Care Home: Drayton Road

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What the care home does well Overall, the inspector believes this to be a good service, and service users expressed satisfaction with the home. One commented that "I really like it here." while another said "The staff are very good." Through observation and discussion there was evidence that staff have built up good relations with service users, and that they have a good understanding of their individual and collective needs. Service users have a large degree of control over their daily lives. The home provides a wide range of training to service users to help promote their independence and to empower them, for example around recruitment and selection, assertiveness and making a will. What has improved since the last inspection? There have been improvements to the home since the last inspection, and this is illustrated by the fact that the home has met all five of the requirements set at the previous inspection. In particular, staffing levels have increased since the previous inspection, and comprehensive risk assessments are in place for all service users. Accidents and incidents within the home are now recorded appropriately, and the broken fireguard in one of the bedrooms has been replaced. The home has also introduced a new system of care planning, which is comprehensive, and includes service users in the process. What the care home could do better: A total of three requirements have been made as a result of this inspection. Thorough pre admission assessments must be carried out on all prospective service users, the staffing rota must accurately record the hours worked in the home by the manager, and only staff that have undertaken appropriate training should administer medications. CARE HOME ADULTS 18-65 Drayton Road 2 Drayton Road Leytonstone London E11 4AR Lead Inspector Rob Cole Unannounced Inspection 6th December 2007 10:00 Drayton Road DS0000007262.V356100.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 Drayton Road DS0000007262.V356100.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. Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Drayton Road Address 2 Drayton Road Leytonstone London E11 4AR 020 8556 2550 020 8988 1491 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) Outward Mr Thomas Boyle Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 2006 Brief Description of the Service: Drayton Road is a residential home, registered to provide personal care and support to eight adults with learning difficulties. The home is situated in a residential area of Leytonstone, in the London Borough of Waltham Forest, close to local amenities and transport networks. The home was purpose built over three floors. The home is privately run and managed by Outward. The current range of fees charged by the home is between £550 and £1300 per week. Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 6/12/07 and was unannounced. The inspector had the opportunity of speaking with service users and staff from the home. The deputy manager was present throughout the inspection, and the homes registered manager was present for part of the inspection. The inspection also included an examination of records and other documents, and a tour of the premises, along with an observation of the support and care provided within the home. The home completed an Annual Quality Assurance Assessment (AQAA) at the request of the CSCI prior to this inspection. This formed part of the overall inspection process. An Expert by Experience was also used during the course of this inspection, with the aim of ensuring the views and experiences of those people who live in the home would be understood and reflected within this report. Parts of this report have been written by the Expert by Experience, along with some of the good practice recommendations. These sections are written in bold type. What the service does well: What has improved since the last inspection? What they could do better: Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 6 A total of three requirements have been made as a result of this inspection. Thorough pre admission assessments must be carried out on all prospective service users, the staffing rota must accurately record the hours worked in the home by the manager, and only staff that have undertaken appropriate training should administer medications. 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. Drayton Road DS0000007262.V356100.R01.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 Drayton Road DS0000007262.V356100.R01.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): 1,2,3,4 and 5. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that prospective service users are provided with sufficient information about the home to make an informed choice as to move in or not. This information is provided through written documentation and visits to the home. EVIDENCE: The home has both a Statement of Purpose and Service User Guide. Both documents are subject to regular review, and are in line with National Minimum Standards (NMS). The Statement includes details of the organisational structure and the aims and objectives of the home. The Service User Guide includes a copy of the homes complaints procedure and details of the services and facilities provided. All service users are provided with their own copy of the Guide. Both documents have been produced in written English, pictorial form and on audiotape to help make them accessible to service users, thus helping to meet their needs around equalities and diversity issues. The home has an admissions procedure, this makes clear that service users would be able to visit the home before making a decision as to move in or not. Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 9 There has been one new admission to the home since the previous inspection, and this was an emergency admission, that occurred two weeks prior to this inspection. Although it is accepted that in the case of emergency admissions it may not be possible to carry out a thorough assessment of the service user prior to admission, this assessment should nevertheless be carried out as soon as practical after admission, within 48 hours. This has not been done for the most recent admission. In order to demonstrate that the home is suitable, and that it is able to meet the needs of any new service users, a comprehensive pre admission assessment (or as soon after admission as practical in the case of emergency admissions) must be carried out. The deputy manager informed the inspector that the new service user was residing at the home on a trial basis, and that after six weeks a placement review meeting would be held, to which the service user, their family and social worker would be invited. The service user was able to indicate to the inspector that they are happy with the home. All service users have been provided with a contract/statement of terms and conditions. These include details of services and facilities provided and fees payable, and were in line with National Minimum Standards. Contracts have been signed by service users and a representative of the organisation. Drayton Road DS0000007262.V356100.R01.