Care Home: Easemore Road, 164b

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What the care home does well The home only offers a place to someone if they can meet their needs. The service is small which suits the service users. The home is welcoming and relaxed. The house is comfortable and safe and any equipment needed is provided. Each service user has a care plan, which helps staff to know all their needs and how to meet them and what they like and dislike and want to do. The service users are respected and given good personal and health care. The staff are trained and supported to do a good job. They help service users learn how to care for and make decisions for themselves, as much as they can manage. There are not many staff changes so the service users and staff know each other well. There are enough staff to meet the residents` care needs and to support them at home, to go on outings, and to do the things they want. They are supported to stay in touch with their families. The manager has the right training. She makes sure the home is well run, and that staff know how to do a good job. The service is well organised and there are good records. These make sure staff have the information they need to do their job properly, and show that the home is looked after well so it is safe and comfortable to live in. The manager is well organised and leading the development of good care practice underpinned by sound, effective records. Work asked for after the last inspection has been done to make the service better. What has improved since the last inspection? Service users care records are better at showing their own point of view so someone reading them knows the person better. All service users have health action plans they take to health appointments. Staff help keep them up to date. Most staff have up to date health and safety training to make sure service users keep safe and well. Staff have recently attended specialist training in managing behaviour that challenges the service, ageing and dementia? Other specialist training is being planned such as understanding autism, and communicating with people who have dementia, so that staff give the right help to service users with special needs. Staff have done courses to help them and service users understand each other better. Each service user has a communication board for personal information at home, and a communication book to share information between important people. More work is being done to help service users understand everyday information about how the service works. The manager is looking for a big magnetic board for information they can use to help plan and make decisions. What the care home could do better: The provider needs to show more clearly how people are asked what they think about standards in the home and how it is run.This should result in a plan to keep developing the service to make it better for service users. CARE HOME ADULTS 18-65 Easemore Road, 164b 164 Easemore Road Redditch Worcestershire B98 8HH Lead Inspector Sue Davies Unannounced Inspection 9 January 2008 3:40 th Easemore Road, 164b DS0000064300.V342505.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 Easemore Road, 164b DS0000064300.V342505.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. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Easemore Road, 164b Address 164 Easemore Road Redditch Worcestershire B98 8HH 01527 597883 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) redditch@macintyrecharity.org www.macintyrecharity.org MacIntyre Care Ms Amanda Elizabeth Lewis Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate two service users who have additional physical disabilities. 18th August 2006 Date of last inspection Brief Description of the Service: 164b, Easemore Road is registered to provide residential care for up to 4 adults who have mild to moderate learning disabilities, including 2 people who may also have an additional physical disability. Information about fees was not available at the time of writing this report. The premises is a detached, purpose built property, situated in a pleasant residential area, within walking distance of Redditch town centre. The bungalow is located on the same site as a separate house for 4 people with mild learning disabilities, who have supported living arrangements. The Registered Provider is MacIntyre Care. The property is leased from the New Era Housing Association. The stated purpose of the organisation is, ‘to be recommended and respected as the best provider of services for people with learning disabilities throughout the United Kingdom.’ Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this unannounced visit was to carry out a statutory key inspection. The focus was to find out from the service users’ perspective how well the service is meeting their needs, and to check action to meet previous requirements and recommendations. Preparation for this inspection included reading previous reports and reviewing information about the home, and the information provided by the manager in an annual quality assurance assessment. The inspection took place in winter and was carried out over a period of two days to meet all 4 service users, the manager and staff, and allow for observation of daily life at the home. The inspection included looking at records about service users needs and how the service was meeting these, including care plans, daily care and management records, staffing and staff training records. One service user provided a tour of the building. Time was also spent speaking to service users’ relatives about their experience of the service. Everyone met or consulted during the inspection indicated that they were happy to be living or working at Easemore Road, or for the person they supported to be living there. Thanks go to all the people who gave their time and help throughout the inspection. What the service does well: The home only offers a place to someone if they can meet their needs. The service is small which suits the service users. The home is welcoming and relaxed. The house is comfortable and safe and any equipment needed is provided. Each service user has a care plan, which helps staff to know all their needs and how to meet them and what they like and dislike and want to do. The service users are respected and given good personal and health care. The staff are trained and supported to do a good job. They help service users learn how to care for and make decisions for themselves, as much as they can manage. There are not many staff changes so the service users and staff know each other well. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 6 There are enough staff to meet the residents’ care needs and to support them at home, to go on outings, and to do the things they want. They are supported to stay in touch with their families. The manager has the right training. She makes sure the home is well run, and that staff know how to do a good job. The service is well organised and there are good records. These make sure staff have the information they need to do their job properly, and show that the home is looked after well so it is safe and comfortable to live in. The manager is well organised and leading the development of good care practice underpinned by sound, effective records. Work asked for after the last inspection has been done to make the service better. What has improved since the last inspection? What they could do better: The provider needs to show more clearly how people are asked what they think about standards in the home and how it is run. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 7 This should result in a plan to keep developing the service to make it better for service users. 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. Easemore Road, 164b DS0000064300.V342505.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 Easemore Road, 164b DS0000064300.V342505.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have a full assessment of their needs before they move in. EVIDENCE: This is a stable group of people with no new service users having moved in for several years. Service users moving in can be confident staff know and understand their needs, with written information on record showing full assessments of their needs were carried out before they moved in. Easemore Road, 164b DS0000064300.V342505.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, and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user plans are clear and detailed with information about service users care needs, assessment of risks and how staff are to help them recorded in a person centred way. Service users’ personal development is promoted and they are supported to make their own choices and decisions. EVIDENCE: Two service user plans looked at contain clear, detailed information about all areas of the service user’s life, including a sound approach to assessing and managing risk which balances special needs with improving personal skills so service users can enjoy fulfilling activities. Staff have had training in person centred planning and records are being brought up to date using this approach. Where they are able to understand the process, service users are involved in contributing to their plans but not everyone fully understands the concept of care planning. Plans are kept securely in the office, and service users have Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 11 their own copies. They do not all understand this process so may destroy their own copies of their plans, but the office copy can be used to replicate their own should this be destroyed. Thought has been given to working with service users to make their plans meaningful to them, with photographs, pictures and mementoes. Service users showed these during the inspection and although some did not fully grasp the purpose of their plan, they responded to images of things that were important to them. To help service users understand what is going to happen for them each day, communication boards in their rooms show their days’ planned activities, and in public areas such details as staff on duty. Staff were exploring ways to display this information more clearly and effectively so service users can use it to make choices and decisions of their own. Each service user benefits from key worker one-to-one support to plan their activities, make choices and decisions about their lives and make sure their plan is up to date. A key worker also arranges regular reviews, helps the service user decide who they would like to invite, liaises with family carers, professional and other supporters, and makes sure on the service user’s behalf that everyone understands how he is getting on and any extra help he may need. From discussion with family members it is clear the review is an important opportunity for liaison about meeting service users’ needs, but does not always give the opportunity for detailed discussion. It would be good practice to review the key worker role to see if this could be extended, so that staff and families have more opportunities for exploring issues in depth for the service users benefit. Service users’ plans are well constructed and easy to follow, but need to be kept up to date with consideration given to storing some information separately. Staff spoken to were able to show how these records are used as a working tool to keep up to date with all service users’ activities, day to day and long term needs, in the way which best suits them and helps their skills development. Service users are supported and encouraged to take part in all areas of daily living in the home. A good system of risk assessment and risk management strategies is used to focus on developing skills through understanding and following good health and safety practice. During the inspection service users were involved in cleaning, tidying bedrooms, making their own drinks, preparing an evening meal, and going shopping. One service user explained that everyone has their jobs to do, he said he did not like doing some things such as ironing but thought it was fair everyone did their share. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 12 These service users currently rely on staff for most of their communication so the development of staff skills and a clear communications strategy is a continuing priority. Service users have individual communication needs assessments and profiles on their service user plans. These show how they communicate and what staff need to do to help. To make sure all service users get the help they need all staff are receiving specialist training in total communication. They have in-house support and guidance and are beginning to put this into practice but this needs to be done under expert guidance to ensure it is fully suited to service users needs. For example a good start has been made on the complaints procedure, but the message needs to be kept very simple for everyone to understand it. Some service users’ behaviour poses challenges for the service, staff and each other. Staff carefully record information and guidance about what prompts this and how best to support each person individually. They have appropriate training, specialist support and regular supervision to understand and respond consistently according to individual needs. Records and discussion with staff show they generally find this helpful and effective, although this report highlights some matters needing more attention and the manager is alert to the need for this. In view of their communication needs and to ensure they don’t have to rely solely on staff to articulate their views, advocacy support has also been arranged for service users needing help to express their own views. Easemore Road, 164b DS0000064300.V342505.