Care Home: Church Road (104)

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What the care home does well The service continues to employ longstanding members of staff who offer great stability to the home. Members of the staff team appeared to know people well and have formed good relationships. Some people are provided with work experience and attend local day services in accordance with their wishes and abilities. They also have their own contract for their work placement to show what terms and conditions they can expect. The personal support plans gave enough information to show how each persons personal care and support would be met. They showed how each person would be supported with a range of diverse needs including their medical needs and support with communication. The staff have developed records called, "communication passports." These records are developed over time by staff who get to know each persons needs, choices and behaviours. The passports are a good example of the time taken by staff to produce records that help everyone to be kept updated in each persons likes, dislikes and choices, helping people be supported in all aspects of every day life. This is an example of how much input and development the organisation go to, to continually improve the support and care provided at Church Road. Regular checks are made on the safety of the building and equipment to make sure the service is a safe place to live. What has improved since the last inspection? The service has produced good information and brochures about the home which uses some pictures. They give these documents to people who are thinking about moving there. They have procedures in place for assessing peoples needs including trial visits and overnight visits to help people make a choice about the service. The society`s aims and plans for the future are published in a document called, " Our future strategy for 08/09-2012/13". This has helped to keep everyone involved and updated with the aims of the organisation. Medications are appropriately managed, providing a safe system of supporting people with the administration and storage of their medications. The service had procedures for responding to concerns and complaints and for making sure that people have a pictorial complaints procedure which is clear to read and understand. The commission have not received any complaint about the service following the last inspection. There have been no additional visits to the service since our last visit to Church Road. The company and staff have also managed to deal sensitively with one subject that is often difficult to discuss. They have produced a sensitive document requesting information regarding bereavement. The questionnaire helps identify personal wishes such as, "are there any instructions or personal requests ." The manager had developed training action plans, so each time a person attendstraining they complete a training action plan. This asks them what they had learned and how they would bring the knowledge and skills back to the workplace. This is an example of good practice in developing staffs skills and knowledge after receiving various training. The manager now has 66 per cent of staff with an nvq ( care )qualification and are hoping that this will be 100 per cent very soon. This is an example of how they have exceeded the basic guidance which suggests that at least 50 per cent of staff should have a care qualification. As an example of good practice the manager explained how they have included people living at the service in the interviews and recruitment of staff. A staff satisfaction survey dated Oct 08 was overall very positive with 3/4 of the staff team, "...feeling the society is a good place to work..." We have received 4 staff surveys all positive and they ticked the boxes indicating no problems. Comments made in surveys sent to us were quite positive including, "House manager is always keeping staff up to date with changes in new ways of working." "clients needs are always updated on a regular basis..." "Specialist training regarding autism also enables staff to give correct support to clients...." "CRB was checked before starting employment...." "All mandatory training was done before I was able to work alone...." We received one survey from a medical professional who was overall very positive in their comments about the service, stating, eg, "individualized care appropriate for persons disabilities." "Continue to develop as they have always done." What the care home could do better: Full feed back was given to the manager both during and on conclusion of our visit.The service is meeting the vast majority of the national minimum standards and has met all of those assessed on this occasion. In a number of respects these standards are being exceeded. The manager continues to look at ways in which the service can be exceeded. The manager should have clear procedures and records to show how each persons finances are managed. This will help to provide clear and transparent financial procedures accessible to everyone. People should be included in the management procedures offered in managing their finances. Capacity assessments will help show they are managed in each persons best interest. Staff training records must be up to date to make sure that staff are updated in their practice and able to safely and appropriately support people living at Church Road. To provide information for everyone at Church road as to whether any of the proposed developments would be carried out and if so when, so they can be kept informed andincluded in the developments of their home. To research the current water pressure to see if any actions can be taken to improve on the supply for the pressure in the shower. To look at the heating in one bedroom and see if anything can be done in helping give one person the increased heating they request. To carry out monthly visits and to include the opinions of people at Church Road while carrying out monthly checks, (regulations 26 visits) so that their views can be considered regarding the service. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Church Road (104) 104 Church Road Bebington Wirral CH63 3EE     The quality rating for this care home is:   three star excellent 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: Diane Sharrock     Date: 2 7 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: Church Road (104) 104 Church Road Bebington Wirral CH63 3EE 01512011923 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jane.roberts@wirral.autistic.org Wirral Autistic Society Name of registered manager (if applicable) Jane Anne Roberts Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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 - Code LD The maximum number of service users who can be accommodated is: 2 Date of last inspection Brief description of the care home 104 Church Road is registered to provide personal care for two adults with autism. The home is a two storey semi-detached property located in a residential area. On the ground floor there is a lounge, a kitchen and a dining room. On the first floor there are two single bedrooms, an office/staff room, and a bathroom. There is a patio and a garden to the rear of the home. Parking is available on the drive or on the main road. 104 Church Road is close to local shops and to public transport services. The home is run by Wirral Autistic Society who have several care homes for adults with autism in the area. Wirral Autistic Society provides a range of services and facilities, which are fully utilised by people, accommodated at 104 Church Road. The weekly cost for the service ranged from 1130.00 pounds to 1281.00. pounds. A copy of the statement of Care Homes for Adults (18-65 years) Page 4 of 32 2 Over 65 0 care home 2 Brief description of the care home purpose, which describes the services offered at 104 Church Road, is made available to everyone including relatives and social workers. 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: three star excellent 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 overall quality rating for this service is 3 star. This means that people who use the service experience excellent quality outcomes. This unannounced visit took place on the 27th January 09 over a period of 4 hours. This was carried out with the help of the registered manager and the staff on duty and the people living at Church Road. We gathered information for this visit in a number of ways. We (the commission) looked at records and included both staff and people living at the services comments and opinions. Observations made during our visit have also been used as evidence for this report. Care Homes for Adults (18-65 years) Page 6 of 32 Case tracking was used as part of the visit to the service. This involves looking at the support and care a person gets from the staff including their support plans, medication, money and their living conditions. Inspections involve measuring a number of standards considered as important by the commission. A selection of comment cards were also sent before the inspection and we left some more to offer people further opportunity to give their opinions. The manager completed a questionnaire we sent before our visit. The information from this was used by us to plan this visit and in writing this report. The document was completed and was returned to the commission before this visit took place. What the care home does well: What has improved since the last inspection? The service has produced good information and brochures about the home which uses some pictures. They give these documents to people who are thinking about moving there. They have procedures in place for assessing peoples needs including trial visits and overnight visits to help people make a choice about the service. The societys aims and plans for the future are published in a document called, Our future strategy for 08/09-2012/13. This has helped to keep everyone involved and updated with the aims of the organisation. Medications are appropriately managed, providing a safe system of supporting people with the administration and storage of their medications. The service had procedures for responding to concerns and complaints and for making sure that people have a pictorial complaints procedure which is clear to read and understand. The commission have not received any complaint about the service following the last inspection. There have been no additional visits to the service since our last visit to Church Road. The company and staff have also managed to deal sensitively with one subject that is often difficult to discuss. They have produced a sensitive document requesting information regarding bereavement. The questionnaire helps identify personal wishes such as, are there any instructions or personal requests . The manager had developed training action plans, so each time a person attends Care Homes for Adults (18-65 years) Page 8 of 32 training they complete a training action plan. This asks them what they had learned and how they would bring the knowledge and skills back to the workplace. This is an example of good practice in developing staffs skills and knowledge after receiving various training. The manager now has 66 per cent of staff with an nvq ( care )qualification and are hoping that this will be 100 per cent very soon. This is an example of how they have exceeded the basic guidance which suggests that at least 50 per cent of staff should have a care qualification. As an example of good practice the manager explained how they have included people living at the service in the interviews and recruitment of staff. A staff satisfaction survey dated Oct 08 was overall very positive with 3/4 of the staff team, ...feeling the society is a good place to work... We have received 4 staff surveys all positive and they ticked the boxes indicating no problems. Comments made in surveys sent to us were quite positive including, House manager is always keeping staff up to date with changes in new ways of working. clients needs are always updated on