Care Home: Clacton Family Trust

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What the care home does well Clacton Family Trust provides a service that recognises the individuality of people who live there. Staff are able to provide support for people in a way that meets their complex needs. The personal and healthcare needs of people living in the home are met and relevant healthcare professionals are consulted where appropriate. Pre-admission assessments and care plans are written in a way that ensures the focus of care is on the individual and there is sufficient detail to ensure that people living in Clacton Family Trust receive care in the way that they need and want. The home provides a comfortable, homely environment for people. Throughout the home the furnishings are of a high standard and bedrooms are decorated to reflect individual tastes. The aids and adaptations that are available in the home help ensure people living there maintain a degree of independence.Visitors are made welcome and people are encouraged to maintain contact with families and friends. What has improved since the last inspection? There have been improvements to the environment as part of the home`s ongoing programme of maintenance, repairs and renewals. Staff supervisions are now carried out more regularly and staff made positive comments about the way they are supported, including "My manager is always there to listen and give advice". What the care home could do better: The storage of medication could be improved, including the provision of a controlled drugs cabinet in line with recent changes to legislation around the storage of controlled drugs. There is evidence that the management team seek the views of people using the service, staff and other health and social care professionals. However, the Quality Assurance process needs to be developed further so that information obtained from this process may be collated into a report that forms the basis of a development plan for the home. CARE HOME ADULTS 18-65 Clacton Family Trust 111 Pier Avenue Clacton On Sea Essex CO15 1NJ Lead Inspector Ray Finney Unannounced Inspection 5th August 2008 09:30 Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clacton Family Trust Address 111 Pier Avenue Clacton On Sea Essex CO15 1NJ 01255 421676 01255 474363 liz@clactonfamilytrust.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Clacton Family Trust Manager post vacant Care Home 23 Category(ies) of Learning disability (23), Physical disability (23), registration, with number Sensory impairment (23) of places Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 18 years and over, who have a learning disability and may also have a physical disability and sensory impairment (not to exceed 23 persons) 29th August 2007 Date of last inspection Brief Description of the Service: Clacton Family Trust is a residential care home providing long stay care for younger adults with learning disabilities, who may also have physical and/or sensory disabilities. The home is situated in the centre of Clacton-on-Sea, close to the shops and within walking distance of the seafront promenade and beach. The service consists of three detached properties: Archway House, which can accommodate up to seven people, Pathway House, which can accommodate up to ten people and Norfolk House, which can accommodate up to seven people. The original Victorian town house has now been demolished and a new unit is in the process of being constructed. All of the bedroom accommodation is for single occupancy and there is ample communal space available in each building. The site also has a purpose built ‘day services’ unit that provides facilities including a sensory room and a swimming pool, which may be used by the people living at the home. The home has car-parking facilities, which are situated at the Old Road entrance and there is a ‘pay and display’ car park nearby. The home charges between £965.58 and £1,960.77 a week for the service they provide. This information was given to us in August 2008. Additional items not covered by the fees include toiletries, hairdressing and personal items. Information about the home can be obtained by contacting the manager. Inspection reports are available from the home and from the CSCI website www.csci.org.uk Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A range of evidence was looked at when compiling this report. Documentary and computer held evidence was examined, such as food records, staff rotas, care plans and personnel files. An Annual Quality Assurance Assessment with information about the home was completed by the joint managers and sent to us before the inspection. Throughout the report this document will be referred to as the AQAA. A visit to the home took place on 5th August 2008 and included a tour of the premises, discussions with some of the people living in the home, the manager and members of staff. Some of the people living there have complex needs and are unable to communicate verbally, although the inspector was able to have some communication based around facial expressions and gestures. Observations of how members of staff interact and communicate with people living there have also been taken into account. On the day of the inspection the atmosphere in the home was sometimes relaxed and sometimes lively. We were given every assistance from the joint managers and the staff team. What the service does well: Clacton Family Trust provides a service that recognises the individuality of people who live there. Staff are able to provide support for people in a way that meets their complex needs. The personal and healthcare needs of people living in the home are met and relevant healthcare professionals are consulted where appropriate. Pre-admission assessments and care plans are written in a way that ensures the focus of care is on the individual and there is sufficient detail to ensure that people living in Clacton Family Trust receive care in the way that they need and want. The home provides a comfortable, homely environment for people. Throughout the home the furnishings are of a high standard and bedrooms are decorated to reflect individual tastes. The aids and adaptations that are available in the home help ensure people living there maintain a degree of independence. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 6 Visitors are made welcome and people are encouraged to maintain contact with families and friends. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Through the thorough admission process, people choosing to live at Clacton Family Trust can be confident that their needs would be met EVIDENCE: Since the last inspection, the Service User Guide has been updated and is now available in a large print version. The manager explained that they are exploring ways to incorporate Makaton signs into the Service User Guide and will seek advice from Speech and Language Therapists who have been supportive of the home around developing good systems of communication for people with complex needs. The manager stated in the AQAA, “Each individual house has a Statement of Purpose which is updated regularly. The Statement of Purpose and Service User guide can be found in each house in the lobby area”. A sample of records examined on the day on the inspection confirm that there is a comprehensive pre-admission assessment process in place. The manager states in the AQAA, “We undertake initial assessments prior to any admission and care plans are established during transition . Family and Friends input are sought when completing Service User agreements after seeking permission from the Service User”. The pre-admission assessment covers a wide range of areas including previous history, beliefs, health medication, safety and risk, Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 9 communication, behaviour, sleep pattern, activities, social skills, mobility, personal hygiene, eating and drinking and finance. The assessment is centred on the person’s individuality and addresses areas relating to ‘self’ such as how the person shows their emotions and what management strategies in place to help with this, how they express their sexuality and their general mood. How the person is empowered to make choices and decisions is also recorded. The initial assessment of someone who recently moved in contained ample detail of the person’s assessed needs and formed the basis of the care plan. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Clacton Family Trust receive good quality care, which is based on their assessed and identified needs. EVIDENCE: The home operates a computer based system called ‘Residata’ for recording care plans and other information relating to people living there. The manager states in the AQAA, “Care Plans are developed with the Service User involving appropriate individuals [such as] advocate, family, friends and appropriate healthcare professionals. Key workers work closely with the Service User to ensure that Care Plans are agreed and up to date”. On the day of the inspection a sample of four care plans were examined. These were written in a person centred way from the individual’s perspective. There are a wide range of care plans covering areas as diverse as mobility, mealtimes, sexual awareness, transport, manual handling and use of hoists, nail care, breathing, behaviour management, body temperature, Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 11 communication, dressing, hygiene, safe environment, social interaction, community access, pressure sores, sleeping and mental wellbeing. Care plans contain sufficient detail to guide staff and enable them to provide support in the manner needed. There is positive language used in the care plans and staff are guided to encourage people to self care where possible to maintain or improve independence. Care plans examined included information on how people prefer to have care carried out and there was ample evidence of how people are encouraged to make choices. The manager said that good communication is important, particularly when people have complex needs and limited communication. Staff were seen to use ‘Makaton’ signing to complement spoken communication. The manager stated in the AQAA, “Key Workers work closely with individuals to support any decisions that are made where appropriate. Service users have ‘All about me’ books and communication passports or are currently being developed or updated and reviewed”. The sample of care plans examined contained ‘Communication Passports’ with information relating to the individual’s communication needs. One Communication Passport examined had a section on ‘How to offer me choices’, with ample detail about the person’s ability to choose and what staff need to look out for. It stated “I can ask for things if I can see them. I’ll look at them intently or point until you get the message. Please show me choices and I’ll pick what I like.” Another said, “I understand a lot of what you are saying. I will listen but may get things a bit wrong. For example, if you talk about my relatives I might expect them to turn up soon”. One person’s Communication Passport said, “I would like to use some of my signs. These are the ones I remember best” and contained pictures of the signs. Individual records examined contained information about the person’s past history, things they like, activities they enjoy, important people in their lives and what makes them happy or sad. The information is accompanied by photographs. During the course of the inspection we observed good communication between members of staff and people living in the home. The manager stated in the AQAA, “Management Strategies and Risk Assessments are in place to safeguard individuals against self harm and harm to others. Risk assessments are put into place prior to admission”. Records examined contain evidence that risks are identified throughout the care plans and strategies to minimise the risks are in place. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Clacton Family Trust can expect to enjoy a lifestyle that meets their wishes and interests. EVIDENCE: The manager stated in the AQAA that people living in the home, “are encouraged to undertake educational courses via local educational services to promote their personal development, communication skills and independent living skills” and staff spoken with were enthusiastic about encouraging people to take part in courses that will interest them. Daily records confirm that people go to courses for music, drama, cooking, pottery and ‘Communicating Through Senses’. Staff said that they support individuals to go to the college for the initial assessment to see if the course is suitable and is what they want to do. They can have ‘taster’ classes before they enrol. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 13 Clacton Family Trust has three vehicles that have the capacity to take wheelchairs and have easy access for people with limited mobility. The manager said that people use the vehicles for appointments, to access local facilities and for holidays. Records show that some people have recently had holidays in Cleethorpes and Great Yarmouth. The manager states in the AQAA, “planned social outings are derived via service user meetings for their decisions on choice. We [support] all choices of service users for outings and their holidays which they enjoy annually for seven days. They choose their holidays supported by their key worker”. People living in the home were coming and going during the course of the day accessing shops and other local facilities. Staff spoken with said that they support people to keep in touch with their families and care plans examined contained evidence of input from relatives. One person has a relative living abroad and, as well as weekly telephone calls, is supported to keep in touch through email and using a ‘web cam’. One person living in the home regularly phones their family. The manager said that they are planning a quarterly newsletter for people living in the home and their relatives. They hope to incorporate surveys into the newsletter so that they can gather people’s views of the service on a regular basis. The manager said that arts and crafts are enjoyed by many people and some of the work they have produced has been framed and hung around the home. One person enjoyed drawing and colouring and brought their book into the office to show us. They also said they like going to the ‘Resource Centre’, which is on the site. People living in Clacton Family Trust are encouraged to take part in daily routines such as shopping and cooking to the best of their abilities and this is documented in their care plans. The manager said that even if someone has very complex physical needs, they can still be part of the food preparation process by being in the kitchen. The manager states in the AQAA that people can be empowered by, “undertaking everyday living tasks as and where possible”. The manager states in the AQAA, “Input from a dietician is sought before a new menu is implemented. Service User meetings are held to ensure choice and individual preferences are considered. Three structured meal times are in place and a choice of snacks and drinks throughout the day are offered and to hand. Service Users are able to access the kitchens to prepare, plan and serve meals to promote independence and cultural and religious requirements are all adhered to. Meal times are relaxed and very flexible to suit the requirements Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 14 and choice of the Service User. The Dietician and Occupational Therapists are regularly involved to ensure all nutritional needs are met and appropriate aids [are available] for eating and feeding”. Records examined confirm that there is a good range of food available. On a tour of the premises, food stocks were seen to be plentiful and included fresh fruit and vegetables. Records examined showed that, anyone with specialist needs around nutrition have input from the dietician, who is involved in planning and advising on appropriate meals. The home has worked with Speech and Language Therapists to ensure they support people who may have difficulties around swallowing and who may need to have their food mashed or pureed. Speech and Language Therapy services have provided food moulds so that pureed food can be shaped to resemble the original food, such as chops, which makes the food more attractive and enhances the mealtime experience. People were observed enjoying the lunchtime meal on the day of the inspection. People ate in a variety of places, some in the dining room, others in the lounge and the atmosphere was relaxed. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can expect their personal and healthcare needs to be identified and provided with the support to ensure these needs are met as they would wish. EVIDENCE: Care plans examined contained sufficient detail to ensure people receive the support they need in ways that they wish. Details include ‘what makes me happy’ and ‘what makes me sad’ and there are clear guidelines for staff about how people want their personal care carried out. The manager states in the AQAA, “Personal support is undertaken by a person of the same gender wherever possible. Privacy and dignity is maintained at all times. Service Users have a flexible timetable for personal support. Service Users and staff work closely together to identify a key worker who will support the Service User to be individual in their appearance”. Information about people’s individual medical and healthcare needs were well documented in the sample of records examined. The manager and senior staff spoken with were able to demonstrate a wide knowledge and understanding of Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 16 people’s needs in relation to health. There was ample evidence in people’s personal records of input from a range of healthcare professionals, including occupational therapists, dietician, clinical nurse specialists, continence advisor and G.P. As stated in the AQAA, “All Service Users have regular health checks in private and any potential illness is picked up at an early stage and referred to the appropriate healthcare professional”. On the day of the inspection medication records and storage were examined. Medicine Administration Record (MAR) sheets were completed appropriately. The cupboard used for storing medication was secure and large enough to accommodate all the prescribed medication. However, the cupboard also contained other items not related to medication and storage would be improved if the cupboard was better organised. There were no controlled drugs in use at the time of the inspection. The manager was able to demonstrate an awareness of their responsibilities around appropriate storage and recording of controlled drugs. Consideration should be given to how medication storage could be improved, in particular the provision of an appropriate facility for the storage of controlled drugs so that they meet the requirements of recent changes to legislation. The manager states in the AQAA that they plan to purchase “lockable cabinets in all units for controlled drugs”. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. EVIDENCE: The manager states in the AQAA, “We have a complaints policy in place which clearly states the procedures which Clacton family trust will follow including stages and time scales for the process”. As reported at the last inspection, Clacton Family Trust operates a robust procedure for dealing with complaints and records them appropriately. On the day of the inspection the manager and senior staff spoken with were able to demonstrate an awareness of the importance of dealing with complaints promptly and appropriately. The manager explained that they have an accessible complaints form that has been produced using Makaton symbols for people in the home who use this method of communication. Staff spoken with on the day of the inspection understood their responsibilities around safeguarding people (previously called Protection of Vulnerable Adults or POVA). Personnel records contain evidence that all staff undergo Criminal Record Bureau (CRB) checks before commencing employment and staff have received safeguarding training. Recently there has been an issue that was raised and dealt with through the local authority safeguarding procedures. The management team have dealt appropriately with the issues raised. They have put considerable effort into reviewing their procedures and have made Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 18 improvements in the recording of people’s finances. The management team, including finance managers, have demonstrated a commitment to ensuring their processes are sufficiently robust to safeguard people living in the home. The manager stated in the AQAA, “A new appointee has been identified and Managers are independently audited monthly to ensure all service users finances have a clear paper trail”. Mental Capacity Act assessments have been carried out regarding finances and individual care plans are in place to safeguard Service Users finances. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People can enjoy living in an environment that suits their lifestyle and which is homely, well maintained and clean. EVIDENCE: The manager stated in the AQAA, “All buildings have been newly furnished to a high quality are regularly decorated by our team of maintenance staff and are designed for domestic purposes”. A tour of the premises showed that people’s rooms were individually decorated to a high standard and there was ample evidence of personal possessions such as photographs. One person spoken with who was recuperating after a hospital procedure said that they were happy and liked their room. Communal areas are also decorated and furnished to a high standard. Although the home overall is quite large, each of the three houses is individual and homely. Norfolk House is has leather sofas, laminate flooring and a large Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 20 wall mounted flat screen television all of which give a spacious, modern feeling. As previously reported, each house is self-contained with its own kitchen Throughout the home there are a range of aids and adaptations, including overhead tracking, hoists and specialist beds to meet the complex physical needs of some of the people living in the home. The manager stated in the AQAA, “Specialist equipment is installed and maintained regularly”. Aids and adaptations are up to date, good quality and are ‘high tech’. All bedrooms, bathrooms and communal rooms are fitted with ‘call alarms’. All the separate houses are maintained to a high standard of cleanliness with no unpleasant odours anywhere in the home. The laundry areas are clean and contain appropriate washing and drying facilities for the size of the home. Laundry areas are situated so that soiled laundry does not need to be carried through areas where food is prepared or served, which helps protect people by maintaining good infection control. Floors and walls have surfaces that are easily cleaned. There are liquid soap and paper towels for hand washing in toilet and laundry areas. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Clacton Family Trust are cared for by a competent, well trained staff team who can meet their needs and have been employed following thorough recruitment checks to ensure people living at the home are protected. EVIDENCE: We had discussions with the management team and members of staff and from observations during the course of the inspection it was evident that care staff have a good understanding of their responsibilities and they follow good practices. Staff enthusiastic about completing National Vocational Qualifications (NVQ) and the manager is committed to supporting them to gain the award. Information provided in the AQAA indicates that, out of a staff team of 47 fulltime carers, 21 people have completed a National Vocational Qualification (NVQ) at level 2 or above and a further 14 are working towards the award. The numbers of staff already holding the award are just under the minimum of 50 of carers with NVQ as recommended in the National Minimum Standards. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 22 However, staff who are in the process of undertaking NVQ demonstrate a commitment to completing the award and the management team are also committed to supporting them. A sample of rotas examined in Archway House show that there are either for or five members of staff on duty during the day and two awake staff on duty at night. On the day of the inspection staffing levels were seen to be appropriate and people’s needs were being attended to promptly. A sample of three personnel files examined contained all the documentation required by regulations, including two written references, relevant proofs of identity, Criminal Record Bureau (CRB) enhanced disclosures, a completed application form with no unexplained gaps in employment and declarations that people are fit to carry out their role. Staff files were well organised with a checklist of contents at the front. The manager said, “Prospective staff undergo a rigorous interview process involving 2 interviews with different managers to ascertain whether they are right for the role. During the interview process the management team strive to ensure that the staff member has the right attitude and characteristics”. The manager said that all new staff undertake a three month induction programme and are given a copy of the General Social Care Council code of practice. Personnel records examined contained evidence that staff complete a thorough induction. Staff training records examined contained evidence of a range of training relevant to the roles they are carrying out. Training includes Manual Handling, Infection Control, Food Hygiene, Intensive Interaction, Medication and First Aid. There is also training around people’s special healthcare needs including Epilepsy Awareness and the administration of rectal Diazepam and Buccal Midazolan (these are interventions that may be needed in the event of severe or prolonged epileptic seizures). The manager said that they work closely with the community learning disabilities nursing team around ensuring staff understand people’s specific needs and have appropriate up to date training to meet these needs. Staff have also received specialist training in a range of methods of improving communication skills to meet the needs of some people living in the home who have limited communication skills. This includes Makaton (signing) and specific training developed by speech and language therapists called ICE (Inclusive Communication Essex). It was clear from observing staff that people living in Clacton Family Trust benefit from a staff team who have developed good communication skills that they can use to support people with complex needs and communication difficulties. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 23 All members of staff in Pathways have received training to support people with swallowing difficulties. Recently staff have received training around understanding the Mental Capacity Act. One member of staff spoken with said, “the level of training is amazing”. The manager stated in the AQAA, “We currently have a designated person in charge of Training programme”. The manager said that a training and development needs assessment will be carried out on the workforce as a whole to identify future planning. Since the last inspection there have been improvements in the supervision process. Personnel records examined contain evidence that staff receive regular supervisions. A senior care officer spoken with said that they feel well supported by the management team. The manager stated in the AQAA, “Staff have received a supervision contract and will receive monthly supervisions, and yearly appraisals. All Senior members of staff have received appropriate training to supervise staff”. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately managed in the best interests of people living there. EVIDENCE: There has been a change in the management structure since the last inspection, with the home now jointly managed by two people who have a number of years experience in care and who are familiar with the home. The two managers lead a team that consists of a Senior Care Officer, Team Leaders, Care Staff, maintenance staff and cleaners. They are supported by the Chairman, who is the registered Individual for the service, and by the directors of Clacton Family Trust. Both of the managers were spoken with on the day of the inspection and both were able to demonstrate an awareness of their roles and responsibilities. The AQAA received from the managers was completed with sufficient detail and the Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 25 information was well supported by the evidence examined on the day of the inspection. One of the managers has obtained NVQ level 4 in care and the other is working towards the award; both have at least two years experience of working in a supervisory role within care settings. The manager stated in the AQAA, “Both managers approach to running the home is open and positive enabling staff and service users to benefit from the positive and inclusive atmosphere. Both managers are aware that any identified requirements must be implemented within an agreed timescale”. On the day of the inspection we discussed the home’s Quality Assurance system with one of the managers, who was able to demonstrate a good awareness of how they seek the views of people living in the home or their representatives. Records examined contain evidence of ways in which people are consulted including minutes of meetings, reviews and communication passports. Similarly staff are able to give their opinions through regular staff meetings. Sufficient evidence was presented to confirm that the management team actively seek the views of people living in the home and their representatives and act on the information that they receive. However, the process could be developed further so that all this information is pulled together to form a development plan for the home, which demonstrates that people’s views and wishes are taken into account. The manager stated in the AQAA, “A quality and development plan to be implemented to measure success within the home. We will produce an annual development plan which reflects the aims of the home”. The manager said they are developing a quarterly newsletter for distribution to relatives, friends advocates and healthcare professionals. They plan to incorporate a survey into this newsletter to obtain ongoing feedback on the service they provide. As at the last inspection, up to date policies relating to health and safety are in place. Records relating to safe working practices were examined and all were found to be in order. There is a comprehensive health and Safety Risk Assessment in place and a Fire Risk Assessment. Portable Appliance Testing (PAT) has been carried out and records show that fire alarms and emergency lighting are tested regularly. Records show that fire equipment, hoists and weigh scales have had recent maintenance checks. The manager said that all staff receive training in moving and handling, fire safety, first aid, food hygiene and infection control. Water outlets have thermostatic valves fitted and windows have restrictors fitted to reduce the risks to people living in the home. Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 4 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 (4) (a) (c) Requirement An appropriate facility for the storage of controlled drugs must be available in the event someone in the home may be prescribed medication that requires this type of secure storage. Timescale for action 30/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA32 Good Practice Recommendations The management team should continue to support staff working obtaining an NVQ award so that the minimum of 50 of care staff have the qualification, as recommended in the National Minimum Standards. The management team should continue to develop the Quality Assurance system so that when they seek the views of people living in the home and other interested parties, the information is used to form a development plan, which demonstrates that people’s views are being acted upon. 2. YA39 Clacton Family Trust DS0000017794.V369637.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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