Care Home: Cosin Lodge

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What the care home does well What people who live there said about the home. "I like it here." "I don`t want to move." One community nurse said, " The staff are very flexible in adapting their ways of working to suit the individual needs of clients." Another said, "The staff all seem to have a good rapport with the residents." The home is a positive place to live; the atmosphere is `up beat` and lively but also secure and comfortable. The manager and staff are dedicated, talented and clearly enjoy working with the people who live there. People who live at the home like it. They have an individual service and are able to be in control of their lives whilst being respected and supported by staff in the best interests. This promotes their wellbeing and quality of life. People who move to the home have their needs assessed in detail by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important where people have complicated care and lifestyle needs that require well-managed and agreed ways of supporting them. Staff at the home are detailed organised and have well thought out ways that they meet the social, emotional and healthcare needs of each person who lives at the home. And these are written down in ways that are clear so that people who live at the home and the staff who work there can see exactly how the support is to take place. One person who lives at the home said, "Its very good here they know what`s important to me and how I like things." Staff help people to have interesting lives, they help make sure that people can take part in activities they like and they help them to find and try new ones. The staff and manager help people to make choices about their lives and support them to be as safe as possible when they want to do something risky. The staff work well as a team. One person who lives at the home said, "I`ve never lived anywhere as good as this." People who visit their relatives or friends at the home are made to feel welcome and relationships are supported. Staff are well trained so that they have the necessary skills to support the care and lifestyle needs of people living at the home and there are sufficient staff available so that these needs can always be met. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 7The acting manager and senior staff have the experience and training to run the home effectively so that the in the best interests of the people who live there can be met. And people are asked about the way they wish to live and listened to when they have concerns. Many of the staff have worked at the home for several years and have a good understanding of their roles and work well as a team. They have very strong principles about how they support peoples` rights and empower them as valued citizens within society and follows the government`s White Paper `Valuing People.` They remain enthusiastic about their work and give good quality, person centred care and support. Care is provided to people with a wide range of needs, with varied ages, expectations and backgrounds. This diversity, including age and gender, is reflected in the staff team, giving the opportunity for staff to be `matched` to people where appropriate. Both care practice and staff recruitment practices are governed by equal opportunity principles. What has improved since the last inspection? All the legal requirements made at the last inspection have been met. For example: Care planning has been dramatically improved and is now a strength of the home. Staff have regular, detailed and thorough training about what they must do in the event of a fire and further straining to make sure that they have the skills to carry out their work. The way that the quality of care is measured has improved and includes the views and wishes of people living at the home. What the care home could do better: There is a new manager in post who has made dramatic improvements to the way that the service is run. To comply with the law, she must be assessed by the Commission to make sure that she has the skills, experience and knowledge to be registered as the manager of this home. CARE HOME ADULTS 18-65 Cosin Lodge Cambridge Avenue Willington Co Durham DL15 0PW Lead Inspector Steve Tuck Key Unannounced Inspection 6th August 2008 10:00 Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cosin Lodge Address Cambridge Avenue Willington Co Durham DL15 0PW 01388 748702 01388 748 703 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) Voyage.com Milbury Care Services Ltd Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (4) of places Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2007 Brief Description of the Service: Milbury care services are the owners of Cosin Lodge which is based in Willington, County Durham. The home is situated in a quiet residential area within close reach of the town centre and shops, pubs etc. The home was first registered in January 2005. It is registered to provide care (but not nursing care) for 4 people who have a mental disorder or learning disability. The home is a purpose built bungalow set in its own grounds with a garden at the rear. Each pair of bedrooms have direct access to a shared bathroom and there is a large lounge, dining kitchen and relaxation room. The home has been designed and fully equipped so that people who have a physical disability can get around the home. The home is owned and run Milbury Care which is a private limited company. The homes fees range from £1537 to £1724. The actual fees that people pay varies depending on their circumstances, further details can be found in the homes Service User Guide. The costs of newspapers, hairdressing, and toiletries are not included in the fees. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality Rating for this service is 3 stars. This means the people who use this service experience Excellent quality outcomes. This inspection took place over three days and was a scheduled unannounced inspection. Before the visit: We looked at: • Information we have received since the last Key Inspection. • How the service dealt with any complaints & concerns since then. • Any changes to how the home is run. • The provider’s view of how well they care for people. We asked them to examine their own service and write to us with the results. • We sent surveys to get the views of people who live at the home, the people who arrange it for them and the staff who work there. The Visit: An unannounced visit was made on 6th August 2008. During the visit we: • Talked with the people who use the service, the staff and the acting manager. • Observed life in the home. • Looked at information about the people who live at the home & how well their needs are met. • Looked at other records, which must be kept. • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. • Looked around parts of the building to make sure it was clean, safe & comfortable. • Checked on what improvements had been made since the last visit. We told the acting manager what we had found. What the service does well: Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 6 What people who live there said about the home. “I like it here.” “I don’t want to move.” One community nurse said, “ The staff are very flexible in adapting their ways of working to suit the individual needs of clients.” Another said, “The staff all seem to have a good rapport with the residents.” The home is a positive place to live; the atmosphere is ‘up beat’ and lively but also secure and comfortable. The manager and staff are dedicated, talented and clearly enjoy working with the people who live there. People who live at the home like it. They have an individual service and are able to be in control of their lives whilst being respected and supported by staff in the best interests. This promotes their wellbeing and quality of life. People who move to the home have their needs assessed in detail by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important where people have complicated care and lifestyle needs that require well-managed and agreed ways of supporting them. Staff at the home are detailed organised and have well thought out ways that they meet the social, emotional and healthcare needs of each person who lives at the home. And these are written down in ways that are clear so that people who live at the home and the staff who work there can see exactly how the support is to take place. One person who lives at the home said, “Its very good here they know what’s important to me and how I like things.” Staff help people to have interesting lives, they help make sure that people can take part in activities they like and they help them to find and try new ones. The staff and manager help people to make choices about their lives and support them to be as safe as possible when they want to do something risky. The staff work well as a team. One person who lives at the home said, “I’ve never lived anywhere as good as this.” People who visit their relatives or friends at the home are made to feel welcome and relationships are supported. Staff are well trained so that they have the necessary skills to support the care and lifestyle needs of people living at the home and there are sufficient staff available so that these needs can always be met. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 7 The acting manager and senior staff have the experience and training to run the home effectively so that the in the best interests of the people who live there can be met. And people are asked about the way they wish to live and listened to when they have concerns. Many of the staff have worked at the home for several years and have a good understanding of their roles and work well as a team. They have very strong principles about how they support peoples’ rights and empower them as valued citizens within society and follows the government’s White Paper ‘Valuing People.’ They remain enthusiastic about their work and give good quality, person centred care and support. Care is provided to people with a wide range of needs, with varied ages, expectations and backgrounds. This diversity, including age and gender, is reflected in the staff team, giving the opportunity for staff to be ‘matched’ to people where appropriate. Both care practice and staff recruitment practices are governed by equal opportunity principles. 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. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 8 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 Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 9 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. Each person’s needs are assessed before they move in which helps to make sure that these can be met at the home and inappropriate admissions are avoided. EVIDENCE: Each person’s needs are assessed before they move to the home by a team of workers such a social worker, a community nurse, a psychologist, as well as the acting manager. This is to make sure that the home is suitable for meeting the needs of people who are going to live there. The acting manager has shown that she has a leading role to make sure that the home is able to successfully support people before they move there. Records show that the acting manager and staff have found out about the cultural and lifestyle needs of people who wish to move to the home to make sure that these can also be met. All people’s assessment information is detailed which helps staff to plan and write down the ways that they are going to support them. This is important where people have complicated needs and social networks which require a lot of insight and well-organised support. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 10 The home has written information called the Service Users Guide which gives all of the important details that people need to know about what it is like to live there. This includes information about how to make a complaint and the most recent Inspection report. The Service User Guide for this home has been drawn up in ways which help people to understand what the information means and staff also help to explain it. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 11 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 Excellent. This judgement has been made using available evidence including a visit to this service. Each person has an individual plan of care, which sets out their preferences and how their assessed needs will be met. These plans describe the measures which staff use so that they can consistently meet peoples’ needs. EVIDENCE: Some people at this home have needs which require the staff to respond to them in particular ways for example to give them support to feel confident and help them to manage their anxieties. All people living at the home have a detailed plan of care, which gives a thorough description of how their physical, emotional and lifestyle needs are to be met. People get support from staff which is individual and tailored to their specific needs so that they can live as valued citizens within their community. Care is carried out in ways that arranged so that each person is at the centre of a network of support and tailored so that they have highly individual lifestyles. Staff have a good understanding of people’s histories, needs and preferences Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 12 which they need to support people. They also work closely with other community-based health and social support staff to make sure that peoples wider needs are supported by fully co-ordinated care. The way that care plans are written down shows that how they are to be supported and there are reviews to see if their needs have changed. There are examples of where a great deal of thought consideration and care has gone into this planning. For example how peoples relationships are supported, how the service makes sure that they are not vulnerable to abuse are clearly and carefully recorded. One social worker said that the service is, “Very flexible in adapting their ways of working to suit the individual needs of clients.” People living at the home are treated with respect by staff who know them well. Relationships between people and with staff are relaxed, friendly and informal which helps them to feel comfortable. People appeared to be relaxed and happy with the support they get from staff. Staff meet at the start of each shift where they talk to each other about peoples needs so that they remain up to date, work well as a team and remain consistent. One person who lives at the home said, “I’m confident that they will treat me well, with dignity and I trust them.” All people living at the home have access to someone outside of the home who can speak on their behalf and help to make decisions in their best interests if they wish. One staff said, “We encourage people to speak up for themselves, have control of their lives and make decisions.” One of the home’s strengths is how the manager and staff help people to be as independent as they can and to take measured risks if they wish. The manager and staff take actions to support people and reduce the risks which they take so that that there is a balance between promoting people’s independence and rights and making sure that they are safe. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 13 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 14 15 16 and 17 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. People are encouraged and supported by the staff to make choices about their lifestyle so that they can lead fulfilling and interesting lives and staff help people stay in touch with their circle of family and friends so that they can keep links with people outside of the home. EVIDENCE: People living at this home have the opportunity to have active lifestyles. Everyone has his or her own routines and activities many of which occur outside of the home. The staff are very knowledgeable and skilled at helping people to choose activities that they would like to take part in or to try out and to find opportunities and arrange them. Staff also encourage people to make decisions, and help them to organise the different opportunities they have each Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 14 week. Examples of opportunities include shopping, social clubs / drop in centres, football matches. People also have opportunities to continue with their further education at local colleges and to gain work experience or voluntary or paid employment. One person who lives at the home said, “Staff will help you to think of ideas for things you might want to try out and then helping to arrange it.” Staff at the home were busy planning how individual support for service users was is to take place so that all of their choices and event commitments could be met. One care staff said, “We know it’s important that people have things to do that interest them and help them to feel confident in themselves.” Staff are good at finding out about opportunities or activities which are taking place in the local and wider community and making sure that support and transport is available for those people who want to take part. Photographs of people taking part in activities and during visits are displayed in people’s rooms. Staff help people to keep in touch with friends and relatives where this is possible. Some people have taken college courses where they have an interest or skill and several certificates are displayed which show their success and commitment. Several choices of meals are offered at all times and people help to plan their meals. Attempts to offer a balanced diet whilst still responding to people’s choices were noted. Mealtimes are pleasant sociable events at the home where people meet and share each others company. People said that they liked the food, one person living at the home said, “I do joke that the food, but staff really make an effort to make it taste nice and I know I’m going to have to do more cooking myself someday.” Cosin Lodge DS0000062455.V371145.R01.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 Excellent. This judgement has been made using available evidence including a visit to this service. Peoples’ personal and health care needs are identified and arrangements are in place to help make sure that they can have a healthy lifestyle. EVIDENCE: Staff keep records of people’s healthcare needs in care plans. These show that staff look out for changes in their physical or emotional state which may need the involvement of specialist healthcare workers from outside the home. This has promoted joint working with healthcare staff and helped home staff make sure that people get the healthcare support that they are entitled to. People are registered with healthcare facilities for example their general practitioner or dentist and are supported to attend appointments if they wish. One doctor said that staff are, “Very knowledgeable about clients health and always make reasonable requests for GP input or reviews.” Contact can also be made with health workers who are part of the integrated community team when necessary and appropriate. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 16 Any personal care is carried out in private with staff encouraging people to be discrete where this is required. Due to their levels of need, most people living at the home need support to administer their own medicines, and designated staff therefore help in this area. A number of people have been able to safely take responsibility for their own medication which fits in better with their lifestyle. The home has weighed up the risks and taken steps to minimise the likelihood of harm. Medication is securely stored and there are effective systems in place which help to minimise risks. When checked there were no errors found. The acting manager confirmed that staff at the home are to undertake further training to help them to be able to administer medication. Cosin Lodge DS0000062455.V371145.R01.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 live at this home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people from being harmed which helps to promote their safety and security. EVIDENCE: There is a clear complaints procedure in place at the home, which tells people how to complain, and the length of time a response will take. Observations of the staff’s day-to-day practices show that they ask for the views of service users all the time and help people to make real choices and decisions. People who live at this home assert their views and preferences and were clearly empowered to say what they thought. One person living at the home said, “I didn’t use to say anything when things were happening that I didn’t like, and that would upset me. Now I tell people if I’m not happy and they listen when I make choices and decisions which is better – I just feel a lot happier.” Another person said, “If there is something they’ve done that I don’t agree with I tell the staff or the manager, I think its best to do that.” No one at the home or advocates for the people who live there had decided to use the complaints procedure to resolve their grievances in the past 12 Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 18 months. But there is a clear process in place which shows how complaints will be handled. The homes has an adult protection procedure which is robust and complies with the Public Disclosure Act and the Department of Health Guidance. There is a staff guide, which gives clear instructions about the actions which they must take if abuse is disclosed or witnessed and all staff spoken to are knowledgeable and vigilant. In the last 12 months, staff and the present acting manager have taken direct steps to protect people whom they suspected were being financially abused. They have alerted the Police and their managers and worked with the law enforcement agencies and local council to make sure that a successful prosecution was made. Their actions are commendable. Cosin Lodge DS0000062455.V371145.R01.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 and 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The house is homely, well equipped and clean and provides people who live there with a comfortable environment in which to live. EVIDENCE: Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 20 People who live at the home are encouraged to have ownership of their own rooms and staff help them to keep them clean when this is needed. Areas used by all of the people who live at the home are kept clean by staff who take effective steps make sure that these are pleasant. The house is in an estate of similar properties and has been purposely deigned and built so that it is suitable for meeting the needs of the people who live there. The home fits in with those around it which helps people who live there to be accepted citizens within their community. More new houses are being built in the area around the home which helps to promote the area generally. Inside the house, facilities have been made to help people get around the house who have mobility difficulties or who use wheelchairs. For example there are wide corridors and doorways, there are aids to help people to use the bathroom or get in and out of bed. The home has been designed so that the people who live there can have safe access to the house and garden without restricting their rights, freedoms or independence. And people are able to lock their bedroom doors so that they can have privacy. The bedrooms are large pleasant attractive areas, which have a range of good quality furniture, and fittings which are comfortable and useful for people to use. All of the people living at the home have decorated their rooms with their items, photographs and keepsakes and some have bought their own furniture and soft furnishings. One person living at the home said, “The staff know that I like my bedroom, they respect my privacy and know that my room is my own space.” The acting manager is looking at ways that notice boards and information can be stored so that corridors can look more domestic and ‘homely’. The home is inspected by the Fire Prevention Service and overseen the local authority to make sure that risks from an accidental fire are lessened and a safe and healthy environment is promoted for the people who live and work there. There is evidence that repairs and maintenance has been carried out and the acting manager has drawn up a refurbishment programme to improve those areas that are now looking dated. Cosin Lodge DS0000062455.V371145.R01.