a regular basis... Specialist training regarding autism also enables staff to give correct support to clients.... CRB was checked before starting employment.... All mandatory training was done before I was able to work alone.... We received one survey from a medical professional who was overall very positive in their comments about the service, stating, eg, individualized care appropriate for persons disabilities. Continue to develop as they have always done. What they could do better: Full feed back was given to the manager both during and on conclusion of our visit.The service is meeting the vast majority of the national minimum standards and has met all of those assessed on this occasion. In a number of respects these standards are being exceeded. The manager continues to look at ways in which the service can be exceeded. The manager should have clear procedures and records to show how each persons finances are managed. This will help to provide clear and transparent financial procedures accessible to everyone. People should be included in the management procedures offered in managing their finances. Capacity assessments will help show they are managed in each persons best interest. Staff training records must be up to date to make sure that staff are updated in their practice and able to safely and appropriately support people living at Church Road. To provide information for everyone at Church road as to whether any of the proposed developments would be carried out and if so when, so they can be kept informed and Care Homes for Adults (18-65 years) Page 9 of 32 included in the developments of their home. To research the current water pressure to see if any actions can be taken to improve on the supply for the pressure in the shower. To look at the heating in one bedroom and see if anything can be done in helping give one person the increased heating they request. To carry out monthly visits and to include the opinions of people at Church Road while carrying out monthly checks, (regulations 26 visits) so that their views can be considered regarding the service. 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 10 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 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is given to anyone thinking about moving into the home. This makes sure that the home is the right place for the person to live and that their needs and be met. Evidence: The manager has developed a residents guide and a statement of purpose which are available to anyone including any prospective person wanting to live at the home. The guide includes good levels of information on the purpose of the home and the facilities on offer and includes visual pictures which may help some people understand the information given. The manager plans to develop this document further with the use of more pictures to describe the service. Good information is given to any new prospective person including the option of having a trial visit to the home. This makes sure the home is the right place for the person to live in and and that their needs can be met. This happened last year were one person was supported in having a trial visit to the service to see what they thought before Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: they made any decisions to move in. We received 2 surveys from people living at the home and one comment made said, Came to look around had dinner with client and staff on several occasions before deciding to move. Following our last visit the manager explained that they had been unable to get any advocate to help support people at the service. The manager then approached the local authority to help support people with the review of their terms and conditions and review of their support packages. They have not signed documents on behalf of people who live at the service but they have attended reviews and agreed with the reviews and terms and conditions. Care Homes for Adults (18-65 years) Page 13 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. The individual needs and choices of the people living at 104 Church Road are identified so that staff can support them to meet those choices and all aspects of daily living. Evidence: Detailed individual support plans were available for each person. Each person has a person centred plan in place. These plans have lots of pictures to help each persons understanding and help keep everyone updated about the person. This includes things such as what they like and dont like to do. The plans were detailed and regularly reviewed and gave enough information to show how their personal, medical and social needs would be met and covered a diverse range of needs. The staff have developed records called, communication passports. These records are developed over time by staff who get to know each persons needs, choices and behaviours. The passports are a good example of the time taken by staff to produce records that help everyone to be kept updated in each persons likes, dislikes and Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: choices, helping people be supported in all aspects of every day life. In discussions with staff they were able to explain the way in which people living there make decisions and how they are able to decide for themselves. For example, staff support people in going out almost daily. Staff were fully knowledgeable about each persons needs and could explain how they supported each person with communicating their needs. Staff were observed to be respectful and seemed to have a good rapport with each person. We looked at a sample of financial records kept at the service of personal allowances which were well kept and accurate and in good order. However the manager explained that various monies were stored and managed at head office. There was no evidence of whether capacity assessments had taken place. It wasnt clear as to whether peoples mobility benefits were used for the use of the communal vehicle or whether permission or assessment had been sought regarding the use and