Care Home: Blossoms

Similar services:

• Hillside
• Applegarth
• 122 Scorer Street
• Jubilee Villa Care Home
• Thornham Grove
• Beech Lodge
• 8 Thorndale Road (Homefield College)
• Hunter`s Lodge

What the care home does well The staff make sure that people have all the right information to help them make a decision bout whether they would like to live at the home. New residents are able to visit the home, meet the other residents and staff and find out what it would be like to live there. The staff make sure that they have all the right information about the person to make sure that the staff are able to look after them properly before they move in. Residents say that the staff managed their admissions to the home well. Each resident has an individual plan of care, which sets out how the resident is to be cared for and residents are involved in the care planning process. The individual plans of care contain the right information and are being improved to make sure that they are up to date and easy to readResidents are able to choose their key worker, who works closely with them and helps them achieve their goals. The staff make sure that residents are able to make decisions for themselves and that their rights are respected. Residents are able to take risks in their lives and join in activities such as cooking, going out on their own and expressing their individuality. The staff try hard to find activities that the residents enjoy and support residents make use of the local facilities such as churches, shops, pubs, clubs, cinemas, sporting facilities. Residents are able to take courses at local colleges in the things that interest them. They also attend day care centres where they can join in activities that they like. Some of the resident`s have part time jobs. Residents are able to keep in touch with their families and friends, through home visits and visitors are welcomed at the home. Residents said that they food provided by the home is good, they said that they are able to help plan the menu and that there are always two choices of food for the main meals. The staff ask the residents how they wish to be supported and know about their preferred routines such as the time that they like to go to be and to get up in the morning. The staff treat the residents well, use the name that they prefer and make sure that they knock before going into a resident`s bedroom. Residents have their own bedrooms; these are comfortable rooms, which have privacy locks and showers. Residents can bring their own things into the home and have their rooms the way that they want them. The staff make sure that residents have the right healthcare checks and that they have the right treatment form doctors, nurses and other specialists. The staff make sure that residents receive their medication safely. Residents say that they feel safe living at the Blossoms and that the staff are nice to them. They have the right information and know how to complain if they are unhappy about something. The Management make sure that staff have all the right checks done before they start working in the home. Staff receive the right training so that they are able to care for the residents safely and the manager does regular checks to make sure that they are doing their jobs properly. The manager has the right qualifications and experience to do her job properly and systems are in place to make sure that the home is safe and that the residents are satisfied with their experience of living in the home.DS0000070121.V352247.R01.S.docVersion 5.2Page 7 What has improved since the last inspection? This is a newly registered service. What the care home could do better: Residents need to be given new contracts that contain up to date information. Staff need to make sure that residents have all the right safety checks in place when they join in activities such as swimming. The staff need to ask the residents if they would like to have a key to the front door and to make sure that they do the right safety checks. Staff need to make sure that they have all of the right information in the individual plans of care about the residents medical conditions and that these are up to date. The staff need to find out if residents want to look after their own medication and need to do the right checks to make sure that it is safe for them to do this. The right care plans and safety checks should be put in place when residents have a specific vulnerability. The staff need to make sure that the right safety checks are done about the use of door wedges. CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Blossoms 20 Swans Pool Parade Wellingborough Northants NN8 2BZ Lead Inspector Stephanie Vaughan Unannounced Inspection 5th November 2007 08:45 DS0000070121.V352247.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 DS0000070121.V352247.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 Older People and 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. DS0000070121.V352247.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blossoms Address 20 Swans Pool Parade Wellingborough Northants NN8 2BZ 01206 224100 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) www.concensusupport.com Consensus Support Services Ltd Janice Peskett Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000070121.V352247.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons 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 are within the following category: Learning Disability - Code LD The maximum number of residents who can be accommodated is 6. 