Care Home: Emmie Dixon Home

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What the care home does well The service user guide for Emmie Dixon Home is clear and detailed. It is available in different formats such as large print and a video version. This is to help people who may have difficulty reading and understanding standard print. People had had assessments of their individual needs before they moved into the home. This means that those moving in and the staff at the home had the information they needed to decide if the person`s needs could be met at the home. There is an established staff team at the home so they and the people who live at the home know each other well and the staff can give care and support in the way people prefer. Staff are keen for high standards to be maintained so the people living there receive good quality care. Staff working in the home are well supervised and get good support from the manager to make sure they can provide good care for people living in the home. Regular staff meetings were also taking place so staff could have a say in how the home was being run to make sure the needs of residents are being met.Plans of care and individual case notes for people who live in the home are well documented so staff know what they should do to meet people`s needs. Staff at the home make sure that people living there get advice and treatment from healthcare professionals when they need it so they stay as healthy as possible. The medication system used in the home is clear and well managed, so people who live there get their medicines safely and as prescribed. Meals are varied there is choice that reflects each person`s preferences. The people who live in the home sit down together each week to plan the menus for the following week, to provide choice and variety so everybody can enjoy a varied diet to help keep them well and healthy. The home is clean and well maintained so people live in comfortable, homely surroundings. People who live in the home know how to make a complaint about the home, and any concerns they have are dealt with quickly and effectively so people can be confident that their concerns will be listened to. People living in the home told us, "If I was not happy I would speak with the carers", "I can do what I want to each day" and "I decide where I want to go with my carer". They also told us, "The home is always fresh and clean and the staff always treat me well". Staff of the home told us, "My induction mostly covered what I needed to know" and "We give good quality care to service users as they would in their own home environment". What has improved since the last inspection? A requirement we made at our last inspection has been met so the medicines are now stored more suitably at the home so they are kept safely and securely. People who live in the home have up to date social services reviews, healthcare needs sheets and risk assessments so that they and staff have up to date information about the care they need. The way that information about complaints is stored has been altered to make sure it is secure and confidential.Staff receive regular supervision and appraisal so they are fully supported by the management team to provide good quality care for the people who live in the home. What the care home could do better: A record that a full assessment of a person`s needs had taken place and that those needs could be met at the home should be made. Some improvements are needed to make sure that the care records of people who live at the home are up to date and contain all relevant information about them and their needs. This will ensure that the staff at the home are fully informed about each person`s up to date needs so they can provide the right care and support for them. Up to date contact details for the Commission for Social Care Inspection should be included in the complaints procedure so people know how to contact us if they wish to. Steps should be taken to involve the people who live in the home in recruiting new staff so they can have a say on who provides care for them. Another quality assurance survey should be carried out to obtain up to date views about how the home is running from the people who live there, their relatives and professionals who work with them. This will ensure that their views can be taken into account when planning future developments at the home. CARE HOME ADULTS 18-65 Emmie Dixon Home 149 Richmond Road Crewe Cheshire CW1 4AX Lead Inspector Maureen Brown Key Unannounced Inspection 22 September 2008 09:15 Emmie Dixon Home DS0000006596.V367481.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 Emmie Dixon Home DS0000006596.V367481.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. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Emmie Dixon Home Address 149 Richmond Road Crewe Cheshire CW1 4AX 01270 581314 01270 210384 debbieowen@emmiedixonhome.fsnet.co.uk 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) Emmie Dixon Home Ltd Deborah Owen Care Home 12 Category(ies) of Learning disability (5), Physical disability (5), registration, with number Physical disability over 65 years of age (2) of places Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD; Physical disability - Code PD. The maximum number of service users who can be accommodated is: 12. 3 January 2007 Date of last inspection Brief Description of the Service: The Emmie Dixon Home is a two-storey property that has been adapted to accommodate twelve people who have a physical and/or learning disability and who need personal care. The home is in a residential area of Crewe, close to shops, pubs and other local amenities, local transport and road networks. There are twelve single bedrooms, one with an en-suite toilet, for the people who live at the home. Most bedrooms are on the ground floor, with four on the first floor. People who can use the stairs without help live in the first floor rooms. Shared space for the people who live in the home consists of a lounge, a separate dining room/lounge, conservatory, toilets, bathrooms and a shower room. There is a separate kitchen, laundry and office. Access to the first floor is provided by a stairway. The home has small paved/concreted areas at the front and side, where people who live at the home can sit out. Parking is available on the road outside the home. The fees at Emmie Dixon are between £253.32 and £478.70. Optional extras include personal items, transport costs and hairdressing. Emmie Dixon Home DS0000006596.V367481.