management of it. Care Homes for Adults (18-65 years) Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at 104 Church Road are supported so they can live a lifestyle of their choice. Evidence: We had discussions with people and looked at records which showed that the people living at Church Road always receive the support they need to get out and about in their local community. Most comments made were quite positive including, House manager is always keeping staff up to date with changes in new ways of working. During our visit we met people who live at Church Road. Most people are out at work each day or at the day centre in accordance with their wishes and abilities. If someone has a job within the organization they are provided with a contract which is very detailed in explaining their terms and conditions. Each person is provided with a range Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: of opportunities to help their personal development and they have a time table of activities that they would do during the week. Each persons file showed that staff do try to plan social events and activities and also carry out risk assessments to help make activities as safe as possible. Staff explained that people pay for their own holidays and there are no funds provided by the company. The service shares a communal vehicle with another local house which was in use during our visit. The records around the management and funding of the communal vehicle wasnt clear. This needs to be reviewed to show that everyone is included and in agreement to the current arrangements regarding who manages, maintains and funds this service. The manager organises regular house meetings to discuss the running of the home. We looked at recent minutes and they showed good discussions on everything at the home keeping everyone informed and included in developments of their home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual support and healthcare needs of the people living at Church Road are identified, so that staff can support them to meet those needs to keep safe and healthy within all aspects of daily living. Evidence: Detailed individual support plans were available for each person. The plans were detailed and regularly reviewed and gave enough information to show how their personal, medical and social needs would be met and covered a diverse range of needs, including , eg, optical check ups and hospital checks on any medical condition. The system for recording health checks also makes sure that each person is offered regular health checks. These sections were called, My personal health profile. They were all regularly updated and gave details of any health concerns or conditions the doctor or hospital were treating. The company and staff have also managed to deal sensitively with one subject that is often difficult to discuss. They have produced a sensitive document requesting information regarding bereavement. The questionnaire helps identify personal wishes Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: such as, are there any instructions or requests, arising from the individuals ethnicity, culture or religion that effect how the individual should be treated after death. We met some people living at the service and generally chatted to the staff during our visit. Most comments made were quite positive including, clients needs are always updated on a regular basis... Specialist training regarding autism also enables staff to give correct support to clients.... We received one survey from a medical professional who was overall very positive in their comments about the service, stating, eg, individualized care appropriate for persons disabilities. Continue to develop as they have always done. We looked at the storage and procedures of managing medications at the home and they were found to be well maintained and safely managed. Staff who support people with their medication have received previous training in dealing with medication. The medications records were very detailed and everyone had worked hard to offer accurate and up to date medication records, providing a safe system of supporting people with the administration and storage of their medications. This was also clear in how they support people to be as independent as possible and to safely manage their own medications. Risk assessments and support plans show how support is offered and the service has lockable storage provided for medications to help reduce any identified risks. Care Homes for Adults (18-65 years) Page 19 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. People are protected by the homes procedure for responding to concerns and complaints. Evidence: The organisation has policies in place for dealing with complaints and safeguarding issues and these provide guidance for everyone. Information about how to raise a concern or complaint is made available to the people living at Church Road. Staff have developed this policy using pictures to help everyone understand how they can be supported in making their views and concerns known. There is a book in the home for recording complaints received about the service. They had recorded approximately 5 for 2008. They had detailed records showing they were listening to peoples concerns and taking some actions in helping people feel better about their concerns. Following our previous visit the manager explained she had contacted a local advocacy team to request they support people who did not have any next of kin. She explained that due to their restrictions of staffing levels and workloads they were unable to offer assistance with advocacy. The manager submitted the training plan for staff at 104 Church road following our Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: visit. It gave details of the training already identified for staff. This helped keep all staff up to date in all necessary policies and procedures including abuse awareness. We discussed the various training that staff had attended including, safeguarding and abuse awareness. However in looking