Care Home: Creative Support

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What the care home does well The people living in this home are supported and encouraged to contribute on how the home is run, and are able to talk or show their concerns and worries and be able to make choices that affect them. From talking to people in the home and the staff team, the service showed that they encourage people to be as involved as possible in areas such as keeping their home and personal space clean and homely. Each individual is supported to keep their room clean. People are encouraged to make their own decisions and choices about lifestyle, social and leisure events. There were examples of people being supported to attend local classes, and local community resources. There was good access to medical and health treatment, and people were supported to keep appointments with healthcare professionals. The home helps people living in the home to maintain their health and wellbeing through supporting them to regularly visit their G.P, dentist, optician and specialist health providers. The home has a lot of knowledge and understanding of people`s specific individual health needs and works closely with other healthcare services to monitor and respond to any changes. The home have a good admission policy which helps to ensure that placements are successful and that people are appropriately placed there. This means that people making an enquiry to the home can be confident that staff will work with them and give them the information they need to make the right lifestyle choice. During the visit there was a relaxed atmosphere and a mutual respect between people living in the home and the staff team. It was evident that the staff were approachable and people wee constantly calling into the office which operated an `open door` policy. Five people living in the home were spoken to and some of their comments about their experience of living in the home are included below: "They ( the staff) help me when I need it. I go to a textile class once a week, I like this. The staff help me to prepare and cook my own food". "I came for a visit before I moved in. I like to go out shopping, the staff come with me sometimes". "I can talk to the staff if I have a problem". What has improved since the last inspection? Since the last inspection there have been improvements in the physical building as a number of areas had been decorated and new carpets had been laid. All parts of the home were clean. The appointment of a domestic to clean communal areas has significantly improved the cleanliness and hygiene in the home. The support co-ordinator has put a number of systems in place to improve the monitoring of care and support practices in the home. Weekly auditing forms have been introduced to look at all day to day aspects of the running of the home, for example medication, environment, health and safety checks and fire safety checks. Monthly audit sheets are linked to the National Minimum Standards and look at personal healthcare and support, complaints and lifestyle issues for the people living in the home. The support co-ordinator has set up regular supervision sessions for staff and has used this to re-in force good practice issues and introduce new procedures. CARE HOME ADULTS 18-65 Creative Support 401 Wilmslow Road Fallowfield Manchester M20 4NB Lead Inspector Ann Connolly Unannounced Inspection 31st July 2008 10:30 Creative Support DS0000021610.V363440.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 Creative Support DS0000021610.V363440.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. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Creative Support Address 401 Wilmslow Road Fallowfield Manchester M20 4NB 0161 248 6070 0161 248 6070 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) Creative Support Ltd Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2) Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users are female and require care by reason of mental ill health (excluding learning disability and dementia). 6 of the service users are below pensionable age, 2 named service users are over 60 years of age. 12th May 2006 Date of last inspection Brief Description of the Service: 401 Wilmslow Rd is a care home, which provides care for up to eight women who suffer enduring mental ill health, emotional difficulties and who are vulnerable. The women who live at Wilmslow Rd prefer to be referred to as residents. The range of fees at the home are £373.54 to £427.12. The home is situated on the boundary of Withington and Fallowfield, close to public transport links to Manchester City Centre. Public transport links are also available to Stockport, Didsbury and Chorlton. A selection of shops, doctors surgeries and churches of various denominations are situated close by. The home is a large Victorian detached house, set in its own grounds with ample car parking to the front. The home is similar to some of the other residential houses on the street. The home does not have a sign outside to identify it as a care home to make sure that the residents live as normal a life as possible in the community. The accommodation is provided on three floors accessed via stairwells. All 8 residents have single bedrooms with en suite bathrooms. The home has plenty of communal space for the residents to use. This includes a lounge with adjoining conservatory, three kitchens (two of which have dining areas) and two laundry areas. Where possible, residents are supported to prepare their own meals in the 3 kitchens, but staff prepare some meals for some of the residents. The main dining area can seat all 8 women comfortably if they wanted to eat a meal together. The home is comfortably furnished. Ramped access is available for people who have impaired mobility. Creative Support DS0000021610.V363440.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 was a key inspection that included a site visit to the home. The support co-ordinator and staff team were not told beforehand that we were coming to inspect, this is called an unannounced inspection. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social Care (CSCI) about the service provided at the home since the last inspection. During the site visit a selection of records, care plans, policies and procedures were examined. Discussions took place with the support co-ordinator and staff working in the home. Prior to the inspection, questionnaires were sent out to the people who live in the home, asking them to comment on how the home is run and managed, and for their views about how the staff supported them, and all of these were returned. A tour of the home was undertaken and people living in the home were asked for their comments and views about the environment. Several people living in the home were spoken to in private during the visit, and discussions took place with them to find out what they thought about the home and what they felt about how the staff supported them. Before the inspection, we also asked the service to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This is one of the ways that we get information from the management of the service, about how they are meeting outcomes for people using their service. The information that was provided in the (AQAA) for this service was detailed and comprehensive. This provided evidence of a service that was committed to assessing and evaluating the quality of the support services provided, and provided robust action plans to meet shortfalls and improve outcomes for the people in the home. Since the last inspection visit, the home had received one concern, which was investigated and not upheld. The Commission for Social Care Inspection has not received any concerns about this service. There was evidence of an open and transparent approach to complaints, and all the people spoken to felt confident that if they had a concern they could raise it directly with the staff and were confident that this would be addressed. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 6 What the service does well: The people living in this home are supported and encouraged to contribute on how the home is run, and are able to talk or show their concerns and worries and be able to make choices that affect them. From talking to people in the home and the staff team, the service showed that they encourage people to be as involved as possible in areas such as keeping their home and personal space clean and homely. Each individual is supported to keep their room clean. People are encouraged to make their own decisions and choices about lifestyle, social and leisure events. There were examples of people being supported to attend local classes, and local community resources. There was good access to medical and health treatment, and people were supported to keep appointments with healthcare professionals. The home helps people living in the home to maintain their health and wellbeing through supporting them to regularly visit their G.P, dentist, optician and specialist health providers. The home has a lot of knowledge and understanding of people’s specific individual health needs and works closely with other healthcare services to monitor and respond to any changes. The home have a good admission policy which helps to ensure that placements are successful and that people are appropriately placed there. This means that people making an enquiry to the home can be confident that staff will work with them and give them the information they need to make the right lifestyle choice. During the visit there was a relaxed atmosphere and a mutual respect between people living in the home and the staff team. It was evident that the staff were approachable and people wee constantly calling into the office which operated an ‘open door’ policy. Five people living in the home were spoken to and some of their comments about their experience of living in the home are included below: “They ( the staff) help me when I need it. I go to a textile class once a week, I like this. The staff help me to prepare and cook my own food”. “I came for a visit before I moved in. I like to go out shopping, the staff come with me sometimes”. “I can talk to the staff if I have a problem”. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 7 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. Creative Support DS0000021610.V363440.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 Creative Support DS0000021610.V363440.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. People wishing to use this service are given sufficient information about the home to help them in making a decision about their support arrangements. People’s needs are assessed prior to admission to the home so they are confident their needs will be met, and so that the home can be sure it can meet individual personal needs. EVIDENCE: Information in the Annual Quality Assurance (AQAA) document completed by staff in the home prior to the inspection, stated that the referral and allocation procedure is regularly reviewed. During this visit, there was evidence to support this, and the information provided to prospective people wishing to use the services of this home, was currently under review. There was evidence to show that the service had clear polices and procedures about admissions to the home. These were designed to ensure that placements were well planned and provided people with sufficient information to help them in making an informed decision about their living and support arrangements. Information in the AQAA stated that none of the placements had broken down. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 10 This shows that the service works hard to ensure that admissions are managed well. The AQAA stated that people’s needs were thoroughly assessed before admission, and plenty of opportunities were provided for people to visit the home and spend time there before a placement admission was agreed or admission to the home was arranged. Information in the surveys completed by people in the home, or by a representative or advocate stated that they were always given sufficient information. People who were spoken to during this visit confirmed that they had information about the home and said that if they were unsure about anything this was explained to them. All admissions are planned and people are given an information/welcome pack before moving into the home. The home uses an ‘offer letter’ which makes it clear to all prospective applicant what the terms and conditions of living at the home are. The support plans of three people were looked at. All of them contained detailed and comprehensive information, which was used by staff to generate a working care/support plan. This ensures that staff have the necessary information to provide individual care and support to each resident in an appropriate manner. Creative Support DS0000021610.V363440.