed goals. Staff should be more proactive about engaging him on the days when this is an issue, rather than just leaving him in bed. However, it should be acknowledged that this person has specific and complex support needs, and this issue is one of a number that staff are seeking to address. Members of the care team work hard to encourage residents to be as independent as their skills and levels of disability allow, and to respect their choices. Records show that residents are supported to keep in touch with family members and friends, and people themselves confirmed this. One person has an “independent visitor” who comes and takes him out regularly. Another visits and keeps in touch with his parents, with staff support. Residents were also very happy to talk about the holidays they enjoyed this year. One went to Tenerife, and another to France. Plans have yet to be made for supporting the newest resident to take a break. Sampling of food stocks showed that supplies were adequate. The Manager reported that fresh produce was purchased on a day-to-day basis as required. Fresh fruit was available on the kitchen table. The small size of the home makes it easy to facilitate individual meal choices. Residents all confirmed that they enjoyed their food and could have whatever they wanted. Care plans show that they are supported and encouraged to make positive choices about healthy eating. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and health care needs are generally well met. They get their medication when they need it and in the correct amounts. The ways in which information about their health is managed could be improved, to make absolutely sure that they get all the support they need. EVIDENCE: As previously reported, all three residents in this house are male, and there are male staff on the care team, ensuring that gender sensitive support is available. Direct observations of people’s grooming and clothing on the day of the fieldwork visit provided evidence that they receive a good standard of basic personal care. At the time of the last inspection visit it was noted that it was not always easy to follow when or how identified health needs had been met. This continues to be the case. Sampling of personal records provided evidence of the involvement of health professionals including GP, Consultants, Optician, Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 16 Dentist and Chiropodist. Previous concerns about seeking specialist Dietician support have now been dealt with. Information recorded in monthly supervisions show that appointments have been arranged, but this is not systematic. Health Action Plans have been started. These are fine as far as they go, but more work needs to be done to take them from their current “assessment” stage onto developing them into proper plans. As with general care plans, these need to include identified goals (e.g. six-monthly dental check-up, annual well person clinic etc.) which can be evaluated so that it is clear what has been achieved and what needs to be done. Currently, information about people’s healthcare needs is dispersed throughout their personal files. It is suggested that this should be systematically organised into one place (Individual Health Action Plan might be an appropriate choice) so that it becomes easy to follow through when appointments are due and to check that necessary actions have been taken. It should be acknowledged that there is clear evidence that good work is going on to promote individuals’ health and wellbeing, including initiatives for healthy eating and exercise. Organising the way in which health-related information is processed and recorded could help make this better and ensure that residents get all the support they need. The home uses the Boots Monitored Dosage System (MDS) for managing medication. The medicine cupboard was secure, clean and tidy. Records included sample signatures of staff authorised to administer medicines, copies of prescriptions and information about specific medication. Protocols for PRN (“as required”) medication were in place, and the Medication Administration Record (MAR) had been completed appropriately. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know that they can complain, and feel that their concerns are listened to and taken seriously. They are generally well protected from abuse, neglect or self-harm and feel safe. EVIDENCE: Appropriate complaints and adult protection policies are in place, as required. The Manager has put a complaints record in place since the last key inspection and this was examined. One complaint had been received: records and subsequent discussion with the Manager and the person who made the complaint showed that this had been dealt with appropriately and that he was satisfied with the outcome. It was recommended that the complaints file be developed to include a pro forma for each complaint, summarising action taken and the outcome. All of the residents said that they knew they could complain if they were unhappy about anything and were able to do so. The staff training record showed that six of the current staff team have not yet received training in adult protection. This was discussed with the Manager, and action should be taken to address this shortfall as a matter of priority. Previous concerns about checks on staff during the recruitment process have now been addressed: sampled files contained required documents, including Criminal Records Bureau checks. Staff spoken to showed their awareness of the importance of raising any concerns relating to residents’ safety with senior personnel. Residents said that they felt safe in their home. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 18 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy the benefit of living in a house that is homely, clean and comfortable. Private and shared spaces meet the needs of the people who live there. EVIDENCE: A tour of the building was completed. The house is generally well maintained and requirements made at the time of the last key inspection regarding repair and redecoration have been met. All three residents’ rooms were seen: they all include en-suite facilities and were well-furnished and individual in style. Personal possessions and effects were much in evidence. Downstairs there are two sitting rooms: one is used as the main lounge and television room, while the other offers residents alternative space and is generally used as a “quiet room”, another place to relax in, listen to music or receive visitors. Both rooms are comfortably furnished and a new suite of furniture has recently been bought for the main lounge. The Manager advised that the carpet in this room Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 19 is to be replaced shortly. The kitchen – dining room is similarly well equipped, and provides residents with a pleasant space to get involved in preparing their food and enjoying their meals. At the rear of the house there is an enclosed private garden that has recently been upgraded and provides an attractive outdoor space for residents to use. The house was clean and tidy and a good standard of hygiene maintained. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff available at all times to make sure that people can get the support they need. People can be confident that proper steps have been taken to make sure that staff are fit for the job but some staff need particular training to make sure that they know how to support residents to stay safe. Staff are properly supervised to make sure they support residents according to their needs. EVIDENCE: Staff records were sample checked. All files examined contained required documents including complete applications, written references, and checks with the Criminal Records Bureau. Records also included written job descriptions, declarations of medical fitness, and code of conduct. Residents enjoy the benefit of 1:1 staffing and waking night cover. Since the last inspection visit, the Manager has produced a training matrix for the staff team and provided a current copy. This shows that all staff either hold qualifications at NVQ level 2 or above, or are working towards obtaining Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 21 them. As reported above, it was noted that six members of staff have yet to receive training in adult protection, and this must be addressed. In order to develop the existing matrix into a full training and development plan, it was suggested that dates for retraining (“refreshers”) be included, so as to alert the Manager and assist him in scheduling training in good time. It was also suggested that additional training in autism and supporting people with challenging behaviour should be made available to members of the team who have not yet done this, in view of the assessed needs of the current group of residents. Other records examined provided evidence that staff receive regular formal supervision, and also meet together as a group, as required. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 22 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are confident that the home is generally well run, but some more work needs to be done to improve ways of finding out what residents think about the quality of the service provided. Health and safety practices are carried out regularly, to make sure that the home is a safe place for the people who live and work there. EVIDENCE: The Manager is a qualified Nurse for people with learning disabilities, and also holds the Registered Manager’s Award (RMA). Staff say that he is approachable and that his style of management is open and inclusive. Positive comments about his professional attitude were also received from other people associated with the residents. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 23 At the time of the last key inspection a requirement was made that surveys should be made available to residents, their families, staff and other professionals, with a view to finding out their opinions of the quality of the service provided. This was done, but the Manager reported that the number of responses received was disappointing. Surveys were also sent out as part of the inspection process. These were returned for all residents, who were helped to complete them by a student social worker on placement at the home. Responses received suggest that alternative ways of finding out what residents think about the service they get should be further explored, taking account of their individual levels of learning disability and capacity for understanding the process. One resident’s mother wrote back “I am very pleased with the care in every way of my son. Thank you.” The Manager reported (in the Annual Quality Assurance Assessment) that the organisation’s Care Director visits regularly, to ensure that the service is being run appropriately. Safety records were sample checked. The fire alarm system has been serviced, and records show that the alarm and emergency lighting systems have been tested each week as required, and checks carried out on fire fighting equipment. The home’s electric circuit and Landlord’s gas safety certificates are in date, and portable appliance testing of electrical equipment has been carried out. Regular temperature checks of the fridge, freezer and water outlets have been carried out and a full record maintained. Packages of food stored in the fridge were labelled with the date of opening. The COSHH store was secure. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 24 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 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 3 2 X X 3 X Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 13 (4c) Requirement Timescale for action 28/02/08 2. YA23 13 (6) Ensure that potential hazards are properly identified and measures put in place to minimise the risk of occurrence, so as to keep people as safe as possible. Ensure that all staff have 28/02/08 received training in adult protection, so as to help prevent people who use the service from being harmed, suffering abuse or being put at risk of being abused. 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 YA6 YA9 Good Practice Recommendations Further develop the use of person-centred practices in care planning. Set goals with outcomes that can be measured and evaluate these when the plan is reviewed. Index and cross-reference risk assessments with care plans and vice versa, so that important information can be found quickly and easily DS0000059595.V353164.R01.S.doc Version 5.2 Page 26 Bells Court 3. YA19 4. 5. 6. YA22 YA35 YA39 Develop health action plans to include clear goals, so that it is possible to see whether or not these have been met. Organise health-related information in a clearly identified place, to ensure that people get the support they need to stay healthy and well. Include a summary sheet with each complaints record, so that it is easy to see what action has been taken, and the outcome. Develop the staff training and development plan to include dates when training is due for renewal, so as to ensure that training required can be delivered on time. Develop the system for quality assurance and monitoring so that the views of people using the service clearly underpin its review and development. Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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 Bells Court DS0000059595.V353164.R01.S.doc Version 5.2 Page 28 - 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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