2. Date of last inspection New Service Brief Description of the Service: The Blossoms is a care home registered to provide care for six people with Learning Disability. It is a large bungalow situated in a residential setting close to the town centre, local amenities and good transport links. There are three communal areas comprising a large sitting room and kitchen diner and a small entrance hall, which provides an additional seating area. There are six bedrooms, which are for single occupancy, and they are fitted with appropriate fixtures and fittings including ensuite facilities. The provider ensures that prospective residents receive information about the service, including Commission for Social Care Inspection reports before residents are admitted to the home. The current fees range form £790: 00 per week to £1,100:00 per week, with additional charges for hairdressing, extra toiletries, newspapers, and personal items such as clothing and footwear. DS0000070121.V352247.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to this statutory inspection, a period of four hours was spent in preparation. This comprised reviewing the registration report, the service history and the pre-inspection documentation supplied by the provider. Four Comment cards were returned; three from residents and one form a relative, all of the responses provided favourable feed back about the service. There have been complaints, concerns or allegations about this service. The Commission have a focus on Equality and Diversity and issues relating to this are included in the main body of the report. This site visit to the home was conducted over a period of five and a half hours during which the inspector made observations and spoke to residents and staff. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where of a sample of two residents were selected and all aspects of their care and experiences reviewed, including individual plans of care and associated documentation. The Acting Manager was present throughout this visit. What the service does well: The staff make sure that people have all the right information to help them make a decision bout whether they would like to live at the home. New residents are able to visit the home, meet the other residents and staff and find out what it would be like to live there. The staff make sure that they have all the right information about the person to make sure that the staff are able to look after them properly before they move in. Residents say that the staff managed their admissions to the home well. Each resident has an individual plan of care, which sets out how the resident is to be cared for and residents are involved in the care planning process. The individual plans of care contain the right information and are being improved to make sure that they are up to date and easy to read. DS0000070121.V352247.R01.S.doc Version 5.2 Page 6 Residents are able to choose their key worker, who works closely with them and helps them achieve their goals. The staff make sure that residents are able to make decisions for themselves and that their rights are respected. Residents are able to take risks in their lives and join in activities such as cooking, going out on their own and expressing their individuality. The staff try hard to find activities that the residents enjoy and support residents make use of the local facilities such as churches, shops, pubs, clubs, cinemas, sporting facilities. Residents are able to take courses at local colleges in the things that interest them. They also attend day care centres where they can join in activities that they like. Some of the resident’s have part time jobs. Residents are able to keep in touch with their families and friends, through home visits and visitors are welcomed at the home. Residents said that they food provided by the home is good, they said that they are able to help plan the menu and that there are always two choices of food for the main meals. The staff ask the residents how they wish to be supported and know about their preferred routines such as the time that they like to go to be and to get up in the morning. The staff treat the residents well, use the name that they prefer and make sure that they knock before going into a resident’s bedroom. Residents have their own bedrooms; these are comfortable rooms, which have privacy locks and showers. Residents can bring their own things into the home and have their rooms the way that they want them. The staff make sure that residents have the right healthcare checks and that they have the right treatment form doctors, nurses and other specialists. The staff make sure that residents receive their medication safely. Residents say that they feel safe living at the Blossoms and that the staff are nice to them. They have the right information and know how to complain if they are unhappy about something. The Management make sure that staff have all the right checks done before they start working in the home. Staff receive the right training so that they are able to care for the residents safely and the manager does regular checks to make sure that they are doing their jobs properly. The manager has the right qualifications and experience to do her job properly and systems are in place to make sure that the home is safe and that the residents are satisfied with their experience of living in the home. DS0000070121.V352247.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000070121.V352247.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) DS0000070121.V352247.