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 good. This judgement has been made using available evidence including a visit to this service. Care plans provided details of individual care and support needs and the interventions required to meet these needs. Appropriate risk assessments are in place to ensure the safety and well being of the people in the home. EVIDENCE: Three support / care plans files were looked at during this visit. These were detailed and comprehensive and provided staff with the information they needed to support people in the home in an appropriate way. Support needs were clearly identified, and included the strategies and interventions to meet needs. The support plans were well organised with an easy reference system which help staff to look up and reference information about people in order to provide support appropriately. Discussions with staff provided evidence that they used support plans in their day-to-day practice. One member of staff arriving for Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 12 duty was seen making reference to the support plan files before commencing her shift. The support co-ordinator has developed a weekly evaluation document, which is linked to the care/support plan. This document has been introduced to staff during individual supervision sessions. The document encourages staff to link their recording about people they support, with the care/support plans and risk assessments. Staff are encouraged to make frequent references to support plans in their day to day work as a support worker. This will ensure that care and support needs are not overlooked. Support plans focused on a person centred approach, and there was evidence that people in the home were consulted on how they wanted to be supported. Care plan documentation included a client information form, which provided staff with important contact information. The risk assessments were very detailed and identified any risk to self or others. The information provided details where risk circumstances may arise, the desired outcome, and a risk management strategy. The risk management strategy ensures that staff have the right techniques and guidance to support people to live their life in a safe way. A primary worker is allocated to each person in the home, and during discussions with the people living in the home, it was evident that they were familiar with this arrangement and all of them knew who their primary support worker was. There was evidence that people in the home were supported to access healthcare services as appropriate. Recordings on files demonstrated that people were supported to keep appointments with a range of health care professionals, including hospital appointment, regular contact with community psychiatric nurses, and dental and optical appointments. There was a notice board in the hallway, which included a wide range of information about the home, the local community, events and activities available inside and outside the home. The notice board included advanced notification of all forthcoming tenants meetings. Minutes of these meetings were looked at, and showed that people in the home were consulted about all aspects of daily life and running of the home. The minutes provided evidence that the service listens and acts upon the views of the people living there. During this visit there were numerous examples of people making decisions about their preferred activities. People were seen coming and going, to the local shops, shopping trips, and spending quiet time in their own bedroom. Some people hare supported to manage their finances independently. Where the home provides support, appropriate records and documentation is maintained. Creative Support DS0000021610.V363440.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): 12,13,15.17 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are supported to engage in activities and maintain social contacts. They are supported to develop skills in independent living and are provided with opportunities for personal development. EVIDENCE: This is a service that can provide numerous examples of good practice in supporting people in the home to live a lifestyle, which provides opportunities for personal development. People are supported to engage in meaningful activities. One person has shown an interest in art and painting, and is supported by an art therapist on a weekly basis to develop this skill and talent. A regular art and craft group is Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 14 provided by staff in the home, and people in the home expressed enjoyment and enthusiasm about this activity. The information provided in the Annual Quality Assurance Assessment (AQAA), states that three people attend day centres on a regular basis and some people attend a bingo session at a local community centre on a weekly basis. The information in the AQAA states that meetings with people in the home provided opportunities for discussion groups, and discussions have included sexual relationships and family links. The information states that the service intends to make improvements by supporting people in the home to develop a personal book specifying their likes and dislikes which can be used to develop their individual lifestyle plan. One care/support plan provided evidence of a service that demonstrates a commitment to supporting people to achieve their goals and aspirations, and supporting them appropriately with disappointments by finding positive and meaningful alternatives. One person living in the home had specific aspirations regarding education and future