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, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are improving opportunities for service users to extend their interests and skills, in and outside the home. Most service users have good contact with families, or with friends where there is limited family support. Service users are supported to choose, prepare and eat healthy meals. EVIDENCE: All service users attend day centres during the week, and younger service users have a varied programme of other stimulating activities suited to their needs while older service users choose and are supported to lead quieter lifestyles. Opportunities for involvement in the local community include for example swimming, bowling, cinema, gym, walks, cinema and theatre, trips out, visits to the pub and meals out. Service users also have regular short breaks and holidays, with family or with staff and other service users. Activities at home include football, snooker, garden games, board games, television, music and craft activities. One service user has his own bicycle. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 14 Service users all enjoy the chance to go on holiday with families or with staff, for example one service user recently chose a holiday to Cyprus. Service users social and emotional needs are recognised and supported. Opportunities for meeting people with shared interests have been extended with visits to watch football with one new staff member. One service user meets regularly with a friend, taking a taxi to the home where he lives. Others enjoy regular visits with their families, and good communication between staff at the home and service users families is valued and promoted. Key workers have responsibility for taking the lead on keeping in touch. Families spoken to in the course of inspection were pleased with the service and their contact with the home, felt they were welcome and encouraged to speak up at reviews, and were kept in touch so that they knew what was happening and could make a positive contribution to their relative’s care. Some responses suggested more informal opportunities for exploring issues would also be welcomed, to achieve the best outcome for service users, and this could be explored further. Staff have been supporting families to get more involved with improving communication, and have been encouraged by positive responses to an offer of training. Service users benefit from support and encouragement to take part in all areas of daily living in the home. A good system of risk assessment and risk management strategies is used to focus on developing skills through understanding and following good health and safety practice. During the inspection service users were involved in cleaning, tidying bedrooms, making their own drinks, preparing an evening meal, and going shopping. One service user explained that everyone has their jobs to do, he said he did not like doing some things such as ironing but thought it was fair everyone did their share. Service users have a selection of breakfast choices available every day, prepare their own packed lunch for the day centre. Main meals are freshly prepared on the day and service users help with preparation. Methods such as pictures and photographs help service users express choices, and a range of alternatives are always available to further provide for choice. Only one service user was able to comment on the choice or quality of meals, but he explained that each person chose what they liked on the day it was their turn to help prepare the meal, and that he himself liked everything offered. Easemore Road, 164b DS0000064300.V342505.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, 20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed information about service users personal and health care needs, behaviour management assessments and how staff are to help them is recorded in clear service user plans and there is evidence this is working well for them. Health action plans support service users to have a more central role in the management of their own health care. EVIDENCE: One service user is supported to manage his own personal care but others need staff help with personal hygiene and dressing, and supervision with meals. Staff show they know service users well, they are able to explain with understanding and respect how each person prefers to be helped, and this information is clearly recorded and kept up to date in their plans. The staff team is now more balanced with both male and female staff, so that although service users are very familiar with female carers supporting them and show no clear preference, same gender staff can be available to assist with intimate personal care if this is preferred. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 16 For some service users having male staff on the team has also been particularly welcomed in extending social activities, to include for example going to football matches. Health action plans have been completed. Staff spoken to were keen to help service users play a more central role in their own health affairs, and use the provider’s online training on health action planning and promoting service users’ health care. There is a careful approach taken to managing service users health care, and records show service users receive timely attention both to regular health check ups and in response to emerging problems. Staff have detailed information about all aspects of each service user’s health care, appointments and medical interventions, together with follow ups, monitoring and outcomes. One service user who has joint problems is awaiting assessment for surgery and staff are aware of the need to assess his capacity to understand and consent to this if it is recommended, using the provisions of the Mental Capacity Act to get this right for him. All service users plans contain clear guidance on their special behavioural needs and individual management strategies. Staff have received training in the management of challenging behaviour and support from the behavioural management team, with positive outcomes. Careful attention is paid to gathering and analysing information that may help staff understand service users better, and support them in making changes that improve their quality of life. For example, one service user whose behaviour has challenged the service has benefited significantly from staff identifying what was important to him and following his behaviour management programme consistently. His family are pleased with his progress and feel he is now much calmer and happier. Another service user currently facing difficulties is being supported to explore possible health factors that may need attention. No service users are deemed able to handle their own medication, and this is recorded on service user plans. There is a sound medication policy and procedure. All staff have received recognised training and understand their responsibilities, staff spoken to were able to give a clear account of the procedures to be followed and understood the purpose, effects and side effects of medication used in the home. Two staff were observed carefully administering medication following correct procedures, although care needs to be taken that the person signing the record is the person who has given the medication to the service user. A pharmacist from the supplying pharmacy provides regular inspection of the home’s medication arrangements and ongoing support, with no concerns noted in the latest report. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 17 Medication storage, handling and recording are generally well managed, but care is needed to make sure medication profiles in plans correspond fully with information on current MAR sheets. For example, one service user’s medication profile dates from 2005 with corrections dated 2007, but some medication is no longer used. It is essential medication profiles are clear, up to date and accurate. As this service user group includes older people, all staff have attended awareness training on managing and supporting the ageing processes, including special conditions such as dementia associated with ageing for which some service users have been assessed. Other linked training needs and sources of training are being identified, for example, communicating with people who have dementia. Easemore Road, 164b DS0000064300.V342505.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 good. This judgement has been made using available evidence including a visit to this service. There is a clear written complaints procedure and staff are working on a format to help all the current service users better understand this process. A complaint has been investigated and responded to appropriately. Staff are aware of local procedures for responding to suspicion of abuse, and have up to date training on safeguarding people. EVIDENCE: Service users have a written complaints procedure telling them how to voice complaints. As it is unlikely they would be able to understand or use the process should they have any concerns, staff are developing an accessible complaints procedure they can understand better. Two service users have been supported to request an advocate. Service users are protected by sound procedures for following up concerns about how they are treated, and these have been tested in practice in one instance which shows the system is used properly and serves service users well. The Commission and Adult Protection Co-ordinator were consulted regarding one complaint from a service user about staff attitude and behaviour, and were satisfied the provider’s proposed response was appropriate. A senior manager from outside the service subsequently investigated the matter very thoroughly. Detailed records confirm the complaint was responded to in a timely way, that required procedures were followed, and that a balanced and careful investigation was carried out with the outcome that the complaint was upheld. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 19 A suitable strategy has been put in place to support the service user, with an additional programme of staff training and support designed to promote sound practice, and the situation continues to be carefully monitored. Service users in this home are especially vulnerable due to their special needs and limited communication. To ensure they are safeguarded from harm, adult protection training needs to be provided and regularly kept up to date by suitably qualified trainers to make sure all staff are familiar with current thinking and good practice, including the management of challenging behaviour with regard to the particular needs of the service users in this home. Discussion during the inspection showed staff are familiar with the organisation’s and local policies and procedures on adult protection. They have up to date training on safeguarding service users from abuse and most have had recent in-house guidance from the manager. The above complaint is a reminder of the need for continuing vigilance by all staff in exercising their responsibilities. Easemore Road, 164b DS0000064300.V342505.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 service users are able to enjoy living in a home which is designed for their needs and well maintained to be comfortable safe and homely. EVIDENCE: The service users’ have a safe and secure home which is homely and welcoming, comfortably furnished and pleasantly decorated reflecting their own choices. Pictures and belongings around all areas of the home reflect their interests and personalities. Their accommodation is a purpose built bungalow that is well laid out around a central hallway with easy access to all facilities, bathroom, shower room and sufficient toilets. People with mobility problems would be able to get around everywhere without any problems, although the building is not designed to accommodate wheelchair users. One service user uses a wheelchair when out if he cannot walk too far, but not in the home. No one needs other specialist aids at present. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 21 Service users can walk to shops and leisure facilities, and can also reach them by public transport, car and taxi. There is a very large garden with a wide level area where service users are able to enjoy outdoor pursuits, and enjoyed using new equipment during the summer which they had bought earlier in the year. A summer house is planned, to add to garden amenities. The home is kept safe and comfortable for service users through an effective system for general maintenance and repair. Staff have very good guidance and training on health and safety and controlling infection that they follow carefully, ensuring the home remains a safe, clean, fresh and pleasant place for the people who live here. The premises meet fire safety requirements and the fire safety officer is consulted appropriately for advice. Easemore Road, 164b DS0000064300.V342505.