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): 6,7,8,9 and 10. People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that service users have a large measure of control over their daily lives, and that service users are routinely involved in the day to day running of the home. EVIDENCE: The home has introduced a new system of person centred care plans since the previous inspection. These are of a good standard, clear and comprehensive. Care plans are drawn up with the involvement of the service user, their keyworker and the homes management, and are subject to regular review. Care plans demonstrate how the home is able to meet the needs of service users across a wide range of issues, including around health, mobility, personal care, social and leisure needs and issues around equalities and diversity such as sexuality and religion. To help further meet the needs of service users with Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 11 regards to equalities and diversity issues care plans have been produced in written form and on audio format to help make them more accessible to service users. Care plans are signed by the service user, to demonstrate their involvement with them. The inspector was pleased to note that since the previous inspection comprehensive risk assessments are now in place for all service users. Assessments identify any potential risks, and include strategies to manage and reduce these risks. The risk assessments make clear that service users are supported to take reasonable risks in line with their wishes. For instance, one assessment has identified that a service user faces the risk from burning when involved in food preparation. The assessment states that this service user should still be supported to prepare food, but that staff support should be provided at all times, and also the service user has been supported to complete an NVQ in catering to help improve their skills in the kitchen. Risk assessments are subject to regular review. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives. Service users informed the inspector that they are able to get up and go to bed when they choose, and that they choose their own clothes to wear, what to have for meals, and when to take meals etc. Indeed, it was observed that service users were able to get up over a three hour period during the course of the inspection, and to have breakfast and lunch at a time of their choosing. There was evidence that service users are involved in the ay to day running of the home. Service users are involved in the homes daily routines, for example keeping their bedrooms tidy, and several service users were observed to be involved in putting the weekly shopping away. The home holds fortnightly service user meetings, which are minuted. These include discussions on menus and activities, and any other issues that service users may wish to bring up and discuss. All service users are allocated a designated keyworker, and meet regularly with them, giving them the opportunity to discuss any issues of interest to them. Service users are involved in choosing new décor for the home, for example the bathrooms have recently had new floor coverings installed, and some lamps have been purchased for the sitting room, and service users where involved in choosing these. On the day of inspection one service user was supported to go to the shops to buy a new bed for themselves. The inspector was impressed by the level of training provided for service users, with a view to developing their independence and giving them more control over their lives. For example, service users have attended training on recruitment and selection, and are now involved in the recruitment process for new staff. Other training attended includes on sexuality, assertiveness, fire safety and personal safety when out in the community. Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 12 The home has a confidentiality policy in place, which makes clear under what circumstances a confidence may be broken in the health, safety and welfare interests of service users and others. All confidential information is stored securely, and staff and service users can access their records as appropriate. We observed the staff being very friendly with the residents. Residents told me they were able to use the garden and liked the garden, key workers help residents to plant flowers in the garden. Residents are able to choose food and drinks from the cupboards in the kitchen, and make their own drinks with staff. Resident told us they would like a pet, they told us she would like a rabbit. Resident told us they could go to the pub if they wished. Resident told us they were to go out for Christmas dinner. Resident also told us they were going to their brother’s house and that he comes to get them from the residential home. Resident told us they choose when they go to bed and wake up. Resident told us he chooses to have a bath when he wishes. Residents are able to choose what they watch on television. Residents are able to smoke if they wish to outside. A resident is to have a birthday party and friends from the day club are to attend the party. Resident were smiling and seem to look very happy. Staffs were seen to be with the residents and be very helpful. Drayton Road DS0000007262.V356100.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): 11,12,13,14,15,16 and 17. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the judgement of the inspector that service users are supported to live valued and fulfilling lives. Service users have regular access to the community, and are offered a varied, balanced and nutritious diet. EVIDENCE: Service users are currently involved in various educational opportunities at local adult education centres and various day services. One service user is doing work around finances and budgeting skills, while three service users are currently involved in course on working with computers. Service users informed the inspector that they would like the opportunity of using a computer at home. The deputy manager informed the inspector that the home is looking into the possibility of purchasing a computer for the exclusive use of Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 14 service users, and this is recommended. One service user also attends classes in English. Other service users are involved in drama classes. The home supports service users to meet their needs around equalities and diversity issues through various activities within the community. Three service users regularly attend church, one is able to attend the church they went to prior to moving into the home. One service user regularly visits an AfricanCaribbean centre, where they take part in a variety of activities, and have the opportunities of developing and maintaining friendships. Service users also attend Eastsiders, which provides opportunities for adults with learning disabilities to engage in various social activities. Service users also attend discos and play in football matches, arranged by MENCAP. The organisation that runs the home, Outward, provide various activities, including art, photography and music sessions. On the day of inspection several service users attended one of these music sessions, those spoken to by the inspector said that they enjoyed it. As well as various social clubs, service users have regular access to the local community. Service users routinely visit banks, (they all have their own bank account), post offices, shops, parks, markets, cafes and the local library. Service users access public transport, including buses, trains and mini cabs, and the home has its own unmarked vehicle. Service users have access to a variety of social and leisure activities, both in house and in the community. In house service users have access to TV, music, board games and puzzles. Service users are also involved in maintaining the homes garden, and various vegetables have been grown which service users have helped to produce and eat. The home holds occasional parties to celebrate special occasions. One service user informed the inspector that “It’s my birthday next week, I am having a big party to celebrate.” It was evident that the service user had chosen to have a party to celebrate their birthday, and that they were involved in planning it. All service users are offered a weeks holiday away from the home as part of their basic contract price. This year service users have been to France, Ireland and Spain. One service user showed the inspector photographs of their trip to Spain and said “I liked my holiday in Spain.” Day trips are also arranged, and recent day trips have included Brighton, Southend and the Science Museum in London. One service user wished to go abroad for a holiday, but was concerned about having to fly. The home offered support around this to reduce their fear, they supported them to visit an airport and take a meal there, then progressed to a short domestic flight before going abroad. The service user was able to confirm that they had enjoyed the holiday. The inspector was impressed by the degree of choice on offer over meals. As mentioned, service users are able to take their meals at a time of their choosing, and mealtimes were observed to be relaxed and unhurried. On the Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 15 day of inspection all service users were able to choose their own lunch, some had sandwiches, others fish cakes, while others choose soup. Records are maintained of menus, these indicated that service users are offered a varied, balanced and nutritious diet, with the main meal been served in the evening. Service users were observed to help themselves to drinks and snacks throughout the day, and are involved with the food preparation, including buying and choosing food. The kitchen was clean and tidy, and food was stored appropriately. Records are maintained of fridge and freezer temperatures. One resident told us that she chooses her own breakfast and also has a diet she follows. She likes choosing her own drink. She has her own menu to choose from. Resident told us they use public transport with key worker or staff when they wish to. Resident told us she goes to her day clubs and goes out to dinner with staff, she enjoys going to the cinema with staff and her friend. Resident told us they were able to have a bath when they wished. Resident told us she has her own personal belongings in her room. She chose the colours for her own bedroom. A resident told us they felt very safe living in the home. Residents are able to use the telephone at any time to family. Friends are welcome to telephone residents. Resident told us she spends her birthday in the home with her friends and staff. She has close friends to share her birthday with. A resident told us they enjoyed spending Christmas in the home with staff. One resident told us that they try to work a problem out for themselves but if they can’t they talk to staff and they sort their problem out for them. Drayton Road DS0000007262.V356100.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): 18,19,20 and 21. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the inspector’s view that the home is able to meet the health and personal care needs of service users. Service users have routine access to health care professionals as appropriate, and staff support service users to manage their own personal care as much as possible. EVIDENCE: Clear guidelines on supporting service users with their personal care are in place on individuals care plans, and these indicated that service users are encouraged to do as much for themselves as possible, to help promote their independence and dignity. Service users choose their own clothes to wear, and on the day of inspection all were appropriately dressed. Personal care support provided to female service users is always provided by female staff. The deputy manager informed the inspector that service users would be able to remain in the home with a terminal illness, so long as the home was able to meet their medical needs. A service user recently passed away, service users Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 17 who wished to attend were supported to attend their funeral, and have been offered support around the issue. The home has sought the views of service users on their wishes in the event of their death, and this forms part of their care plans. The inspector was pleased to note that training has been arranged for service users on making a will, and the inspector considers this to be an example of good practice, which will help to empower service users to have more control over the choices they can make. All service users are registered with a GP and a dentist. Records are maintained of medical appointments, including details of any follow up action required. Records indicated that service users have routine access to health care professionals as appropriate, including opticians, psychologists and physiotherapists. The home makes use of the Continence Advisory Service, and used continence products are disposed of appropriately. A health action plan has been drawn up for each service user, detailing how the home