at training records it was noted that some records had not been updated and were in need of review. Staff explained that they are usually provided with just one training session on safeguarding. There was no other evidence of how staff are updated in this area during their employment or how they keep up to date with this topic. We looked at financial records which were well kept, accurate and in good order. People at the service had financial records in place, however they did not include how their money was being managed or stored at head office. Care Homes for Adults (18-65 years) Page 21 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. People live in a safe, comfortable and well maintained home. Evidence: We were shown around the home and looked at a sample of areas. Each person has their own bedroom were they are encouraged to have personal belongings and to individualize the room the way they want. They also have their own key and can have complete privacy of their own room by keeping their door locked when they choose to. One person felt the pressure of water in the shower room was too low and that the heating in their bedroom was not hot enough for them. Staff explained that some of the neighbours also had problems due to the low water pressure in the area. The lounge is furnished with colour co ordinating furnishings. The kitchen and dining room offer a domestic style facility accessible to everyone. The home was decorated to a good standard offering a homely and well presented environment to live in. We looked at a sample of maintenance certificates. They showed up to date checks as listed in the homes pre inspection questionnaire which helped show what actions were taken to keep the home safe and well maintained. Risk assessments were detailed and regularly reviewed showing what actions are taken to always maintain peoples safety. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: The manager forwarded details of what developments she had identified would be needed for Church Road, such as, needing an allowance for community days to cover staffing, food and outings, extra hours to help hand overs at the weekend, a new washing machine, a Vax between the two services at church road, new garden furniture, to decorate the lounge and bathroom and to put a door under the stairs to make a cupboard. The manager also identified the benefits of the service having their own vehicle rather than sharing with the other service. There were no details from the organization regarding when any of these requests were being carried out. Care Homes for Adults (18-65 years) Page 23 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. People are supported and protected by the services recruitment and selection procedures. Evidence: We spoke with staff and looked at staff training records which showed what training had been provided. Most of the records were kept at head office and the manager had been able to develop her own training records. Following our visit the manager submitted updated records for 2 staff at the service. These records showed that staff undertake a variety of training to help them support people. This included diverse needs and areas such as, eg, health and safety, food hygiene, epilepsy, abuse awareness, moving and handling, first aid. Some dates for training were last recorded as 31/10/06 for epilepsy. We did not see a training development agreement which would advise staff of the organisations commitment to keep them updated with training and would identify how often they could expect to be supplied with necessary training and refresher training. The manager felt that some training was considered a one off and a refresher was not needed ie medication, fire training, safeguarding and epilepsy. The manager explained they had developed training action plans, so each time a Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: person attends training they complete a training action plan. This asks them what they had learned and how they would bring the knowledge and skills back to the workplace. This is an example of good practice in developing staffs skills and knowledge after receiving various training. The manager stated they now has 66 per cent of staff with an nvq ( care )qualification and are hoping that this will be 100 per cent when the remaining one person finishes their training. This is an example of how they have exceeded the basic guidance which suggests that at least 50 per cent of staff should have a care qualification. Records showed that before anyone is appointed to work at Church Road they have a series of checks which are carried out. These include obtaining written references and checking with the criminal records bureau (CRB). These checks help to make sure the people living there are safe and that staff are suitable to support them. These records are currently stored at head office and the manager has to go the the main offices to access this information. As an example of good practice the manager explained how they have included people living at the service in the interviews and recruitment of staff. We have received 4 staff surveys all positive and they ticked the boxes indicating no problems. Comments made included, clients needs are always updated on a regular basis... CRB was checked before starting employment.... All mandatory training was done before I was able to work alone.... House manager is always keeping staff up to date with changes in new ways of working. Specialist training regarding autism also enables staff to give correct support to clients.... Care Homes for Adults (18-65 years) Page 25 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. The home is well managed and the health and safety of everyone at the home is is promoted and protected. Evidence: Church Road continues to benefit from an experienced and appropriately qualified manager who is able to demonstrate that she effectively manages the service in the best interest of everyone living there. The manager has an open and positive management approach. The manager is responsible for 3 other small homes situated locally and owned by Wirral Autistic society. The home is effectively managed and any development is in the best interests of people living there ensuring a good quality of service is provided. eg, The manager meets with everyone on a regular basis and the minutes of these meetings shows good communication keeping everyone up to date and included with the developments of their home. Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: The home is visited on a regular basis by a representative of the organization. These visits form part of the quality assurance process and form an opinion on the standard of care provided. These visits are also a requirement of the care home regulations and a report has to be produced to show evidence of these checks. The manager acknowledged that the reports had not always been been done, however one was done recently but they were not always fully completed to include views from people at the home. The organisation had developed a publication of a recent staff satisfaction survey dated Oct 08. Overall it was very positive with 3/4 of the staff team expressing comments such as, feeling the society is a good place to work. The organisation were able to use the survey for a benchmark to the future and following the survey the Chief Executive of the company visited each establishment to discuss the findings and the developments for the future. This published document was called, Our future strategy for 08/09-2012/13. This has helped to keep everyone involved and updated with the aims of the organisation. TThere were various comments and compliments from staff regarding the manager and her role within the service. Staff comments were very positive about working within the organisation, one comment stated, House manager is always keeping staff up to date with changes in new ways of working. Records and certificates showed that regular checks are carried out on the building and equipment. This includes checking electrical appliances, the gas supply and regular fire checks. These checks help to make sure that the home is well managed and is a safe place to live and work in. The manager explained that various records such as, personnel files and financial records are usually kept at head office. This meant that the manager was not always in receipt of nessessary records covering Church Road. We discussed the managers responsibilities within the care home regulations wereby all necessary information should be accessible to her. This will allow her to evidence that the service is safely managed and show evidence of good practice and management of finances and personnel checks. The manager produced various detailed monthly audit reports that she carries out to make sure that the service is being managed appropriately and providing the right support at all times. The audit was a good example where the manager had been able to show what quality assurance checks she had put in place to show that the standards are always maintained within the service to always benefit the people living there. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: Care Homes for Adults (18-65 years) Page 28 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 29 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 1 7 20 To have updated financial 10/08/2009 records, care plans in place. To provide people with the name of the appointee and summaries of financial procedures. These records must be clear and accessible to everyone residing at Church Road and their representatives. To show clear and transparent records as to how each persons monies, benefits are managed and safeguarded. 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 7 The Manager should have clear procedures and records to show how each persons finances are managed. This will help to evidence they are kept in the best interest of everyone living in Church Road. People should be included in the management procedures offered in managing their Page 30 of 32 Care Homes for Adults (18-65 years) finances and capacity assessments will help show they are managed in each persons best interest. 2 14 The organisation should look at the feesability of being able to financially provide at least one holiday each year for each person living at Church Road. To provide information for everyone at Church road as to whether any of the proposed developments would be carried out and if so when, so they can be kept informed and included in the developments of their home. To research the current water pressure to see if any actions can be taken to improve on the supply for the pressure in the shower. To look at the heating in one bedroom and see if anything can be done in helping give one person the increased heating they request. The manager should be kept up to date with all necessary personnel records currently stored at head office, for every member of staff employed at Church Road. To have updated individual training and development plans for each member of staff so they can be supported with updated training to help them with their job roles. A training development plan and company commitment to training will help people be aware of what training they will be provided with including timescales for refresher courses including specific timescales for medication, safeguarding, epliepsy and fire training. To provide evidence of at least 5 days paid training per person each year. To carry out monthly visits and to include the opinions of people at Church Road while carrying out monthly checks, (regulations 26 visits) so that their views can be considered regarding the home. The manager should have all necessary information accessible to her so that she can evidence systems are safely managed and show evidence of good practice and management of the finances and personnel checks. 3 24 4 24 5 34 6 35 7 39 8 39 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. 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. 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