Care Home: East Bank Road

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What the care home does well People`s needs are assessed prior to them being offered a place at the home. This is to ensure the staff can meet people`s needs. One person said, "I came for visits and tea before I moved in", Another person told us, "My staff visited East Bank Rd on my behalf, to ensure that it would meet my needs". One person who lives at the home told us, they had been supported by staff, to devise a care plan, which met their needs. We asked people whether they are supported to take part in activities this is what they said; "I go to day services everyday". " I have a choice of activities in my house, and I can choose what I do". We asked people if they are supported to see their relative and this is what they told us; "I sometimes go to see Mum and Dad" and "the staff help me to see my sister, I go to her house for a bit of tea". A relative told us, "They not only care about my (relative) and take in to consideration their needs, but also those of his disabled wife when she visits on a weekly basis". Some people, who were able to, said they took part in domestic routines in the home.One person told us, "I like to make a weekly shopping list and go to the shops with staff". They also said, "We go to the supermarket to buy our own shopping". People said they enjoyed the food on offer at the home. We saw evidence that staff had devised a pictorial menu to show people what, choice of meals are available to them. One person told us, "I like the lunches". Staff also told us they had completed food tasting with the people who live at the home to enable people to make choices and to experience food from different cultures. We asked one person who lives at the home if they are offered appropriate support from staff with personal care tasks. This is what they said; "The staff help me to have a shave" and "to keep my clothes nice". One of the ladies who lived at the home looked lovely, she had been supported to wash and style her hair, she had earrings in and a neck scarf on all of which matched her outfit. She told me, "Jackie helped me get ready, she`s my keyworker, we have a good laugh together". The home has a complaints procedure for people. This is in accessible formats, it was called, `HOW TO COMPLAIN`. There was evidence people had been supported to understand how to use the procedures. One person said, "I have got a complaints form in my care plan which, I can get if I need to". One relative said, "I know how to make a complaint but I have never had to as the care has always been so good". We asked people whether they liked living at East Bank Rd and this is what they said; "I like Jackie she`s my key-worker". "I like it here", " I like the staff" " I like Jackie best she takes me to the shop". The staff we spoke to said they were aware of the adult protection procedures and they had completed training on this subject. The deputy manager also confirmed this. One member of staff told us, "staff have regular mandatory training in all aspects and other specialist training as required".East Bank RoadDS0000002957.V364243.R01.S.docVersion 5.2Page 8Another member of staff told us " I have frequent supervisions and an annual appraisal". We observed the relationships between staff and people who lived at the home. This showed that staff had positive regard for all of the people who lived in the home, staff were respectful, in the way they spoke to and of people. The manager said and the staff confirmed that regular staff meetings were held. Minutes of the meetings were seen. People are benefiting from a well run home. The provider monitors the development of the service to support the registered manager and staff team. The management of the home promotes the health, safety and welfare of people. What has improved since the last inspection? The format of the care plans used person centred approaches. One member of staff told us, "A care plan is in place to make sure all aspects of a persons life is recognised and then, people are treated with respect". People were being supported to develop their communication skills by the staff team who used photos and pictures to support people to make choices. For example to choose which meal they preferred or to tell them which staff were on duty each day. People had risk assessments to ensure they were still able to carry out activities, whilst being aware of how the staff could minimise any risks to them. What the care home could do better: Medication procedures must be reviewed to ensure that peoples` health and welfare is protected. We checked the staff training records, however, many of these were out of date and the manager explained that this was an area she knew needed to be updated. This must be addressed to make sure all staff have completed the training required to support people safely. CARE HOME ADULTS 18-65 East Bank Road 458a East Bank Road Sheffield South Yorkshire S2 2AD Lead Inspector Ms Shelagh Murphy Key Unannounced Inspection 14th May 2008 9:15 East Bank Road DS0000002957.V364243.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 East Bank Road DS0000002957.V364243.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. