Care Home: Charlbury Avenue

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What the care home does well Information is given to the people at the home and there relatives telling them about the service they can expect to receive and how much they are expected to pay. This is good practice so that everyone is clear about their rights and responsibilities. Everyone has a care plan containing information about their needs and routines so that staff know what support they need to give and how it is to be provided. People are involved in reviewing their care plans so that they can take control over their lives. Everyone is involved in planning activities for the week. People are encouraged to try new activities and supported to do the things they are known to like to do. Pictures are used to help people to choose their activities and what they want to shop for. Staff are friendly and get on well with the people at the home. The people at the home spoke positively about staff and the support they give : "They (staff) help me to go to the shops." "The staff are nice, they are good." "I can do what I like". Everyone is helped to stay in touch with their relatives and to receive their support at planning meetings and care reviews. People`s health needs are well monitored and they are supported to get help from health professionals to help them stay well. People are able to complain if they are unhappy and know that there concerns will be followed up by managers and staff. Overall the home is well furnished and nice and clean, providing a comfortable place for people to live in. Proper checks are carried out to make sure that staff are suitable to work at the home. They are well trained and supervised to make sure they have the skills they need to support people properly. Surveys are carried out to check that the people that live at the home and their relatives get to say what they think of the home so that they can contribute to the ongoing development of the service. Equipment in the home is checked and kept in safe working order so that people have a safe place to live in. What has improved since the last inspection? Licensee agreements have been signed by people to show that they have seen them and had the information explained.People are supported to choose what they want to do each day and the plans are monitored by the manager to ensure that people get out more and go to the places they want to go to. The temperature in the medication cabinet is being monitored closely. There are plans to move it to another area of the home that is cooler so that medication is kept in good condition for people. Staff are now provided with medication training to make sure they understand how medication should be stored and given out safely to people. What the care home could do better: There has been no healthy eating training at the home recently. More training would be helpful to ensure that a greater number of staff are able to support people to plan menus and have a healthy diet. The decor on the stairs is not in very good condition and the stair carpet is worn. Plans need to be made to improve this area to make it look nicer for people. The bedroom locks are opened by individual keys, which could cause delays, evacuating the home in the event of a fire. There is a need to carry out a risk assessment to decide what is the safest way to overcome this potential hazard. Monitoring visits are not being carried out very often. These visits (and reports) are necessary so that senior managers have a clear picture of the the home is operating so that they can give support where necessary. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Charlbury Avenue 2 Charlbury Avenue Chelmsley Wood Birmingham West Midlands B37 5BG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kevin Ward     Date: 2 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Charlbury Avenue 2 Charlbury Avenue Chelmsley Wood Birmingham West Midlands B37 5BG 01217796546 01217796546 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Solihull Care Trust Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users to be accommodated is 4. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 4 Date of last inspection Brief description of the care home 2 Charlbury Avenue is a small home, providing accomodation and care for 4 people with learning difficulties. The Registered Provider is Solihull Care Trust. The home is located in a residential area, close to bus routes for Chelmsley Wood, Solihull and Birmingham. Local amenaties are close by including shops that are within walking distance. The home provides single room accomodation, including one downstairs bedroom with and ensuite. The home is not equipped to meet the needs of wheelchair users. The fees for the service are one thousand and thirty seven pounds per week. Care Homes for Adults (18-65 years) Page 4 of 32 Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use the service experience good outcomes. This was a key unannounced inspection, which addresses all essential aspects of operating a care home. This type of inspection seeks to establish evidence showing continued safety and positive outcomes for residents. Since the last inspection 2 Charlbury Avenue has been re registered with Solihull Care Trust being the Registered Provider. The inspection focused on assessing the main key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file by us, Care Homes for Adults (18-65 years) Page 6 of 32 such as notifications of accidents, allegations and incidents. The inspection included seeing everyone living at the home to get their views of the service. They also completed questionnaires beforehand giving their views. The inspection also included case tracking the needs of two people that live at the home. This involves looking at their care plans and records and checking how their needs are met in practice. Discussions took place with Three staff on duty, as well as the manager and a senior worker. A number of records, such as care plans, complaints records, and fire safety records were also sampled for information as part of this inspection. An annual quality assurance assessment was completed and returned by the provider in time for this inspection, providing the manager’s views of the home’s performance during the last year. What the care home does well: What has improved since the last inspection? Licensee agreements have been signed by people to show that they have seen them and had the information explained. Care Homes for Adults (18-65 years) Page 8 of 32 People are supported to choose what they want to do each day and the plans are monitored by the manager to ensure that people get out more and go to the places they want to go to. The temperature in the medication cabinet is being monitored closely. There are plans to move it to another area of the home that is cooler so that medication is kept in good condition for people. Staff are now provided with medication training to make sure they understand how medication should be stored and given out safely to people. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information about the home so they are clear about the support they can expect from the service. Evidence: Copies of the service user guide were seen on peoples files and on display on the notice board. The service user guide has been illustrated with pictures to make it easier for people to read and understand. Two people at the home also confirmed that they have their own copies that they keep in their bedrooms. One person does not like to keep any documents in their bedroom and has refused to have a copy. The Statement of Purpose was also on display. These documents provide a good picture of the service provided at the home. The manager said that the service user guide has also been sent to relatives so that they can be clear about the support people are entitled to receive from the service. The home has recently been re-registered with Solihull Care Trust. The manager said that the service contract is being revisited to clarify any changes in responsibilities on Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: the part the Housing Association and the Care Trust that may have resulted. The manager said that any changes in responsibility would be included in the service user guide e.g any changes to transport charges made by the Trust. Two peoples files were checked. Both contained letters from the Local Authority, advising them of the fees for the current financial year. Both files also contained Housing Association licensee agreements detailing their rights and responsibilities whilst at the home. These documents have been illustrated with pictures to make the information easier to understand. No new people have moved into the home since the last inspection. The manager confirmed that anyone moving to the home would have their needs assessed with the involvement of a social worker and the home manager. The manager anticipated that no new people would be admitted to the home in future as there are plans to close the home and support people to move to other accommodation. Care Homes for Adults (18-65 years) Page 12 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are planned for and reviewed with their involvement so that staff have the information they need to support people sensitively. Evidence: Two peoples care plans were checked. Both care plans contained satisfactory levels of information for staff to support people. The people are at the home are largely independent in most aspects of personal care but require some prompts and a little practical support. Individuals daily routines are recorded to enable staff to support them in a sensitive manner. Staff demonstrated a good knowldege of peoples needs and of their known preferences and routines, e.g how they like to rise and the order in which they like to do things, such as wash and take breakfast. The files include information to enable staff to support people in a safe manner, such as risk assessments for travelling, fire safety, epilepsy and a range of lesiure activities, such as bowling and swimming. Extra guidlines were seen on file, where necessary, Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: e.g to manage challenging behaviour, health conditions and dietary advice. The records show that other professionals, such as Psychologist and speech therapist have been used to support the development of the guidelines. The people at the home confirmed that they are involved in their care plan reviews and other planning meetings. This was verified in social work review records. The people at the home are also involved in monthly consultations to monitor their ongoing care and support needs and to set new objectives with them. In surveys returned by the people at the home they confirm that they are able to make make everyday choices about what they eat and what they do. Weekly meetings are routinely held with the people at the home to plan the menu. Their choices are then recorded on the menu sheet. Staff were seen to encourage people to choose and take part in making their breakfast and drinks. The people at the home confirmed that they had been consulted over the decor and furniture in the home and go shopping to choose their own clothing and personal items. Care Homes for Adults (18-65 years) Page 14 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people at the home are supported to gain access to a good range of activities and to stay in touch with friends and relations so that they enjoy a valued lifestyle. People are involved in planning menus so that they get to eat the food they enjoy. Evidence: The people at the home confirmed that they meet together each week to plan their activities. The chosen activities are then recorded on individual records and an activities sheet in the kitchen. A record of peoples preferred activities are recorded in the activities file to help staff with ideas for activities if necessary. Pictures of leisure activities, places to visit and items to buy are used to help people to make their choices. The activities recorded on the chart were observed to include a number of those listed on peoples list of preferences indicating that their choices are respected. A staff photo board is on display in the kitchen. A staff member explained that this is Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: updated daily so that the people at the home know who will be arriving on duty to support them. The people at the home said that they liked living there and enjoyed their activities. One person attends a day service 3 days a week and is supported to enjoy leisure pursuits on other days, such as visits to garden centres, shops, pub and watching their favourite football team. The person concerned is a season ticket holder for Birmingham City Football Club and said they go to see the home games with support from staff. They also subscribe to Sky TV football