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, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing is more stable so service users and staff know each other well, and there is a better gender balance with men as well as women on the team, so service users are well supported by staff who understand their needs. Staff recruitment procedures are robust to safeguard service users’ well being. Staffing is generally well deployed, the existing vacancy is being staffed by current staff taking extra hours to offer more flexibility for service users. EVIDENCE: The manager provided detailed information about staffing prior to the inspection and this was confirmed from records, observation and discussion with staff in the home during the inspection. To make sure service users get the best help and support the manager works hard only to employ staff with the right qualities, and she also makes sure they get the personal and professional training and development they need. Recruitment is no longer a significant issue. One more staff has been appointed and existing staff are doing more hours to make sure service users are supported by people who know them well and understand their needs properly. This provides flexibility for shifts to be extended if service users are Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 23 out on activities, without the need for agency staff to be used. Service users are able to enjoy more one-to-one time with staff, for example, to do things spontaneously or try new leisure opportunities, and relatives have commented on the improvement. Service users are benefiting from a more settled staff team which includes both men and women, so that they have confidence the staff who care for them know them and understand their needs well. The manager described the robust recruitment practices used to safeguard service users, which makes sure staff backgrounds are properly checked before they start work and good staff records are kept. Some elements of this recruitment process are carried out at headquarters and these need to be verified in records held in the home. Service users are benefiting from a team of staff who are being supported and encouraged to get the right training to support them properly, and who are becoming knowledgeable and skilled. 50 of staff are now trained to National Vocational Qualification level 2 or above, and the remainder booked or about to start on NVQ2 programmes. This means 100 staff will have a National Vocational Qualification. Records, discussions and observation during the inspection showed staff are caring and competent, and are committed to helping service users have a really good quality of life. The organisation recognises the benefits of a skilled and well trained workforce, and the manager is making sure steady progress is being made. There are still some gaps in training records that do need to be brought up to date, with evidence supported by training certificates. Staff are well supported to do their job, through regular supervision and staff meetings, and the manager has systems for monitoring quality of practice. For example she regularly reviews daily records, medication, personal care and health records, observes practice while working alongside staff, while surveys conducted as part of the quality assurance process provide an opportunity to hear the views of others outside the service. Where practice needs improvement this is responded to fairly and constructively with decisions and actions being based on service users best interests. For example, staff may be helped to address practice issues through a structured retraining and support process that helps ensure problems are resolved without losing valued people and skills. Easemore Road, 164b DS0000064300.V342505.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 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well run, and the manager has good systems for monitoring the way staff work and helping them to make sure they do their job well. The providers visit monthly and report on the way the service is delivered. They check with people who use the service and their supporters if the service is right for the people who live here, and a report on any plans to improve their service is awaited. Staff are well trained to keep people safe. EVIDENCE: To make sure the service meets the needs and wishes of service users, their own and their families’ views have been sought as part of a quality assurance system. The results have been audited and an action plan drawn up. A report to the Commission is now awaited to see if this system is working, and to make sure the service users can be confident their views are listened and responded to properly. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 25 Many changes have taken place in this service in recent months, with improvements beginning to take effect and show benefits for the service users. Strong management and leadership are making sure the service is getting better for the people who live here, with real progress towards putting the people who live here at the centre of the service. Staff feel they have the support and good training they need to do their jobs with increasing knowledge and skill, to make sure service users are helped to keep safe and well while helping them to do more things for themselves wherever possible, and enjoy life to the full in the ways that suit them best. Staff have fire safety training from a recognised trainer every other year, this has been confirmed as appropriate by the fire safety officer. The manager has good systems and records to help staff communicate well with each other so that everyone knows what each service user needs to help them best, what other jobs have to be done to look after the home and make sure it is a comfortable and pleasant place to live, and to help her check that everyone is well trained and doing their job properly for the service user’s benefit. The manager completed and returned an AQAA showing the progress the service has made over the last year and forthcoming plans for service development. Work on the in house quality assurance system is developing with the providers’ Big Respect programme seeking and reporting on service users views. Easemore Road, 164b DS0000064300.V342505.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 x 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 3 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 4 3 3 3 3 x 3 x x 3 x Easemore Road, 164b DS0000064300.V342505.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations Care should be taken to ensure medication administration is signed for by the person giving the medication 24 2. 1. YA32 YA39 Total communication training should be provided for all staff The quality assurance system should be fully implemented at the home, and a copy of the audit submitted to the Commission. Easemore Road, 164b DS0000064300.V342505.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection 1st Floor Chapter House South Abbey Lawn Abbey Foregate Shrewsbury SY2 5DE 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 Easemore Road, 164b DS0000064300.V342505.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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