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are appropriately assessed prior to moving into the home, ensuring that their needs can be met. EVIDENCE: The service has a Statement of Purpose which reflects the changes in ownership of the home and which complies with the criteria specified in schedule one of the National Minimum Standards. DS0000070121.V352247.R01.S.doc Version 5.2 Page 10 The service also has a Service Users Guide, which complies with the criteria specified in standard one of the National Minimum Standards. In addition there is also a user-friendly version, which is produced, in an easy read format with graphic illustrations. There is evidence that all existing residents have received a copy of this information. Residents and staff are informed of the outcome of the inspections conducted by the Commission for Social Care Inspection and the reports are discussed at both residents and staff meetings. There have been no admissions to the home since registration. However the individual plans of care for existing residents evidence that the service obtains preadmission assessments from the funding authorities and conduct their own preadmission assessments before admission to ensure that the service is able to meet the needs of the prospective resident. Residents were able to confirm satisfaction with the admission procedures and said that they had received good information about the home and that they had had opportunities to visit, meet the other residents and staff and to view the facilities before deciding whether they would like to live there. There was also evidence that residents have a three-month trial period and a review to ensure that they are satisfied with the placement. Each resident has a contract in place, however these are now out of date following changes in ownership of the home. These need to be reviewed and reissued so that residents have access to accurate and up to date information. DS0000070121.V352247.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) 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 good. This judgement has been made using available evidence including a visit to this service. Residents have detailed individual plans of care, which indicate that they are treated as individuals and that they are able to exercise choice in their daily lives. EVIDENCE: DS0000070121.V352247.R01.S.doc Version 5.2 Page 12 Each resident has an individual plan of care that reflects the information obtained in the preadmission assessments. These are currently being reviewed to ensure that they are person centred, are in a user friendly format and that they cover all aspects of the resident’s personal and healthcare needs. In general these contain a good level of detailed instruction to staff about how care is to be provided and any restrictions are seen to be in the best interests of the residents and are supported by appropriate risk assessments. Individual plans of care also contained information about the support that residents require regarding their behaviour management, potential triggers and instruction to staff about de-escalation techniques. Individual plans of care evidence that residents are involved in the care planning process and regular reviews. There is also evidence that care management reviews are conducted at appropriate times and that residents have access to a key worker of their choice. There is clear evidence within the individual plans of care that the residents rights to make decisions for themselves and that they are respected and supported in their decision making process. Residents also have access to local advocacy services and are supported to manage their finances. Management are aware of the implications of the Mental Capacity Act 2005 and the rights of residents. Residents were able to confirm that the service ensured that they were supported to make decisions about their lives. Residents are also supported to take risks within their daily lives, these include involvement in household tasks such as cookery and other domestic activities and independent access to the local community also activities such as smoking and personal appearance. In addition residents are able to express their individuality and make lifestyle choices. In general these are supported by appropriate risk assessments, which are detailed and provide instruction to staff about how the risks are to be reduced or managed. Individual plans of care and associated risk assessments are currently being reviewed and management should ensure that all activities that have the potential to present risks to the individual, such as swimming have appropriate risk assessments conducted. DS0000070121.V352247.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): DS0000070121.V352247.R01.S.doc Version 5.2 Page 14 12, 13, 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 engage in meaningful activities both inside and outside the home, which promotes a fulfilling lifestyle. EVIDENCE: Individual plans of care contain information about the resident’s lifestyles and these evidence that residents have opportunities to participate in educational and occupational activity. Residents are able to access courses at the local college and adult education facilities. These include courses in Arts and Crafts, Information Technology, Advanced Cookery and Life Skills. Residents attend local day care facilities where they have opportunities to participate in activities of their choice, including paid employment and there is also evidence that the service supports residents to participate in other work experiences. The service is close to the town centre and has good transport links; in addition the service also has its own transport. Residents are able to access a range of shopping, sporting and leisure facilities within their local community. Residents were able to confirm satisfaction with their lifestyles and chosen activities, which include attendance at