programmes to follow their interest in football. Another person said they enjoyed going to college, where they attend life skills and photography classes. They also said they enjoy going to horse riding, pub, karaoke, Tai Chi and using a foot spa. Other examples of recorded activities included, college courses, music and drama classes, meals and drinks out and shopping. Staff confirmed that everyone is encouraged to maintain their independence, e.g. carry out household chores, such as tidying their bedrooms and making breakfast. People were observed to bring their laundry out their rooms to be loaded in the washing machine. Staff explained that everyone is involved in shopping for groceries and the manager reports that everyone collects their money from the bank with staff support. Everyone said that they go to the local hairdressers to have their haircut and one person explained that she also has her arms waxed regularly. A person at the home explained that they had been on holiday with staff. A staff member explained that everyone goes on holiday individually with the support of two staff. The people at the home confirmed that they are supported to maintain contact with family and friends. One person explained that they had been to a family party at the weekend. Entries in peoples dairy records and care review notes show that relatives are encouraged to support people in meetings to review their care and plan for their futures. An advocacy service has also been identified to help people to plan their future living arrangements. An advocate was seen visiting the home during the site visit. As previously noted the people at the home take part in planning the menu together each week. Everyone said that they enjoyed the food provided and confirmed that they take part in shopping and choosing groceries. Staff were observed to encourage people to take part in making their breakfast and one person said that they enjoy doing some Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: cooking. Comments by staff indicated a satisfactory awareness of peoples dietary needs and that they they try to balance healthy eating with peoples choices by buying low fat yogurts and spreads and encouraging fruit snacks rather than too many crisps and biscuits. Fresh fruit was available in a bowl for people to eat. The manager said that a small number of staff had previously been provided with healthy eating training and said that he would arrange for more staff to attend training on this subject to ensure that everyone is kept up to date in this aea of practice. One of the staff on duty confirmed that they had been provided with healthy eating training several years ago. Care Homes for Adults (18-65 years) Page 17 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with support and access to health professionals so that they are assisted to stay in good health. Evidence: The people at the home confirmed that they enjoy flexible age appropriate bedtimes and can sleep in on days when they dont have appointments to go to if they wish to do so. On the morning of the site visit two people slept in late following a busy weekend. One person got up earlier to get ready to attend the day service. The person concerned got dressed slowly and follows a personal routine that they do not like to change. Staff were seen to follow the routine and support the person concerned in a sensitive and unhurried fashion. Comments made by people living at the home indicate they like them. One person said the staff are very good and another said I like them. The peope at the home looked very at ease and relaxed in the company of staff and when approaching them for help and advice. Some friendly banter was observed beween staff and the people in the home contributing to a friendly relaxed atmosphere. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: Everyone was dressed in age appropriate, modern clothing, indicating that they are supported to take pride in their appearance and maintain a good self image. Everyone was encouraged to get washed and dressed independently with support provided only where necessary. In this way people retain their independence. Two females living at the home were supported to paint their nails, in keeping with their wishes. A person of African Caribbean background has been provided with culturally appropriate hair products and is supported to use an African Caribbean hairdresser, to meet their haircare needs. Entries in care plans, review notes and health records show that people are being supported to gain access to health professionals to meet their health care needs. For example one person has seen the GP and specialist regarding physical health issues and received advice from the psychiatrist and psychologist to support good mental health. Guidelines are in place for a person with occasional challenging behaviour. A staff member demonstrated a satisfactory understanding of the guidelines and of appropriate approaches to reduce the likelihood of behaviours escalating. Staff explained that the use of PRN (as necessary) medication to help manage behaviour is extremely rare. This was verified in medication records. Entries in peoples health records show that they are helped to attend routine check ups, such as well person checks, dentists, opticians and chiropodist. Two peoples weight charts were checked. One persons weight is being routinely charted, whereas the other persons weight was being recorded irregularly. The manager said that he would ensure this is addressed and weight records are monitored more closely. This is necessary to help identify any health issues that may be related to changes in weight. The medication cupboard was tidy and well ordered and creams were found to be in date. Guidelines are in place in front of each persons medication record stating how they like to take their medication. A member of staff giving out medication was seen to give a person a blackcurrant drink, in keeping with the guidelines. Records are now in place for keeping track of non blister packed and PRN (as necessary) medications that are given out. The record includes a running total of tablets left in the packet after medication is given out so that it can be accounted for quickly and easily. Two peoples PRN medication was counted and found to balance correctly with the records. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: Guidance was seen on peoples medication records for the use of PRN medications and guidelines are in place for managing behaviour appropriately where necessary without resorting to the use medication. A record has also been introduced for staff to record the effect of PRN medications given to people. In this way they can assess if it has a beneficial or adverse affect, to help inform medication reviews. Two staff spoken to confirmed they had been provided with medication training including recent distance learning workbooks. They explained that before being allowed to give out medication they are observed and assessed by senior staff. Copies of the assessments and staff training records were seen on file as verification of this. The medication cabinet is in the kitchen and may get hot on occasions. A record is now being kept to monitor the temperature of the cupboard to ensure that medication is stored at an appropriate temperature. Care Homes for Adults (18-65 years) Page 20 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place for investigating complaints and staff are trained to recognise and report suspicions of abuse so that people are protected from harm. Evidence: There has been one complaint made to us about the home since the last inspection. This has been referred to a senior manager in Solihull Care Trust to investigate. The complaint concerns allegations of staff drinking on duty when taking people at the home for a drink. The manager reports the complaint has been investigated and not been upheld. However stricter protocols have been put in place for sanctioning activities beforehand with managers, including any trips to the pub. An illustrated copy of the complaints policy is contained in the service user guide which is on display in the hallway. The people at the home have also been issued with their own copies and the manager confirmed that copies have also been sent to peoples relatives. More complaints information, including photographs of the manager and assistant manager, to whom people may complain, is on display in the kitchen. Two people at the home said that they would see the manager or the assistant manager if they had any concerns. Staff at the home confirmed that they had received training to recognise and respond to suspicions of abuse. This was verified in staff training records provided by the Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: manager. Two allegations of abuse have been made against agency staff placed at the home. These matters have been appropriately referred to social workers to investigate under the safeguarding procedures. The manager confirms that the staff concerned are not allowed to work at the home whilst investigations are being completed. The manager explained that everyone at the home receives support to fetch their money from the bank. This was verified by a person living at the home. Two peoples expenditure records were checked. Staff sign the record to show money withdrawn from the bank and what money is spent on. Receipts are being kept for auditing purposes and the manager said that these are checked at the end of each month. Monthly returns, signed by the assistant manager, were seen as evidence of this. Care Homes for Adults (18-65 years) Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and comfortably furnished so that people benefit from a homely, comfortable living environment. Evidence: 2 Charlbury Avenue is a normal house that fits in well with others in the street. The home is comfortable and homely. A new leather suite and a new carpet have recently been provided in the lounge. The people at the home confirmed that they were involved in choosing these items. Peoples bedrooms have been personalised to reflect their choice, personalities and interests, such as photographs of relatives. One bedroom has recently been redecorated. The person using the room explained that they chose new curtains and bedding to match the walls. Another persons bedroom has been decorated in Birmingham City wallpaper and other football memorabilia is also on show. The wallpaper in the hallway is lightly soiled in places where people brush past. The manager said that he has reported this area for redecorating this year. Similarly the stairs carpet is looking worn and wearing thin in places. Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: Domestic style toilets and bathrooms are in place. The bathrooms were clean and fresh for people to use. Everyone living at the home is able to walk so there is no need for any specialist equipment to help them to bath safely. Protective aprons and gloves are available for staff to use and red disolvable bags have recently been provided to help manage occasional, light continence laundry safely. Three staff on duty in the morning confirmed that they had received infection control training. Cleaning schedules are in place that sign to record that cleaning tasks have been carried out, including kitchen equipment. Overall the home was clean and free from any unpleasant odours. Care Homes for Adults (18-65 years) Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are properly vetted and trained so that the people at the home are supported by suitable staff equipped to meet their needs. Evidence: Staff explained that there are typically two or three staff on duty to support the three people that live at the home to go about their daily activities. This was verified in staff rotas. The rotas show that typically the assistant manager or the manager are also on duty at the home. Staff confirmed that they are always able to access out of hours managerial support and on call rota was seen with managers telephone contact details. The home also provides a waking night care worker and a sleep in worker so that sufficient support is available during the night, where necessary. Three staff spoken to confirmed that everyone is provided with the full range of Health and Safety related training, such as fire safety, first aid, food hygiene, moving and handling, challenging behaviour and safeguarding abuse. This was verified in staff training records. Staff are also being provided with training in medication and autism. The manager explained that the community nurse has also provided epilepsy training and reinforced good practice in respect of record keeping for monitoring seizures. A senior member of staff explained that certificates had not been issued for this training Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: and said she would arrange for a staff attendance list to be kept