career. There was evidence to show that the staff had taken these aspirations seriously and provided the support and guidance to access resources and had facilitated appropriate meetings with professions. The outcome was that the person was supported following disappointment in not achieving this aspiration, and other suitable alternatives were suggested. During discussions with staff, there was evidence that they had a good understanding and background knowledge of the people they supported. People who were spoken to confirmed that staff supported them and encouraged them to try out different activities, such as courses, and going to local community drop in centres. The service has plans to provide its own mini bus for outings and local trips. The comments in professional surveys stated that the service supported individuals to live the life they choose. People spoken to were complimentary about the meals in the home. Staff prepare the evening meals, and the meal planned today looked appetizing and was nutritionally well balanced. Some people in the home are supported to shop and prepare their own meals. Minutes from tenants meeting showed that menu planning was on the agenda and that people in the home were consulted about their menu preferences. A separate menu has been developed for one person who is vegetarian. In one of the smaller kitchens which is available for people to make their own meals, a menu board provided recipes and examples of easy prepare main meals. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 15 People in the home said that they were responsible for keeping their rooms clean and tidy. Staff provided the appropriate support to individuals to help them to achieve this goal. The house is not identifiable as a care home and this ensures that people living in the home have privacy. They can have a key to the front door and to their own room. Five people living in the home were spoken to and some of their comments about their experience of living in the home are included below: “They (the staff) help me when I need it. I go to a textile class once a week, I like this. The staff help me to [prepare and cook my own food”. “I came for a visit before I moved in. I like to go out shopping, the staff come with me sometimes”. “I can talk to the staff if I have a problem”. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 16 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. Residents are supported to access health care support services when this is appropriate. EVIDENCE: Records in the home provided evidence that the service supports people to access health care support services as appropriate. Where it has become necessary to involve other professionals, the service has made appropriate referrals, and maintains the necessary documentation and recordings to demonstrate that residents are receiving the correct support. Choice, dignity and privacy issues are embedded in the support plans and feedback from people living in the home demonstrates that they are experiencing positive outcomes. All people spoken to said they felt well supported by staff and that they were helped to access medical services including consultations with specialist medical services. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 17 A medication policy was in place. All staff responsible fro the administration of medication has received training, and further updates for training has been arranged for all staff. The practice of handling medication in the home was carried out in a manner to ensure the safety and well being of residents. Medication was administered using a monitored dosage system. Medication records (MAR), contained sample signatures of those staff responsible for the administration of medication. There was evidence to show that the support co-ordinator reviews and audits medication and medication practices on a weekly basis. Medication was stored in a locked cabinet in individual bedrooms, this promoted privacy. The support co-ordinator said that some people have been supported to manage the application of prescribed creams, subject to risk assessment. During this visit it was noted that some people had been supported to access specialist equipment such as wheelchairs and bath chairs. All staff are given training on how to use this equipment in a way that ensures the safety of people using it. From observations made during this visit, it was evident that routines were flexible. People were seen coming and going at different times, and the time for getting up in the morning varied according to individual preferences. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 18 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 excellent. This judgement has been made using available evidence including a visit to this service. Policies and systems are in place to support residents in making a complaint when appropriate, and to ensure they are protected from abuse. EVIDENCE: There is a clear and accessible complaints procedure in place, which outlines the timescales for dealing with a complaint, and informs the people in the home on how complaints are dealt with. A complaints book is in place to record comments and issues raised by residents. The details of the complaints were included with information on the action taken. The support co-ordinator said that there were plans to improve the recording of complaints, as part of the development of policies and procedures. The Commission for Social Care Inspection has not received any complaints about this service since the last inspection. Residents who were spoken to, expressed confidence in approaching the staff with issues of concern. During the course of this site visit, residents were seen approaching staff with issues and concerns, and it was noted that the staff team took time to listen, and respond appropriately. Information provided by the service in the AQAA, provided evidence of a service that was committed to ensuring that residents were fully supported to express their views and to make a complaint. As part of the homes development, they have produced a DVD for people in the home on ‘managing complaints’ The complaints procedure is explained on the DVD, and Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 19 demonstrates further commitment to an open transparent way of dealing with complaints and in ensuring that people in the home have the information they need to help them with this process. A number of staff had undertaken training in Safeguarding Adults, and staff who were spoken to during this visit were able to demonstrate a good understanding of issues surrounding abuse. Most were aware that social service took the lead following an allegation of abuse, and that Commission had to be informed. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 20 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 home was maintained and decorated to a good standard. The standards of cleanliness and hygiene were good, providing residents with a clean and pleasant place to live. EVIDENCE: The home was comfortable and homely and all areas were decorated to a good standard. Information in the AQAA stated that there were monthly audits on the building to look at repairs, health and safety and cleanliness. The support co-ordinator said that all staff were scheduled to receive training in infection control. From information provided in the AQAA and discussions with staff and people living in the home, it was apparent that redecoration and renewals were done on a cyclical basis. People in the home said that they were consulted on decoration and furnishings in the home. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 21 People in the home are supported and encouraged to do their own cleaning, and in addition to this a cleaner is employed to clean communal areas of the home. All people spoken to said they liked their accommodation. There was evidence that a number of residents had chosen to personalise their rooms with their own belongings, reflecting their tastes and interests. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 22 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. Robust recruitment, and training programmes for staff are in place. People using the service can be confident that staff receive appropriate support and training, to ensure that they have the right skills to help them to meet their needs. EVIDENCE: During this site visit, there were sufficient staff on duty to meet the needs of residents in the home. Staff were engaged in discussion, and activities with residents. A duty roster is in place, and details the names of the staff on duty. Since the last site visit, the programme of staff supervision had improved. The staff team who were spoken to confirmed that they were in receipt of regular supervision. Staff also said that they had access to training and development opportunities. The project co-ordinator was currently developing a training matrix so that she can monitor staff training and development issues. She said Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 23 that staff supervision was also used as a method to re-in force good practice matters. A selection of staff files were examined. These were well organised and included a contents section. The information in the AQAA stated that all staff files were audited on a monthly basis. However, the support co-ordinator said that this process had only recently commenced. Some of the files did not contain all the appropriate documentation, and the project co-ordinator confirmed that much of this documentation was held at head office. This shortfall was addressed at the time of this visit. A written request was made to head office to provide copies of references and Criminal Record Bureau checks in order to comply with regulations. Since the inspection the Commission has received written confirmation that this shortfall has been addressed, and to show that recruitment procedures and audit of staff files is taking place so that the interests and well being of people using the service are protected. Creative Support DS0000021610.V363440.R01.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 44 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to ensure that the safety and well being of residents is protected. EVIDENCE: In May 2008 the organisation notified the Commission that the registered manager would be leaving her position on 30th May 2008. They provided details of the interim arrangements for management of the home and confirmed that they had appointed a newly qualified social worker to take up the post of support co-ordinator. The arrangements stated that the area manager for the organisation would support her. The Commission were notified that recruitment was taking place to find a suitable candidate for the manager post. Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 25 The support co-ordinator has made a positive contribution to the running of the home in the short time she has been working there. The staff team said they felt well supported and that the support co-ordinator and areas manager were both very approachable. There was evidence during this visit that the requirements from the last inspection had been met Information in the AQAA states that policies and procedures have recently been updated, and that this was an ongoing process. Staff in the home work in a person centred manner and all support plans are developed with and around the individual personal needs. A clear senior staffing structure is in place to ensure adequate management and leadership of the home. Creative Support DS0000021610.V363440.R01.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 4 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 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 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 3 3 3 3 3 X X 3 X Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA38 Regulation 8 Requirement The registered provider must appoint a suitable manager and submit an application for registration. Timescale for action 21/10/08 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 Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Creative Support DS0000021610.V363440.R01.S.doc Version 5.2 Page 29 - 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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