local clubs, celebration of festive events such as attendance at recent Halloween parties, birthday parties and other activities such as badminton and swimming. There is evidence that residents are able to chose not to take part in activities should they prefer not to or should they be unwell. There was evidence that all residents are on the Electoral Register and are supported to vote in local and national elections. Individual plans of care also evidence that residents are supported to maintain the equality and diversity. Care is individualised and person centred, ensuring issues such as age, gender, disability, race, culture and faith are addressed. The home is registered for six residents and there is currently one vacancy. Three of the five residents living at the home are female and there are two male residents. The management are mindful of the need to maintain a balance in the gender of the residents living at the home and also that the staff group reflects the cultural; age and gender mix of the residents. DS0000070121.V352247.R01.S.doc Version 5.2 Page 15 The Acting Manager is aware of the Mental Capacity Act 2005, the implications for the residents living at the home and the circumstances in which the Independent Mental Capacity Advocates should be consulted. Residents are supported to maintain their faith and practice religions of their choice through attendance at local churches and visiting clergy. Residents are supported to maintain links with family and friends, individual plans of care contain information about important family dates and residents are able to receive their chosen visitors in the communal areas or their own rooms. Residents are also supported to visit family and friends at their own homes for short visits and overnight stays. Routines within the home appear to be flexible within the constraints of residents planned activities. Individual plans of care provided detailed information regarding the residents preferred routines including times of rising and retiring to bed. Each resident has their own bedroom with ensuite facilities, staff were seen to relate well to residents and to be respectful of their privacy and spoke to them using their preferred form of address. All bedrooms are fitted with privacy locks and there is evidence that residents are offered a key to their individual accommodation. The Acting Manager confirmed that currently the residents are not offered a key to the front door due to security reasons and the vulnerability of residents. However there are no risk assessments in place to validate or support this decision. Residents confirmed that they were involved in decisions about the running of the home through regular resident meetings. At these meetings residents make decisions about entertainment and the menus. Residents are also involved in the establishment of a local branch of the British Institute for Learning Disability. Residents were able to confirm satisfaction with the food provided at the home and confirmed that they were offered a choice of two alternatives at main meals. The service also provides residents with a packed lunch for their daytime activities. Main meals are served in a pleasant kitchen diner. DS0000070121.V352247.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) 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. Residents have an individual plan of care, which demonstrates that, their health; personal and social care needs are fully met. EVIDENCE: Residents living at the Blossoms have a high level of independence and the individual plans of care reflect this. Individual plans of care provide detailed instruction to staff about the way that each resident wishes to be supported in DS0000070121.V352247.R01.S.doc Version 5.2 Page 17 the maintenance of their personal and health care, including personal routines and prompts. Daily records indicate that are is provided as specified within the individual plans of care. Residents were able to confirm satisfaction with the way that they were cared for. One of the residents Medication Administration Records indicated that they had been in receipt of treatment for a specific medical condition and there was no specific care plan for this condition. However individual plans of care are currently being reviewed to ensure that they are person centred and that they reflect all of the resident’s healthcare needs. Residents appeared to be well cared for and well presented. They are able to express their individuality through their choice of clothing and general appearance. Residents are supported to access specialist services, aids and adaptations to support their health and independence. Currently all staff working in the home are female, however the management are mindful of the need to ensure that the staff group is reflective of the gender of the residents. There is evidence that residents are supported to maintain their health care, all residents are registered with a General Practitioner and have access to health promotion services such as screening programmes and vaccinations against influenza. Residents are also supported to access services such as podiatrists, opticians, dentists, hospital and Community Learning Disability Team services. Medication systems were viewed and found to be in good order. Medication is stored appropriately in the home and there are arrangements in place to ensure that accurate records are maintained for medication received into the home, of that that is administered and returned to the pharmacist. Medication Administration Records indicate that residents receive their medication as prescribed. A spot check was conducted and the remaining stock found to correspond with the Medication Administration Records. The community pharmacist conducted a recent inspection and systems were found to be in good order. The acting manager confirmed that both the recommendations made had now been implemented. The acting manager confirmed that a resident who has moved to independent living accommodation had been supported to self-administer medication. However there was no evidence that any of the existing residents are supported to administer their own medication. DS0000070121.V352247.