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service East Bank Road Address 458a East Bank Road Sheffield South Yorkshire S2 2AD 0114 265 7717 0114 253 1029 sharon.prior@sct.nhs.uk None South Yorkshire Housing Association 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) Ms Sharon Prior Care Home 20 Category(ies) of Learning disability (20) registration, with number of places East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The 20 beds include 3 places for a service user with an additional physical disability (PD). Service users that reach the age of 65 years can remain at the home provided that their care needs can be met. 9th May 2006 Date of last inspection Brief Description of the Service: East Bank Road is a care home accommodating 20 younger adults with a learning disability. The home is owned by South Yorkshire Housing and is situated in Arbourthorn. This is a residential area of Sheffield with good access to public services and amenities that include bus services, shops and pubs. The service has three houses on East Bank Road. Each house is built over two floors; no lifts are on site therefore upstairs rooms have to be accessed by the stairways. All bedrooms are single and each house has suitable lounge and dining space. The home provides twenty-four hour support to people who have learning disabilities some people also have physical disabilities. There is a private garden area, which is extremely well maintained and safely accessible to all the people who live at the home. The bed fees at this home are currently £304 per week. Additional charges at the home include hairdressing fees, newspapers and some social activities. Further details of these charges can be requested from the registered manager of the home. Prospective residents and their relatives can get further information about the service by contacting the registered manager, Sharon Prior. The manager will also provide a copy of the homes statement of purpose, a service users guide and a copy of the latest CSCI inspection report upon request. East Bank Road DS0000002957.V364243.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 a 2 star. This means that the people who use this service experience good quality outcomes. This visit was unannounced; it took place over one day between 9.15am and 3.45pm. We spent a total of six and a half hours on site. In the report we make reference to “us” and “we”. When we do this we are referring to the inspector and the Commission for Social Care Inspection. We used a variety of information as well as our findings from the visit to assess the quality of service offered to people who use this service. During the site visit we interviewed two people who lived at the home and made observations of how the staff spoke to and interacted with people in their own home. During this visit we also spoke to two carers/support workers, the deputy manager, a team leader and the registered manager. We did this to gauge their views of the service. Sharon Pryor, the manager, assisted with our visit, and she and the deputy manager were given feedback of our findings throughout the visit. During this site visit we looked at the environment, and made observations about how appropriate the environment was to meet peoples needs. We also checked some samples of documents that related to peoples’ care and safety. These included needs assessments, daily record, care plans, medication administration sheets, risk assessments and staff supervision notes and recruitment files. Before the visit the registered manager had completed an Annual Quality Assurance Assessment (AQAA). We have used some of this information within the report. Before the site visit to the service we also looked at a range of other information we had received about the service since the last inspection. This included information provided by the homes monthly reports. We sent out the following surveys to gauge peoples’ views of the service: • Five people who use the service were sent surveys (in picture formats). These were then photocopied at the home as other people who use the East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 6 • • • service wished to give their opinions and in all we received 17 surveys back from people who live at the home. Five staff that work at the service were sent surveys and one of the surveys were returned. Five relatives were sent surveys and four were returned. Eight different health/social care professionals comment cards were sent out and three were returned. This was a key inspection and we checked all the key standards. The inspectors would like to thank the people who live at the service and the staff for their co-operation during our visit. What the service does well: People’s needs are assessed prior to them being offered a place at the home. This is to ensure the staff can meet people’s needs. One person said, “I came for visits and tea before I moved in”, Another person told us, “My staff visited East Bank Rd on my behalf, to ensure that it would meet my needs”. One person who lives at the home told us, they had been supported by staff, to devise a care plan, which met their needs. We asked people whether they are supported to take part in activities this is what they said; “I go to day services everyday”. “ I have a choice of activities in my house, and I can choose what I do”. We asked people if they are supported to see their relative and this is what they told us; “I sometimes go to see Mum and Dad” and “the staff help me to see my sister, I go to her house for a bit of tea”. A relative told us, “They not only care about my (relative) and take in to consideration their needs, but also those of his disabled wife when she visits on a weekly basis”. Some people, who were able to, said they took part in domestic routines in the home. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 7 One person told us, “I like to make a weekly shopping list and go to the shops with staff”. They also said, “We go to the supermarket to buy our own shopping”. People said they enjoyed the food on offer at the home. We saw evidence that staff had devised a pictorial menu to show people what, choice of meals are available to them. One person told us, “I like the lunches”. Staff also told us they had completed food tasting with the people who live at the home to enable people to make choices and to experience food from different cultures. We asked one person who lives at the home if they are offered appropriate support from staff with personal care tasks. This is what they said; “The staff help me to have a shave” and “to keep my clothes nice”. One of the ladies who lived at the home looked lovely, she had been supported to wash and style her hair, she had earrings in and a neck scarf on all of which matched her outfit. She told me, “Jackie helped me get ready, she’s my keyworker, we have a good laugh together”. The home has a complaints procedure for people. This is in accessible formats, it was called, `HOW TO COMPLAIN’. There was evidence people had been supported to understand how to use the procedures. One person said, “I have got a complaints form in my care plan which, I can get if I need to”. One relative said, “I know how to make a complaint but I have never had to as the care has always been so good”. We asked people whether they liked living at East Bank Rd and this is what they said; “I like Jackie she’s my key-worker”. “I like it here”, “ I like the staff” “ I like Jackie best she takes me to the shop”. The staff we spoke to said they were aware of the adult protection procedures and they had completed training on this subject. The deputy manager also confirmed this. One member of staff told us, “staff have regular mandatory training in all aspects and other specialist training as required”. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 8 Another member of staff told us “ I have frequent supervisions and an annual appraisal”. We observed the relationships between staff and people who lived at the home. This showed that staff had positive regard for all of the people who lived in the home, staff were respectful, in the way they spoke to and of people. The manager said and the staff confirmed that regular staff meetings were held. Minutes of the meetings were seen. People are benefiting from a well run home. The provider monitors the development of the service to support the registered manager and staff team. The management of the home promotes the health, safety and welfare of people. What has improved since the last inspection? What they could do better: Medication procedures must be reviewed to ensure that peoples’ health and welfare is protected. We checked the staff training records, however, many of these were out of date and the manager explained that this was an area she knew needed to be updated. This must be addressed to make sure all staff have completed the training required to support people safely. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 9 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. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 10 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 East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 11 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): Key standard 2. People experience good quality outcomes in this area. People who live at the service had their needs assessed, prior to being offered a placement, in order to identify if the service could meet their individual needs. This judgement has been made using available evidence including a visit to East bank Rd. EVIDENCE: This is what people who live at the home told us through their surveys; One person said, “I came for visits and tea before I moved in”, Another person told us, “My staff visited East Bank Rd on my behalf, to ensure that it would meet my needs”. Two of the people we spoke to told us, “I like living at East Bank Rd” and “I like living here”. We checked three people’s pre-admission needs assessments. Two of these people had moved in to the home over the last two years and they showed that people had comprehensive assessments before they came to live at East Bank Rd. These needs assessments had been incorporated in to their care plans to ensure their identified needs were clear to staff. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 12 Staff told us, and the deputy manager confirmed that she and the manager were responsible for visiting and assessing peoples needs, prior to offering them a placement. This was to ensure that the staff could meet peoples’ needs and the home could meet their expectations. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 13 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): Standards 6, 7 and 9. People experience good quality outcomes in this area. People had individual plans, which were being implemented effectively. People had lots of opportunities to make choices. This judgement has been made using available evidence including a visit to East Bank Rd. EVIDENCE: One member of staff told us, “A care plan is in place to make sure all aspects of a persons life is recognised and then, people are treated with respect”. One person who lives at the home told us they had been supported by staff to devise a care plan, which met their needs. We asked if we could check their plan. It had been reviewed in March 2008 and it recorded that the individual had been present at the review. It contained very detailed information about the person and their needs, wants and aspirations. The person’s likes and dislikes were also identified. The plan followed person centred approaches, which helps to ensure each persons individual needs are highlighted. The plans were very detailed and included which toiletries people preferred, as well as their shoe size, weight, clothes size and preferred choice of clothing. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 14 People’s communication needs were recorded in the care plans we checked. There was evidence that people’s individual needs were being met and staff were ensuring that people could make decisions and choices. For example, we observed staff to offer one person a choice of meals, by using photos for the menus. This supported the person to communicate their likes and dislikes. There were also other examples of how staff were supporting people with communication needs, there was a staff rota, which showed which staff were on duty each shift, using their photographs. A health professional wrote, “ Individuals are encouraged to make choices within their homes and to live the life they choose”. They gave the person centred planning approaches used as an example of how this is put in to practice. We checked three people’s risk assessments, they had been reviewed over the six months in all cases and one had been reviewed and updated in January 2008. The local specialist learning disability health team (CAISS) had been involved in devising some of the risk assessments checked and this showed that the staff were working closely with health professionals to ensure people were supported in a safe manner. From discussions with three staff members it was clear that the management of risk is handled in a positive manner, which enables people to carry out activities whilst being aware of the risks that could be posed. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 15 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): Standards 12, 13, 14, 15, 16 & 17 People experience excellent quality outcomes in this area. People were offered opportunities and appropriate support, in order meet their individual needs and lifestyle choices. This judgement has been made using available evidence including a visit to East Bank Rd. EVIDENCE: Some people were observed to be involved in meaningful daily activities. We asked people whether they are supported to take part in activities this is what they said; “I go to day services everyday”. “ I go down town on Saturdays with my new staff”. A member of staff from a different care agency supported this person, as they had requested to go to town with people other than their own staff. This was an excellent example of how people’s individual needs had been creatively met. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 16 Other people said, “ I have a choice of activities in my house, and I can choose what I do”. A health professional told us, “The home promotes clients to make choices and certain decisions for themselves. Another person told us they had been out to Gateway club, which is held every week, they said, “I enjoy it”. A relative said, “There are always lots of activities on offer, and the staff include people in lots of things”. The staff also told us and we saw evidence in peoples care plans that the staff support people to access the community on a regular basis. A member of staff told us that one person was in supported employment as a domestic worker, they had managed to access this job with support from their day services staff. This was excellent practice as it recognised this person’s abilities and offered them real opportunities to experience employment. People were offered the opportunity to keep in contact with their relatives and it was clear that a lot of effort went in to helping people to maintain these very important relationships. One person who lives at the home told us, “I sometimes go to see Mum and Dad” and “the staff help me to see my sister, I go to her house for a bit of tea”. This is what relatives told us; “They not only care about my (relative) and take in to consideration their needs, but also those of his disabled wife when she visits on a weekly basis”. One sibling told us, “Our mum is 81 years old and not in the best of health and they take her to see her Mum, whenever there are the staff available”. We also saw evidence in daily records that, some people were supported by staff to phone relatives, on a weekly basis. Some people, who were able to, said they took part in domestic routines in the home. One person told us, “I like to make a weekly shopping list and go to the shops with staff”. They also said, “We go to the supermarket to buy our own shopping”. Other people told us the staff supported them to do their laundry. Another person told us that they help staff with the gardening at the home; they said, “I water the plants and keeping the garden tidy.” East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 17 Staff told us that one person was supported to cook simple meals, e.g. sandwiches and toast. People said they enjoyed the food on offer at the home. We saw evidence that staff had devised a pictorial menu to show people what, choice of meals are available to them. One person told us, “I like the lunches”. Several people at the home needed special or soft diets to meet their needs. The staff advised us that each person had completed a nutritional assessment. They said they also used the ‘eat well plate’ guidance. Two people had been assessed as needing special diets to meet their needs, one was for diabetes and the other was a gluten free diet. Staff also told us they had completed food tasting with the people who live at the home to enable people to make choices and to experience food from different cultures. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 18 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): Standards 18, 19 and 20. People experience good quality outcomes in this area. People were supported by staff, to meet their health and personal care needs. This helped to ensure their well-being and dignity was protected. This judgement has been made using available evidence including a visit to East Bank Rd. EVIDENCE: We asked one person who lives at the home if they are offered appropriate support from staff with personal care tasks. This is what they said: “The staff help me to have a shave” and “to keep my clothes nice”. One of the ladies who lived at the home looked lovely, she had been supported to wash and style her hair, she had earrings in and a neck scarf on all of which matched her outfit. She told me, “Jackie helped me get ready, she’s my keyworker, we have a good laugh together”. One member of staff told us, “ People are treated as individuals, and they also have the right to choose the gender of the staff assists them”. (With personal care). East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 19 One relative told us, “My relative is treated and cared for as an individual, with total dignity and respect, giving me total peace of mind”. “My sister needs 24 hour care, and the staff give her that, they are always trying to improve her life”. People were observed to be well dressed and their clothing was age appropriate. Staff told us that personal care support was offered to people on an individual basis and was flexible to meet people’s needs. For example, rising and retiring times were dependent on the individuals choice, as was the time when people were to be bathed/showered We then asked different stakeholders their views about whether they thought people’s health care needs were met; this is what they told us; “I would like to say that the staff do very well and always have my (relatives) best interests and health needs in mind at all times”. “I am always informed about my relatives