can meet their health needs. The home has a comprehensive medication policy, and medications are stored securely in a locked cabinet inside the office. The most recent member of staff to start working in the home is booked to attend medication training in January 2008, but they informed the inspector that they already administer medications without the support of other staff. The manager confirmed that this was indeed the case. In order to help ensure that medications are administered appropriately at all times, and to help ensure the safety and welfare of service users, it is required that only staff that have received training around medication (including an assessment of competence) actually administer medications. No service users currently self administer medication, or are on any controlled drugs. Records are maintained of medications entering the home, and of those that are returned to the pharmacist. The home maintains Medication Administration Record charts, those examined by the inspector were accurate and up to date. Medications are checked at the beginning of every shift as part of the handover process to help ensure that they are administered appropriately. Resident told us she has their own G.P / dentist and they are both local. Drayton Road DS0000007262.V356100.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. People who use this service experience good outcomes good in this area. This judgement has been made using available evidence including a visit to this service. It is the inspector’s judgement that the home has taken reasonable steps to help ensure that service users are protected from the risk of abuse. Appropriate polices and procedures are in place, and training is provided for staff and service users. EVIDENCE: The home maintains a complaints log, this indicated that any complaints received have been recorded and investigated appropriately. The home also has a complaints procedure, which includes timescales for responding to any complaints received, along with contact details of the CSCI. All service users have been given a copy of the complaints procedure, and it is on display within the home. The procedure has also been produced in video format to help make it more accessible to service users, thus helping to meet their needs around equality and diversity issues. Service users spoken to demonstrated a good understanding of whom they could complain to if they so wished. The home has a policy on adult protection, which appears to be in line with current legislation. The home has also obtained a copy of the Local Authorities adult protection procedure since the last inspection. All but the most recent member of the staff team have undertaken training in adult protection issues, and those staff spoken to demonstrated a good understanding of their roles Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 19 and responsibilities with regard to adult protection. The inspector was pleased to note that training has also been provided for service users around complaints and protection issues. The home holds money on behalf of service users in a locked safe. Records and receipts are maintained of all financial transactions involving service users monies. Those checked by the inspector appeared to be satisfactory. Staff check all service users monies at the beginning of every shift. Residents told us they have their own money. Resident told us they can go to the bank with their key worker and get their own money out and buy what they like. Drayton Road DS0000007262.V356100.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): 24,25,26,27,28,29 and 30. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that the home is suitable to meet its stated purpose with regard to its physical environment. Service users are provided with adequate communal and private space, and the home was generally well maintained. EVIDENCE: The home is situated in the Leytonstone area of the London Borough of Waltham Forest, close to shops, transport links and other local amenities. The home is purpose built over three floors. Not all of the communal areas are accessible to all service users, due to mobility issues. The home is in a good state of repair, and well maintained, both internally and externally. All service users have their own bedrooms, these have locks fitted and service users have been offered keys to their rooms. Bedrooms have recently been Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 21 decorated, and service users informed the inspector that they were involved in choosing the new décor. Rooms have been personalised to service users individual tastes, for example with family photographs and televisions. Rooms had appropriate furniture, including table and chairs, wardrobes and chest of draws. Bedding, carpets and curtains were all well maintained, and domestic in character. Bedrooms had adequate natural light and ventilation. Bedrooms meet National Minimum Standards on size requirements. At the last inspection it was found that the protective covering on one of the bedroom radiators was damaged, and this has since been replaced. One service user has ensuite facilities in their bedroom, and all other bedrooms have hand basins in them. There is a shower room on the ground floor and a bathroom on the first floor. The ground floor shower room was specifically designed to meet the needs of one of the service users. Grab rails are in place in communal areas, and there are sufficient toilets to meet service users needs. On the day of inspection bathrooms were found to be clean, tidy and free from offensive odours, and all had locks fitted to them. The home’s garden was well maintained, and service users were observed to enjoy spending time there during the course of the inspection. The home has various means in place to help prevent the spread of infection, including an infection control policy. Staff are provided with protective clothing, such as aprons and gloves. The laundry facilities are adequate to meet service users needs, and hand washing facilities are situated throughout the home. COSHH products were stored securely. Drayton Road DS0000007262.V356100.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): 31,32,33,34,35 and 36. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The inspector was satisfied that the home is staffed in sufficient numbers to meet the needs of service users, and that staff have a good understanding of their roles and responsibilities. EVIDENCE: The home provides 24-hour staff support, including waking night staff and an emergency on-call procedure. The inspector was pleased to note that staffing levels have increased since the last inspection, and are now adequate to meet the needs of service users. There was a staff rota on display within the home. The homes manager is currently dividing their time between managing Drayton Road, and acting up as the manager of another home run by the same organisation. The rota indicates the hours worked by the manager in total between the two homes. It is required that the staff rota clearly identifies the hours and times that the manager spends working at Drayton Road to evidence that they spend an appropriate amount of time there, and to ensure that staff and service users are aware of when the manager will be working in the home. Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 23 Through observation and discussion there was evidence that the staff have a good understanding of their roles and responsibilities, and of the collective and individual needs of service users. All staff have been provided with a copy of their job description. Staff were seen to interact with service users in a friendly and respectful manner. Service users informed the inspector that they got on well with the staff. Throughout the day the inspector observed examples of positive staff interactions with service users, for example responding to a service users wish to use the computer and tidying a bedroom together. The home has various policies and procedures in place around employment issues, for example on recruitment and selection, equal opportunities and a disciplinary procedure. The organisation holds staff employment records centrally, with the agreement of the CSCI. The home has a pro forma for each member of the staff team which provides details of what employment checks have been carried out. Those checked by the inspector indicated that all appropriate checks had been carried out on staff, including CRB checks and proof of ID. All staff undertake a structured induction programme on commencing working at the home. Staff receive regular training, and records are maintained of staff training. Recent training has included fire safety, manual handling, food hygiene, person centred planning, adult protection and communication approaches in learning disability. It was seen that staff demonstrated a good ability to communicate with service users, some of whom have complex communication needs. All five of the care staff employed at the home have successfully achieved an NVQ Level 2 in Care or equivalent qualification. All staff receive regular formal one to one supervision from the homes manager or deputy manager. Records are kept of these meetings, and staff get their own copy of the records. Supervision includes discussions on service user issues, health and safety and training needs. Drayton Road DS0000007262.V356100.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): 37,38,39,40,41,42 and 43. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. It is the view of the inspector that this is a well run home. Health and safety is well managed, and there are appropriate quality assurance systems in place. EVIDENCE: The homes manager has several years experience of working in a care setting, including in a managerial capacity. They are a Registered Learning Disabilities Nurse, and have successfully completed the Registered Managers Award. They are supported in the management duties by a deputy manager. The management team presents as been open, and as having good relations with service users, staff and other relevant persons including social and health care Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 25 professionals. On the day of inspection the management team were observed to be readily accessible to both staff and services users. The home has all necessary policies in place in line with NMS. Those seen by the inspector, including admissions, adult protection and medication were of a satisfactory standard. Record keeping within the home was of a good standard. Confidential records are stored securely, staff and service users can access their confidential records as appropriate. Care plan reviews, service user meetings and staff supervisions all contribute to the quality assurance within the home. Copies of previous inspection reports were available to view in the home, and there was evidence of monthly Regulation 26 visits taking place. The home also issues questionnaires to service users to help gain their feedback on the running of the home. Completed questionnaires seen by the inspector contained generally positive feedback. Fire extinguishers were situated around the home, these were last serviced in July 2007. Fire exits were clearly signed, and free from obstruction. The home tests its fire alarms on a weekly basis, and these were last serviced on the 17/10/07. The home has in date safety certificates for gas safety, electrical installation and PAT testing. Hot water and ridge/freezer temperatures are checked as appropriate, and COSHH products were stored securely. The home has in date employer’s liability insurance cover in place. Drayton Road DS0000007262.V356100.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 2 3 3 4 3 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 4 3 3 3 3 3 3 3 Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 27 No. 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 YA2 Regulation 14 Requirement Timescale for action 31/12/07 2. YA20 13 3. YA33 17 The registered person must ensure that comprehensive pre admission assessments are carried out on all prospective service users prior to them moving into the home (or within 48 hours of them moving into the home in the case of emergency admissions), to determine whether the home is able and suitable to meet the persons needs. The registered person must 31/12/07 ensure that all staff undertake appropriate training, including an assessment of competence, before they administer any medications within the home. The registered person must 31/12/07 ensure that the staffing rota accurately reflects the hours worked in the home by all staff, including the homes manager. Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 28 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. 2. Refer to Standard YA12 YA24 Good Practice Recommendations It is recommended that the home gives consideration to obtaining a computer for the use of service users, to be kept in the communal areas of the home. It is recommended that the home discusses with service users the possibility of having name plates and photographs on their bedroom doors, and that consideration be given to having more photographs of service users on display around communal areas in the home. It is recommended that the home seeks the views of service users with regard to having a pet. 3. YA14 Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Drayton Road DS0000007262.V356100.R01.S.doc Version 5.2 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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