Care Home: Chapel View

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What the care home does well The home provides a service that has been developed to meet the needs of the three current service users. The service has an established staff team that have a good understanding of needs and are provided with good training opportunities. This training provides the skills required to work within the home. The service makes good use of outside professionals to advise and support service users and staff on the care and future development of individuals. The service provides homely and comfortable accommodation that is private but well situated to access the local community. The home supports and encourages services users to be fully involved in the planning of their care and support, and a structured and professional approach is taken to the development of greater independence. The staff work well as a team and are well supported and supervised by the management of the home. Good systems are in place to monitor and evaluate the progress of the home and the effectiveness of the care and support provided, with regular and detailed Regulation 26 reports being complied and feedback provided to the home. What has improved since the last inspection? The home has developed its care planning systems to be very person centred and to fully involve the service users in the planning and reviewing of their care and support. Improvements have been made to risk assessments supporting the move to greater independence. CARE HOME ADULTS 18-65 Chapel View St Whites Road Cinderford Glos GL14 3HA Lead Inspector Mr Simon Massey Key Unannounced Inspection 27th March 2008 09:00 Chapel View DS0000068131.V360443.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 Chapel View DS0000068131.V360443.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. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chapel View Address St Whites Road Cinderford Glos GL14 3HA 01594 824400 01594 546506 mark@stepasidecare.com 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) Step-A-Side Care Ltd Mr Mark George Carwardine Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2007 Brief Description of the Service: Chapel View provides accommodation for three adults with Learning Disabilities and is situated on the outskirts of the town of Cinderford in the Forest of Dean. The house provides good access to local facilities. The home comprises of a kitchen/diner and communal living room and individual bedrooms for the service users. The home has a large garden to the rear of the property. The home provides 24 hour staffing and is run by the Step-a-side Care Organisation. The current scale of charges is £2280 to £2678 per week. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced Key Inspection took place on 27th March 2008. The Inspector met with all the service users, the Registered Manager, the Deputy Manager and three members of the staff team. Records relating to care planning, health and safety, staff recruitment and medication were seen. An inspection of the environment was also carried out. The Inspector is grateful to the service users for their co-operation and input into the inspection process. What the service does well: The home provides a service that has been developed to meet the needs of the three current service users. The service has an established staff team that have a good understanding of needs and are provided with good training opportunities. This training provides the skills required to work within the home. The service makes good use of outside professionals to advise and support service users and staff on the care and future development of individuals. The service provides homely and comfortable accommodation that is private but well situated to access the local community. The home supports and encourages services users to be fully involved in the planning of their care and support, and a structured and professional approach is taken to the development of greater independence. The staff work well as a team and are well supported and supervised by the management of the home. Good systems are in place to monitor and evaluate the progress of the home and the effectiveness of the care and support provided, with regular and detailed Regulation 26 reports being complied and feedback provided to the home. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 6 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. Chapel View DS0000068131.V360443.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 Chapel View DS0000068131.V360443.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): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough approach to admissions means that people moving into the home can be confident that their needs will be appropriately assessed and met. EVIDENCE: All three service users living in the home were previously accommodated in other registered accommodation run and staffed by the same Provider. The service has been developed initially, specifically for these people, and their transition and move was managed in a structured and professional manner. There have been no admissions to the home and it is fully occupied. The home’s Statement of Purpose was reviewed in December 2007 and updated to reflect recent changes in the service. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 9 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): Standards 6,7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A more structured and person centred approach to care planning with consistent reviewing has been put into place and this provides clear goals and objectives for service users and should provide improved outcomes for people using the service. EVIDENCE: Person Centred Plans are in place and these are all reviewed on a regular basis with the full involvement of the service users, who were able to explain their role in this. One person described how they had prepared and planned for a recent review. The plans are detailed and appropriate to the needs of the individual service user. The plans contain variety of sections including personal support, managing of money, health and exercise and personal relationships. All plans are dated and signed by both staff and service users. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 10 All full-time staff members have been on an Introduction to Person Centred Planning Course, run by a placing authority. Staff were positive about the effectiveness of this training. Any limitations imposed upon service users are correctly recorded and documented and are made in agreement with the service user concerned. Developing independence and the gradual removal of any restrictions are clear objectives that appear to be well understood by the service users. There are also placement plans and detailed care plans in place but the Person Centred Plan is the key document that guides daily practice and is used by the service users to be as fully involved in planning their futures as interest and ability allows. Records showed that staff complete regular daily recording and this is sufficiently detailed. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 11 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): Standards 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. The home supports the service users to develop individual lifestyles and plan for the future by encouraging the development of independence skills. Service users appear confident about their right to make choices and decisions about their lives. EVIDENCE: People are provided with keys to their rooms and confirmed that their privacy is respected by other service users and by staff. Service users gave examples of how they are supported to develop their social activities and their independence. A weekly “social skills” group is run in the house and all service users said that they benefited from participating in this. Examples were also given to show how appropriate contact with families is supported and maintained. All service users said they were happy with the arrangements in place for them to develop friendships, relationships and maintain family contacts. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 12 Service users have opportunities to put across their views and opinions through the normal working contact with staff and were observed discussing various aspects of their plans and activities with the staff on duty. People also explained how there is a suggestions box and also house meetings in which issues can be discussed. Service users also have designated key-working time with their key-workers. Everyone has individual weekly routines that include college courses, work experience and paid employment. People explained how they had changed some of their activities following discussion with the staff or their key worker. All service users were positive about the choice and quality of food provided and their opportunities to be involved in menu planning and cooking if they choose. On the day of the inspection lunch was prepared by one of the service user with support from staff. This included a variety sandwiches and salad and was of excellent quality and made from fresh ingredients. All food was correctly stored and labelled and the records showed that healthy options are encouraged but choice is always respected. One service user explained how he felt it was important that he learnt about this aspect of his health through staff support. People explained how they are able to access food and drink when they like. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 & 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 healthcare needs are met, promoting their dignity and wellbeing. EVIDENCE: People are supported and encouraged to maintain and monitor their health and develop their awareness of how to do this. There was evidence of appropriate recording. One person described how they are supported to manage their weight and attend appointments. Staff have undertaken medication administration training and all medication storage and recording was examined and found to be in order. People are supported and encouraged to take control of any medication they are prescribed. A Person Centered My Medication form is in use. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 14 People’s health needs are met by the maintenance of individual plans, which include details of particular health issues. The home has had contact with the local Community Learning Disabilities Team, though there is not regular involvement at present. The home has regular visits from a psychologist as part of a contract with the training organisation Studio Three. This involves meetings with the service users and staff and may result in changes to the person centred plans if this agreed. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 15 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): Standards 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has excellent arrangements in place to enable people using the service to raise concerns and complaints, helping them to feel valued and listened to. The home has good procedures in place for the protection of service users. EVIDENCE: The home has a complaints process and procedure in place and this is well understood by the service users, who have used this to address issues that have concerned them. These all related to issues concerning domestic issues within the home. Records are kept of these and showed that the staff are responsive to concerns and work with the service users to find solutions. People were also able to describe the full process and different stages they would need to go through if they wished to make a formal complaint about the home or the care they received. This was an example of excellent practice that empowers service users and helps to ensure people feel protected. Several staff have undertaken “POVA” training and demonstrated a good understanding of the practice issues and their responsibilities in relation to adult protection. There are plans for all staff to undertake this training. Service users were very positive about their relationships with the staff team and appeared comfortable and confident in their surroundings. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 16 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): Standards 24 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is well maintained and decorated throughout and provides a comfortable homely environment. Service users are supported and encouraged to personalise their living space. EVIDENCE: The home is well maintained and decorated throughout and provides comfortable and spacious accommodation. Service users expressed their satisfaction with the home and their bedrooms. People are supported to personalise the home. A recommendation in relation to one bedroom is contained in the Management Standards. The home was clean and hygienic throughout at the time of the inspection. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 17 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): Standards 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a motivated and effective staff team that relates well to them and has a positive approach to their care and support. Regular training helps ensure they have the necessary skills and knowledge to meet the needs of the service users EVIDENCE: The home was fully staffed at the time of this inspection and there has been no turnover of staff since the previous inspection. The home has excellent rates of staff retention and low levels of sickness. All staff spoken with were positive about their roles and the aims and objectives of the care that is provided. People said they worked well as a team with good communication and support in place. Staff receive regular supervision and people said they felt well supported by the Management of the home. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 18 All staff members have undertaken training in Food Hygiene, Child Protection / POVA, Managing Challenging Behaviour, First Aid and Person Centred Planning. The majority of staff have completed NVQ 3 training or are registered on the course. The home plans to have all full time staff qualified to NVQ 3 within the next twelve months. Records show low rates of staff turnover and sick leave. The home does not use agency staff and any additional cover required is provided by the home’s own bank staff, who are well known to the service users. Staff commented that the staffing levels were satisfactory and flexible arrangements meant that additional staffing can be organised for specific events or activities. Regular monthly staff meetings take place and are recorded. Interviews with staff demonstrated that people are motivated and committed to providing good quality care and people were able to demonstrate a good understanding of their roles and responsibilities. All service users were very positive about the staff team and their individual key-workers. Comments included “ the staff are excellent” and “very friendly” and that they “are easy to talk to”. One service commented that they “found it good that you can talk to someone who knows a lot about you and your life”. Service users said they were satisfied with the advice and personal support they receive and that they were treated with respect. They also said that their privacy was respected. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 19 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): Standards 37, 39 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is well managed and organised and committed to providing high quality care and support, with systems in place that help to monitor and improve the quality of the service. EVIDENCE: The home has an experienced Registered Manager, who is also the Manager of the home from which the three current services moved. This service was run by the same Provider. The Manager has a good relationship with the service users and an excellent knowledge of the needs. Service users were very positive about the support and advice they get from the Manager and all said they were happy and confident to approach him on any issue that concerned them. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 20 Staff were also very positive about the Management team and people said they were approachable and supportive. Staff also commented that the knowledge of the Manager of the service users was very helpful to them, and that they were supported to develop their professional understanding of their roles. The Deputy is completing the NVQ Registered Managers Award and it is planned that they eventually take on the Managers role at some point in the future. The Manager is also the Provider and has a wider role within the organisation. All fire testing and recording has been completed satisfactorily and there is a fire risk assessment in place. It was observed that some doors within the home were propped open using wedges and it is recommended that an alternative method be utilised. It is also recommended that the home complete an additional risk assessment in relation to one bedroom that could potentially provide a problem in terms of access. Some precautions are already in place and documented and the issue has been discussed with the service user concerned but there is a need to ensure that the room can be accessed safely in the event of an emergency. Weekly checks are completed by a maintenance team on the house, and staff and service users stated that repairs are attended to promptly. All routine safety tests have been completed and the home has appropriate insurance in place. Regulation 26 inspection shave been carried out on a regular basis and copies of these have been supplied to the Commission and are also provided to the staff and service users. These show that these visits are conducted thoroughly and that clear feedback is provided. These visits will always include consultation with the service users. Interviews with service user confirmed that they are kept well informed about the running of the home and are able to contribute feedback on any issues that concern them. The quality assurance process includes questionnaires and that are circulated to service users and families. The Provider employs an external agency to conduct health and safety inspections of the home and provide reports that are then acted upon. All staff have undertaken training in health and safety. Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 4 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 4 X 4 X X 3 X Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA42 YA42 Good Practice Recommendations The home should find an alternative to the use of wedges for keeping doors open The home should risk assess and provide guidelines for maintaining a safe access to the bedroom identified during the inspection Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Chapel View DS0000068131.V360443.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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