health and well-being”. A health care professional told us “clients health and well-being is paramount”. Another health professional said, “ Clients are treated with respect and dignity”. They went on to say, “We are called in when people need our support”. Staff said, “ Regular health appointments are made for people.” We saw evidence of this in care plans showing that people had seen the dentist, the G.P. and a chiropodist on a regular basis. Another member of staff told us, “Each individuals health and wellbeing is monitored closely and any changes are reported immediately”. “ People have health action plans”. This should ensure that people’s health needs are identified and met. Some people had attended appointments with specialist health providers, for example psychologists and specialist learning disability nurses. We checked to see if people had moving and handling assessments in place, they did and several had been updated since January 2008. The staff on duty told us that none of the people who lived at the home were able to administer their own medication. Therefore the support staff and tam leaders were responsible for these tasks. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 20 The medication procedures were checked in House 3. The home used the Nomad monitored dosage system, which the local pharmacist delivers on a regular basis. There were some good practices observed for example, the medication was stored in clean, lockable drug cabinets, in the clinic room. Each person had a separate sheet, which, explained the medication they were prescribed, and its effects and side effects. However, some concerns were identified which must be addressed to ensure that medication managed safely. These included Medication had not been signed for on three occasions on three people’s medication sheets, one person had run out of a pain management medication and this had not been administered on three consecutive occasions. This was brought to the deputy manager’s attention immediately as it may have meant the person was experiencing pain unnecessarily. There were also anomalies found when cross checking the drug sheets and the medication cartridges. We found the times which medication should be administered were different on the drug sheets as on the medication cartridge. This could place people at risk. This was brought to the deputy manager’s attention to address as a priority to ensure peoples welfare. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 21 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): Standards 22 & 23. People experience good quality outcomes in this area. People had access to the complaints procedure. People are protected by the safeguarding policies and procedures as the staff knew how to respond to allegations of abuse. This judgement has been made using available evidence including a visit to East Bank Rd. EVIDENCE: The home has a complaints procedure for people. This is in accessible formats, it was called, `HOW TO COMPLAIN’. One person who lives at the home told us, “my family and friends would know if I was unhappy”. Another person said, “I have got a complaints form in my care plan which, I can get if I need to”. One relative said, “I know how to make a complaint but I have never had to as the care has always been so good”. Another relative said, “ I have never needed to raise any concerns”. The manager stated in the AQAA report that no complaints have been made since our last visit. The manager showed us they had received numerous letters of thanks and praise from relatives and friends of people who lived at the home and these really showed the staffs dedication to supporting people. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 22 We asked people whether they liked living at East Bank Rd and this is what they said; “I like Jackie she’s my keyworker”. “I like it here”, “ I like the staff” “ I like Jackie best she takes me to the shop”. Another person said, “I like Bob, he’s nice and he knocks on your door”. The staff we spoke to said they were aware of the adult protection procedures and they had completed training on this subject. The deputy manager also confirmed this. Over the last year one adult protection referral had been made relating to one person who lives at the home. This was managed well by the service and led to staff being disciplined and offered re-training as they had failed to follow the moving and handling guidance for this person. The inspector checked a sample of two people’s finance records. The system was easy to follow and gave a clear account of their deposits and withdrawals. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 23 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): Standards 24 and 30. People experience good quality outcomes in this area. Overall, the accommodation offered to people was of a good standard. People had been supported to personalise and make their houses, homely in order to meet their specific needs. This judgement has been made using available evidence including a visit to East bank Rd. EVIDENCE: At the time of the visit 18 people lived in the three houses, which made up the home. We asked people what they liked about their homes and this is what they said; “I love living here, we’ve got a fish tank” One person showed us to their bedroom, which was beautifully decorated and furnished to a very high standard. They said “ I chose the paint and the paper and the wardrobe” A relative told us, “The home is always very clean and welcoming”. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 24 Another relative said, “It’s a pleasure to go in to this home and a pleasure to leave as I know my relative feels at home here”. During a tour of the premises by one of the people who live in house three we observed the home was clean, well decorated, safe and homely. We then checked houses 1 & 2 and found that throughout the homes were clean, homely, comfortable and safe. The kitchens and laundry rooms were also checked and were all domestic in size and fittings and clean and tidy. The bathrooms checked were clean and appropriately adapted to meet peoples’ needs. Outside there is a communal courtyard garden area with patio furniture and parasols, a gazebo to shade people completely from the sun and numerous pot plants and hanging baskets. This area looked really inviting and one staff said, “It’s lovely having a large communal area in the summer where everyone can spend time together”. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 25 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): Standards 32, 34, 35 and 36. People experience good quality outcomes in this area. People are supported by a staff team are appropriately skilled and experienced to meet their needs. The staff work effectively as a team in order to deliver safe and dignified care to all the people they support. This judgement has been made using available evidence including a visit to East Bank Rd. EVIDENCE: One member of staff told us, “staff have regular mandatory training in all aspects and other specialist training as required”. Another member of staff told us “ I have frequent supervisions and an annual appraisal”. “ I feel any issues I can freely discuss with the manager or the deputy at any time”. “My (relative) trusts all of the staff”. Another relative said, “the home is always well staffed” and “the staff are friendly” East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 26 “The staff are very good, they really do care about people” “From what I witness, I believe the staff have the right skills and experience” (to look after people properly). One health professional told us, “Staff uphold the clients rights”. We observed the relationships between staff and people who lived at the home. This showed that staff had positive regard for all of the people who lived in the home, staff were respectful, in the way they spoke to and of people. The manager said and the staff confirmed, that they had induction training and completed the required mandatory training. This included moving and handling, fire safety, first Aid, food hygiene and infection control. Other training that had been either planned or completed included, NVQ2 awards, managing challenging behaviour, adult protection and medication. However, when we checked the training records these were out of date and the manager explained that this was an area she knew needed to be updated. The staff and managers told us that staff had also completed two away days with the local specialist learning disability team and the training covered topics including, meeting people’s emotional needs, why people may present services with challenges, how to understand peoples communication styles, supporting people who have complex and sensory needs. One member of staff told us “ I am now far more aware of why people present challenges, what they might be trying to communicate to me and why they behave in certain ways”. Three staff recruitment records were checked. We found these contained all of the information required including CRB’s, application forms, proof of I.D, two references. This will help to protect people’s welfare. The manager said and the staff confirmed that regular staff meetings were held. Minutes of the meetings were seen. Staff told us, “I am usually supervised every 6-8 weeks, I get on well with the managers as they are always there if you need them and we can phone them if we are not sure of anything”. We checked a sample of supervision records, which showed that staff were regularly supervised. This had enabled the team leaders to monitor staff practices and support staff effectively as they were obviously meeting peoples needs to a high standard. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 27 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): Standards 37, 39 and 42. People experience good quality outcomes in this area. People who live at the home were benefiting from a well-run service. The relationship and communication between managers and staff was good. This judgement has been made using available evidence including a visit to East Bank Rd. EVIDENCE: The registered manager is appropriately experienced, has a professional qualification and had completed the registered managers award. The way the service is managed is providing good overall outcomes, to the people who live there. The provider regularly visits the home to carry out quality assurance visits and monitors the service really well. One relative said, “I really don’t know how they could improve the as there standards are already so high”. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 28 The providers of the service South Yorkshire Housing Association had completed the AQAA report and this was accurate in the way it reflected the services strengths and areas for development. The service has good health and safety policies and procedures in place and staff knowledge of these are good. Most staff had completed mandatory health and safety training. The manager was required to check and then update any staff who had not completed this. East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 29 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 X 34 3 35 2 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 3 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 2 X 3 X 3 X X 3 X East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 30 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 YA20 Regulation 13 Requirement Medication systems must be checked and then regularly monitored to ensure peoples health and welfare is protected. This must include ensuring that accurate records of medication administered are maintained and that people always have medication in stock that they have been prescribed. 2. YA35 18 Staff training records must be updated and any staff that are identified as needing mandatory training must be offered this to ensure peoples welfare. 30/09/08 Timescale for action 30/06/08 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 East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI East Bank Road DS0000002957.V364243.R01.S.doc Version 5.2 Page 32 - 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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