on file, as verification of the training. The three staff on duty in the morning all confirmed they all held National Vocational Qualifications. The manager reports that nine staff have completed National Vocational Qualification level II training and the remaining three staff are in the process of doing these courses. The manager reports that he has now completed equality and diversity training and that this training is now being provided to staff. This was verified in comments by staff and in the training plan. This training highlights the need to see people as individuals with their own specific needs and preferences to be respected. The manager said that there have been no new staff employed at the home since the last inspection. The files of two staff appointed previously were checked. Both files contained evidence to demonstrate that proper vetting checks, such as Criminal Record Bureau Checks and references are being taken up before staff start work at the home. The manager explained that a two day organisational induction is in place at the start of the month for new staff, in addition to the homes induction that staff (including agency staff)are taken through when they first start at the home. Three staff, spoken to, confirmed that they are provided with regular supervision training. Evidence of this was seen on staff supervision records. Care Homes for Adults (18-65 years) Page 26 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable arrangements are in place for quality assurance and consulting with the people so that they can contribute to the quality of the service provided. Suitable procedures are in place for maintaining a safe place for people to live and work in. Evidence: The manager has many years experience of working with people with learning difficulties. He holds the National Vocational Qualification (NVQ) level 3 in Promoting Independence and the NVQ level 3 in Management. The manager also reports he is in the process of completing the Leadership and Management of Care level 4. These qualifications are necessary to equip him for the role of registered manager. A range of quality assurance measures are in place at the home. Surveys have recently been sent the people at the home and their relatives to complete to give their views of the home. The manager said that he would be collating the responses and address any issues that the consultation may raise. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: Staff meetings take place on a regular weekly basis. The records show that these meetings are used purposefully to discuss and reinforce changes to peoples care support guidelines as well to discuss policy and practice issues. Shift handover meetings take place between shifts to pass on relevant information to staff arriving on shift. Weekly home audits are carried out and recorded by the assistant home manager, covering a range of issues in the home, such as petty cash, fridge temperatures, fire equipment tests, menus and medication. Monthly medication audits were seen on file and six monthly audits of the medication system are also carried out by a medicine management technician from within the Care Trust. Housing Association managers carry out quarterly vists to the home (reports seen) to make plans to address any maintenance issues. Monitoring visits on behalf of senior managers are not being carried out regularly each month. To date there have only been three reports of visits provided to the home since April 08. The manager said that a new person has recently been employed with specific responsibilities for this role. These visits are necessary to demonstrate that there is external management oversight of the work of the home so that any issues that require their support and intervention may be promptly addressed. The fire log was checked. The records show that alarms and lights are being tested routinely to make sure they work and frequent fire drills are recorded. Certificates were seen, providing evidence that fire safety equipment is being properly maintained by a professional contractor. A hot water monitoring record was seen, verifying that hot water temperatures are regularly checked to ensure that people are not placed at risk of scalding. The electrical equipment has been tested to make sure that appliances are safe to use a landlord gas safety certificate was seen, as evidence that the boiler has been serviced. An in house fire safety audit was carried out in January 08 at which a small number of recommendations were made. The manager reports that the majority of the work has been carried out with the exception of a recommendation that the bedroom door locks should all be put on the same key suite so that only one key is required in the event of a fire. The manager said that the matter has been referred to the appropriate risk management department within the Care Trust to decide on the most appropriate course of action. The bedrooms are fitted with locks that can be opened easily from the inside without the need to use keys. The manager said that in the meantime he would risk assess the situation and colour code the bedroom door keys so that staff are clear which keys open each individuals bedroom doors, in the event that they Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: need to gain access in an emergency. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 17 Proceed with plans to increase the number of staff with healthy eating training so that more staff are better equipped to plan the menus, to ensure they meet peoples dietary needs as well as their choices. Plans should be made to redecorate the staircase and replace the stair carpet, which is worn, so that people benefit from a nicer living environment. Monitoring visits should be carried out each month on behalf of senior managers. This is necessary to demonstrate that senior managers have a clear overview and understanding of any issues at the home which they may need to address. Action should be taken to risk assess the need for a common suite of locks and a master key for staff to peoples bedrooms for staff to use in the event of a fire at the home, as recommended in the organisations own fire safety audit. The risk assessment is necessary to decide on the most appropriate measures to be put into place, to ensure that people are safe in the event of a fire. 2 24 3 39 4 42 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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