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) 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. There is a robust complaints procedure and good staff awareness and attitudes regarding the Safeguarding Adults so that residents felt safe and were well protected. EVIDENCE: The service has a robust complaints policy and this is displayed within the home. Residents are also provided with information that is produced in a userfriendly format to ensure that they have access to the right information. Residents were able to confirm that they knew how to complain and would be confident that their compliant would be handled appropriately. There have been no complaints about this service since registration. DS0000070121.V352247.R01.S.doc Version 5.2 Page 19 Residents were able to confirm that they felt safe living at the Blossoms and that the staff were nice to them. Staff have received training in the Safeguarding of Adults and further training is scheduled for the near future. The acing manager confirmed that the service had not received a copy of the new Safeguarding Adults procedures produced by the Local Authority and has agreed to obtain a copy of these and to ensure that staff are conversant with the content and the appropriate actions that need to be taken in the event of abuse. There have been no Safeguarding Adults allegations about this service since registration. However there is evidence that the management act appropriately and liaise with the appropriate authorities in circumstances that have the potential to lead to abusive situations. However where residents present with specific vulnerability appropriate care plans and risk assessments should be developed. The service holds small amounts of money for individual residents; this was seen to be stored appropriately within a locked facility and in individual wallets. Receipts are retained to evidence expenditure and appropriate records are maintained. A spot check was conducted and the balance seen to accurately reflect the remaining cash. DS0000070121.V352247.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) 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 Standard of the environment is good, providing residents with a safe and comfortable place to live. EVIDENCE: DS0000070121.V352247.R01.S.doc Version 5.2 Page 21 The premises are suitable for their stated purpose being registered to provide personal care for six residents with learning disability. It is a large bungalow within a residential setting, situated close to the town centre, close to local amenities and transport links. The home provides spacious communal areas including a large sitting room and kitchen diner, with a small entrance hall, which provides an additional private area. There are six bedrooms for single occupancy, which are fitted with appropriate fixtures and fittings including ensuite shower facilities and privacy locks. The management confirmed that they are currently making arrangements to ensure that resident have lockable storage facilities within their individual accommodation. Management confirmed that arrangements are already in place to replace some of the uneven carpeting in resident’s bedrooms, which have the potential to cause a trip hazard. Both the kitchen and sitting room fire doors were wedged open. Staff confirmed that the wedges were only used during the daytime and that the wedges were removed at night and that regular fire checks including drills were conducted. Management confirmed that the providers had arranged for a full fire safety audit of the premises and that automatic closing devices have been requested. However, there is currently no risk assessment in place to reduce and manage the risks associated with the use of door wedges and management have agreed to address this in the interim. Residents confirmed satisfaction with the environment and confirmed that they were able to exercise choice in the décor and there was evidence that residents are able to bring in their personal possessions and to personalise their rooms. The standard of the environment is good throughout being well-maintained, ventilated, light, heated, clean and hygienic. Residents confirmed that there were adequate supplies of hot water and appropriate laundry facilities. DS0000070121.V352247.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service employs appropriate numbers of inducted and trained staff to ensure that the resident’s needs are appropriately met. EVIDENCE: Current staffing levels are adequate for the number and dependency levels of the existing residents and comprise one member of staff through out the day DS0000070121.V352247.R01.S.doc Version 5.2 Page 23 and one sleeping member of staff throughout the night. Management are mindful of the need to keep these under review as the needs of the residents change and have access to care staff from other local homes within the group in the event of untoward events such as sickness. Residents benefit from a loyal and stable staff team that exceed the Department of Health Target of 50 of staff having obtained the National Vocational Qualification in Health and Social Care level 2. Others are working