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 33 34 and 35 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There are enough staff at the home to support the people who live there. And they have the skills, training and support from the manager so that they can meet the needs of people living at the home. EVIDENCE: Some people living at the home have complex support needs and additional staff are available so that support can be successful and safe. Care workers are well organised by the acting manager with shift patterns which reflect the demands of people living at the home and records show that sufficient staff have been working there. Staff absences are rare. Information from the acting manager shows that staff have received training relevant to their job roles and the specific needs of people living at the home. There is a detailed training programme is in place which encourages staff to remain interested and motivated by the work they do and helps to improve Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 22 their skills and ideas and the quality of the service. This covers National Vocational Qualifications (NVQ) as well as specialist courses. Over three quarters of the care staff have NVQ Level 2 or above and workers who have undertaken NVQ Level 2 training are being encouraged to continue their training to Level 3. Where new staff are employed, they are given extra training which links with national training organisation standards so that they have sufficient skills to support people and work effectively with other team members. Each member of staff demonstrates that they have an in depth knowledge of people’s needs and the strategies and approaches they use to support them. Staff show that they competent in their role and this is reflected in the good standard of practice when they support and interact with people living at the home. Staff have regular contact with the acting manager who works alongside them on a day-to-day basis. The acting manager has records which show that regular supervision takes place where staffs’ performance and the work they do with individuals is thoroughly discussed. Morale is very good at the home and staff are very ‘up beat’ and motivated about the work they do and genuinely enjoy spending time supporting the people who live there. There are procedures in place so that new staff who are recruited have checks carried out before starting work to make sure that they are suitable to work with vulnerable people. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 23 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): 37,38, 39, 41 and 42 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. The acting manager at the home makes sure that people who live there are supported properly and gives leadership and direction to staff so that the quality of the service they give is improved. EVIDENCE: There has been a new manager appointed at the home since the last inspection. The acting manager has worked in a senior capacity at the home for three and a half years and has been the acting manager for 12 months. She has started the Registered Managers Award (National Vocational Qualification) Level 4 and currently holds an NVQ level 3 in care. Prior to working at this home she Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 24 worked in care services that support children and completed childcare training which was specific to her role. The acting manager demonstrates that she has extensive experience and skills in supporting the needs of people with learning disabilities in this home which she has used to promote their independence wellbeing and lifestyles over the past year. The acting manager has been appointed by the owners but has not yet been assessed by the Commission for Social Care Inspection to make sure that she is suitable to be the registered manager of the home. However, the manager has shown her capacity, skills and insight to organise the service on a day-to-day basis. She is highly motivated, well organised and has an excellent understanding of how the home operates so that the organisations ways of working can be used to improve and promote the lifestyles of people living there. She has an open positive and inclusive ethos and has the respect of her staff, which reassures people living at the home and their relatives that the service can continue to be provided in their best interests. One person who lives at the home said, “ I trust her, she will look out for me.” One staff said, “She is our leader, she has helped us all to work together.” Another said, “the manager works with us, she supports us, if we have a problem she already knows about it.” People living at the home are empowered to give their views about all aspects of the support they get from staff. There are a number of meetings held at the home and also other informal occasions where the acting manager is able to check that people are satisfied with the service. The senior manager also visits the home each month and collects the views of peoples’ families and friends, social work and healthcare staff who visit the home so that they can check to see if the service is meeting the needs of all parties. This helps the acting manager to monitor progress and develop the service. The manager is planning to organise this information in a way which shows how this information is used to make management improvements at the home. Staff at the home help people who live there to manage their money. Detailed records are kept of people’s day-to-day finances and where staff have supported them to make purchases. Checks showed that these are accurate and there are safeguards in place to help prevent theft or fraud. There were no noticeable hazards at the home throughout the inspection and arrangements are in place to minimise risks for people living there and the staff who support them. The home has been subject to inspections by the Fire Prevention Authority and local authority environmental health officers to make sure that the home is safe. Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 25 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 3 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 2 4 3 X 3 3 X Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 26 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 YA37 Regulation 8 Requirement The person responsible for the home must make sure that there is a registered manager at the home who is suitably trained, qualified and experienced. This is to make sure that the home is run by someone who is fit to be in charge. This is a new Requirement. Timescale for action 01/12/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cosin Lodge DS0000062455.V371145.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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