towards their National Vocational Qualification level 3. Staff files evidenced that recruitment processes are sound and that all staff have the appropriate documentation retained on file. In particular staff files evidence that appropriate references and Criminal Records Bureau Clearances are obtained before staff commence employment in the home. Staff files also evidence that staff have access to appropriate mandatory training and training specific to the needs of the individual residents. Mandatory training includes the Common Induction Standards Training for new staff, training in the Safeguarding of Adults, Safe Administration of Medication, Fire Safety, First Aid, Movement and Handling, Basic Food Hygiene and Health and Safety. Training specific to the needs of resident includes the Learning Disability Award Framework, management of Diabetes and Sexuality. Management confirmed that a training needs analysis has been conducted to ensure that individual training needs are identified and that staff training is kept up to date and is accessible to new staff. There is also evidence that staff benefit from formal and timely staff supervision. DS0000070121.V352247.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): DS0000070121.V352247.R01.S.doc Version 5.2 Page 25 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate leadership, guidance and direction means that the home is managed in the best interests of residents. EVIDENCE: The Registered Manager has many years experience in the care of residents with Learning Disability and as a Registered Manager. She is qualified and competent to manage the home having obtained her National Vocational Qualification in Care level 4 and a recognised management qualification. However she confirmed that she continues to act in the capacity of the Group Manager overseeing the management of other local homes within the group. The Commission have received notification that the deputy manager is to become the Acting Manager for the home, having obtained her National Vocational Qualification in Care level 4 and is currently undertaking her Registered Managers Award. It is intended that she will seek registration with the Commission in the near future. Quality Assurance systems are well established, the management conduct regular environmental audits to ensure that the environment is maintained to a good standard and that any hazards are identified. Systems are in place to ensure that appropriate kitchen records are maintained such as safe temperatures for fridges and freezers. Routine regular testing of fire systems and equipment are undertaken and recorded. There are also regular audits of the medication systems, individual plans of care and residents money and staff files. The satisfaction of residents and their representatives is reviewed on a regular basis using formal satisfaction surveys. The responses are collated and used to inform service development. The management conduct regular monthly unannounced inspections to monitor standards within the home and arrangements are in place for copies of these to be forwarded to the Commission on a regular basis. There have been no deaths, accidents or hospital admissions since the service was registered. DS0000070121.V352247.R01.S.doc Version 5.2 Page 26 Notices to promote Health and Safety are evident throughout the home and cleaning chemicals are stored appropriately. There is evidence that routine safety checks are conducted on systems and equipment within the home. Staff have access to appropriate and timely training; policies and procedures are in place and are reviewed on a regular basis. Arrangements are in place to replace uneven carpeting identified in resident’s bedrooms and to conduct risk assessments for the use of door wedges until automatic-closing devices can be fitted. DS0000070121.V352247.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. Where there is no score against a standard it has not been looked at during this inspection. 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 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X DS0000070121.V352247.R01.S.doc Version 5.2 Page 28 New Service 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 4 5 Refer to Standard YA5 YA9 YA16 YA19 YA20 Good Practice Recommendations Residents’ contracts should be reviewed and reissued to ensure that residents have access to up to date and accurate information. Risk assessments should be further developed for any activity in which residents participate that has the potential to cause harm. Residents should be consulted about their wishes to hold a key to the front door any decisions should be supported by appropriate risk assessments. Individual plans of care should be reviewed to ensure that they contain detailed instruction to staff about all aspects of the residents healthcare needs Residents should be consulted about their wishes regarding self-medication and any decisions should be supported by appropriate risk assessments. DS0000070121.V352247.R01.S.doc Version 5.2 Page 29 6 7 8 9 YA20 YA23 YA23 YA24 Where staff continue to administer medication on behalf of the residents, the residents formal consent should be obtained. A copy of the new Local Authority Guidelines on the Safeguarding of Adults should be obtained and staff should be conversant with the content. Where residents present with specific vulnerability appropriate care plans and risk assessments should be developed. A risk assessment should be developed regarding the temporary use of door wedges DS0000070121.V352247.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. DS0000070121.V352247.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!