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 2 stars. This means that the people who use this service experience good quality outcomes. We carried out an unannounced visit to this home on 22 September 2008; the visit lasted ten hours. This visit was just one part of the inspection. Before then the home manager was asked to complete a questionnaire to provide us with up to date information about the home. We sent out questionnaires to people living in the home and staff to find out their views about it. We also looked at other information we had received about the home since our last major inspection there. During our visit we looked at various records and the premises. We looked at care records of a number of people who live in the home, to see how their needs were being met. We spoke with a number of people who live at the home, the manager and staff and they gave their views about the service. What the service does well: The service user guide for Emmie Dixon Home is clear and detailed. It is available in different formats such as large print and a video version. This is to help people who may have difficulty reading and understanding standard print. People had had assessments of their individual needs before they moved into the home. This means that those moving in and the staff at the home had the information they needed to decide if the person’s needs could be met at the home. There is an established staff team at the home so they and the people who live at the home know each other well and the staff can give care and support in the way people prefer. Staff are keen for high standards to be maintained so the people living there receive good quality care. Staff working in the home are well supervised and get good support from the manager to make sure they can provide good care for people living in the home. Regular staff meetings were also taking place so staff could have a say in how the home was being run to make sure the needs of residents are being met. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 6 Plans of care and individual case notes for people who live in the home are well documented so staff know what they should do to meet people’s needs. Staff at the home make sure that people living there get advice and treatment from healthcare professionals when they need it so they stay as healthy as possible. The medication system used in the home is clear and well managed, so people who live there get their medicines safely and as prescribed. Meals are varied there is choice that reflects each person’s preferences. The people who live in the home sit down together each week to plan the menus for the following week, to provide choice and variety so everybody can enjoy a varied diet to help keep them well and healthy. The home is clean and well maintained so people live in comfortable, homely surroundings. People who live in the home know how to make a complaint about the home, and any concerns they have are dealt with quickly and effectively so people can be confident that their concerns will be listened to. People living in the home told us, “If I was not happy I would speak with the carers”, “I can do what I want to each day” and “I decide where I want to go with my carer”. They also told us, “The home is always fresh and clean and the staff always treat me well”. Staff of the home told us, “My induction mostly covered what I needed to know” and “We give good quality care to service users as they would in their own home environment”. What has improved since the last inspection? A requirement we made at our last inspection has been met so the medicines are now stored more suitably at the home so they are kept safely and securely. People who live in the home have up to date social services reviews, healthcare needs sheets and risk assessments so that they and staff have up to date information about the care they need. The way that information about complaints is stored has been altered to make sure it is secure and confidential. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 7 Staff receive regular supervision and appraisal so they are fully supported by the management team to provide good quality care for the people who live in the home. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Emmie Dixon Home DS0000006596.V367481.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 Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People who use this service experience good outcomes in this area. We have made this judgement using available evidence, including a visit to this service. People who are interested in moving in have enough information given to them about the home to help them decide about moving in, and their needs are assessed before they move in so they know they will get the care and support they need from staff at the home. EVIDENCE: The welcome pack for the home contained a lot of information including the home’s statement of purpose and service user guide, general information, the complaints procedure and other useful information. People had a copy in their bedrooms. The information was written in plain English and was available in standard print, large print and on video to make sure that people could understand it more easily. It had been reviewed in February 2008. People living in the home told us that they were involved in planning their own care so they could make sure it would be provided in the way they prefer. Staff we spoke with knew about the needs of the people living in the home, so they know who needed what care and how it should be given. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 10 The manager told us that she would check the assessments done by social services on people who might be interested in moving into the home. If this showed the person’s needs could be met there, she would start the process of helping the person decide whether they wanted to move in. It was recommended that as part of this process, a record should be made to show that the manager or staff from the home had completed a full assessment and that the person’s needs could be met at the home. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The personal care needs of people living at the home are met effectively by the staff team in a way that enables them to maintain their privacy and dignity. EVIDENCE: We looked at care plans of three people who live in the home, to check the care they receive. The plans contained all the information necessary to ensure that people’s needs are met. They were clearly written and covered areas such as healthcare needs, communication, eating and drinking, personal care, mobility, work and play, sleeping and dying. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 12 People’s social services reviews had been brought up to date but copies of the recent reviews were not on the care plan files. It was recommended that these be available so that the people living in the home and staff have up to date information. The manager agreed that it would be a good idea for each person’s key worker should carry out a monthly review about what people had been doing and feeling over the month to find out what people had particularly liked or disliked doing. The daily records were good and staff noted any changes to people. Activities undertaken and the details of visitors were also recorded so staff and others could see that people were well and active. All files we looked at had reviews of the care plans to make sure that these were up to date and still effective. People living in the home confirmed that they had been involved in planning or reviewing their own care. They told us, “The staff usually treat me well”, “I can do what I want to each day” and “I can do what I want during the day and at weekends but not in the evenings.” Risk assessments were included in the care plans. These had improved since our previous visit. All these were up to date and had been carried out for a range of activities including handling, activities, bathing, fire risk, medication; working in the kitchen, having friends to stay and abuse accusations. The risk assessments were completed to make sure that people were safe in their daily activities and that any help they might need was identified. Emmie Dixon Home DS0000006596.V367481.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, 15, 16 and 17 People who use this service experience good outcomes in this area. We have made this judgement using available evidence, including a visit to this service. People who use the service are able to take part in a range of activities so they can stay active and staff help people so they could stay in touch with their friends and family. EVIDENCE: An activities co-ordinator has been appointed at the home. This is a new post to benefit the people who live at Emmie Dixon and help them to take part in a wider range of activities. Activities that had recently taken place included trips to the local shops and a theatre trip to see the show ‘Buddy Holly’. The people who saw this said that they had a great time and they really enjoyed being there. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 14 The activities co-ordinator told us that she was going to keep records of all events and activities, including who had taken part in them, and hoped to have photographs showing where they have been. She said she had been looking at local places that would be suitable and possibly be of interest to the people living at the home. She also has asked all the people to write down or let her know where they would like to go and she hoped to be able to achieve some of these things with people. People who live at the home gave a range of feedback about activities and told us: “I can do what I want during the day and evening but not at weekends”; “I sometimes make decisions about what I do” and “I never make decisions about what I want to do each day”. People who live at the home are offered choices in various ways, such as in the time they get up in the morning and go to bed at night, by choosing the clothes they wear, by deciding whether or not to join in planned activities and by deciding how they wish to be addressed. This enables them to keep some control over what they do each day and to stay as independent as possible. People who live in the home take part in a range of educational and occupational pursuits. These include working at three “C’s” charity, Salvation Army shop and the British Heart Foundation shop. Two people go to college studying computers and beauty therapies. They use the local and wider community. Some people go to local day centres and others go out with family based carers (employed by social services). People in the home take it in turns to take the pet dog, Emmie, out for walks. Other daily activities they do include household tasks such as preparing meals, shopping, cleaning, washing and ironing. They also like to listen to CDs, watch TV and DVDs, go to bingo and go into town. This helps to make sure that people who live in the home to have a full and active life. Family members and friends are welcome at the home and are actively encouraged by the staff and manager to visit. This helps people who live in the home to maintain links with both family and friends. We looked at samples of menus and these showed that there is a varied diet, mostly of popular modern dishes, at the home. The people who live there sit down together and plan the following weeks’ menus with support from the staff, so they were able to enjoy a varied diet to help keep them well and healthy. During our visit, we saw breakfast and lunch being served. There was a choice of food and drinks available mealtimes and the dining area was a pleasant area to eat in. People who live at the home told us they had enjoyed their meals. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 15 During our visit, we watched staff at the lunchtime chatting and working with the people who live in the home. The staff were attentive to people and helped them when they needed it. The general atmosphere within the home was warm and friendly. Emmie Dixon Home DS0000006596.V367481.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 People who use this service experience good outcomes in this area. We have made this judgement using available evidence, including a visit to this service. The healthcare needs of people living at the home are met effectively by the staff team in a way that enables them to maintain their privacy and dignity. EVIDENCE: The medication system used at the home is a monitored dosage system. The medicines are stored in a drug trolley, which is kept locked when not in use. The medicines are now stored more securely in the home. Staff files that we looked at showed that staff had received training about safe administration of medicines to make sure that all staff that give out medicines know how to do it safely so that errors do not happen. A senior member of staff was seen helping people to take their medication during lunchtime. She knew how each person preferred to take their medicines and carried the task out safely so that everybody received their correct prescribed medicines. Visits from healthcare professionals were recorded and it was seen that GPs, district nurses, optician and the chiropodist visited people living in the home regularly to make sure they remain well. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home’s procedures for complaints and for safeguarding adults are effective so that the concerns of the people who live in the home are listened to and they are protected from abuse or harm. EVIDENCE: Staff files we looked at during our visit showed that they had completed training on safeguarding adults. The manager confirmed this and showed that she was aware of the policy, procedures and guidance on safeguarding. There are also policies available at the home dealing with aggression towards staff, bullying in the workplace, detection, management and prevention of adult abuse and whistle blowing. Since our last visit, one referral had to be made from the home under safeguarding adults procedures. All appropriate people were notified and the matter was dealt with effectively to make sure that people living in the home were safe. The complaints procedure was satisfactory and contained details of how to contact us, however, our new contact address needed to be included and this was dealt with by the end of our visit to the home. We have not received any complaints about this home since our last inspection there. The home had not received any complaints since our last visit. People who live at the home told us they would contact the manager if they had any problems. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 18 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 & 30 People who use this service experience good outcomes in this area. We have made this judgement using available evidence, including a visit to this service. The home is well maintained so people who live there live in clean, safe and comfortable surroundings. EVIDENCE: During our visit, we walked round the building. We saw all the shared (communal) areas as well as a number of bedrooms. There is a variety of shared space available including dining area, lounge and an conservatory. The home was clean and odour free. People who live in the home had made their rooms more homely using ornaments, pictures and furniture they had brought with them when they moved in. The home was seen to be in a good state of repair and the décor was good. People who live at the home told us that they liked their bedrooms, saying “I like my room”, “My bedroom is always cleaned and the house is always clean” and “The home is usually fresh and clean.” Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 19 Significant changes to the home had been made since our previous visit. One of the people living in the home now needs a downstairs bedroom. To achieve this, what was the office downstairs has been altered to a bathroom, the bathroom downstairs has been converted into a bedroom and a bedroom upstairs is now the office. The staff toilet has been refurbished and another toilet downstairs had been adapted for people with a disability. The conservatory has been redecorated and it is proposed that the flat roof over the dining room will be replaced. We spoke with the person who had moved downstairs. They told us they really liked their new room and the manager had taken them out to buy new furniture, bedding and curtains. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 People who use this service experience good outcomes in this area. We have made this judgement using available evidence, including a visit to this service. The recruitment procedures are thorough and staff have completed a range of training so people who live in the home are protected from poor practice. EVIDENCE: The staff team consist of the manager, nine care staff, an activities organiser, a housekeeper, and the directors. The staff rotas showed the numbers staff on duty during each week. The staffing levels appeared to be sufficient to meet people’s needs. People who live in the home confirmed there were enough staff around to help them and during our visit we saw that staff were attentive to people’s needs. People living in the home told us, “The staff treat me well” and “The staff make sure I have everything I need”. Staff told us they thought there could be improvements including “There are sometimes enough people to meet service users needs so more staff would be good” and “Appraisals and supervisions are rare and not always confidential”. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 21 We checked three staff files. These had all the necessary pre-employment checks in place, including identity checks, Criminal Record Bureau checks, references, health checks and application forms. These checks are carried out to make sure that staff are suitable to work with the people who live in the home. At our last visit, we recommended that CRB checks should be done for the directors as a precaution and at this visit found that the check for one of these people was not available. The training staff members had been completed included fire safety, moving and handling, safeguarding adults, medication awareness, health and safety, infection control, food hygiene, epilepsy awareness, violence and aggression, lone working and first aid. All these courses ensure that all the staff have completed the training they need to provide good care for the people living in the home. Staff told us various things about their training: “My induction mostly covered what I needed to know”; “Medication training isn’t up to much” and “I am being given training which is relevant to my role.” Good progress has been made with NVQ training. Six out of ten staff had NVQ level 2 or above in care. One person is due to start undertaking this award and three staff are due to start NVQ level 3 shortly. All staff have also completed the infection control NVQ level 2. This means that a good percentage of the staff have a nationally recognised qualification in care to help them provide good quality support for the people who live in the home. Staff appraisals are currently being undertaken. We found that staff supervision on day-to-day basis was good and formal recorded supervisions had been brought up to date. The last ones were completed in February 2008. This makes sure that staff have a chance to discuss their work with their manager, so they can continue to provide good quality care for the people who live in the home. Staff meetings are held twice a year, the last one was September 2008. These meetings help to make sure that manager and staff know what is happening in the home, any changes needed and that things continue to be run in the best interests of the people who live in the home. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 22 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 & 42 People who use this service experience good outcomes in this area. We have made this judgement using available evidence, including a visit to this service. The procedures within the home are thorough so the health, safety and welfare of the people who live there are protected, the staff are well supervised and there are processes in place to make sure the home is run in the best interests of the people who live there. EVIDENCE: The manager is a qualified nurse and has many years experience in providing care for people. She also has the Registered Managers Award, NVQ Level 4 and NVQ level 5 in management. She has been the manager for eleven years so she knows the home and can make sure that it is run well for the people who live there. Staff members told us, “The manager is very supportive and approachable”, “She is fine and I can go to her and talk” and “She is very supportive.” Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 23 There is a quality assurance process for the home but it is sometime since it was last used to find out what people who live at the home, their families and others think about the way it is running. Satisfaction surveys were sent to people who live at the home and their families in 2006. A summary of the results was put together and circulated. We have recommended that another survey is carried out so the views of the people who live in the home, their families and professionals who work with them can be used to influence the running of the home. Other quality assurance processes include residents’ meetings and reviews of people who use the service to make sure their needs can still be met at the home. The most recent residents’ meeting before our visit was held in August 2008. This helps to make sure that the people who live at the home have a say in how it is run. Safe working practices were in place in the home. There were up to date safety checks on the home’s gas installation and electrical system. There were policies available in the home about safe working practices, including a range of risk assessments, dealing with hazardous substances, moving and handling, health and safety, food safety and first aid. We saw the fire safety equipment tests logbook. Up to date checks had been made on the extinguishers and fire safety system as required and regular fire safety awareness training had been provided for staff. There were some gaps in the records of the weekly checks of the fire alarm system. We saw the accident records and these were recorded appropriately. This makes sure that any risks to people are minimised so they are safe and can remain as independent as possible. However, all the records were kept together and it is recommended that they be stored separately to maintain confidentiality of information for the people who live in the home, in line with the Data Protection Act 1998. These systems and checks mean that the home continues to be safe for the people who live and work there. Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 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 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 26 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 YA2 Good Practice Recommendations Documentation to show that the manager has completed a full assessment of a person wishing to move in that shows the person’s needs can be met at the home should be produced. Copies of social services reviews for people moving into or living in the home should be obtained and kept in each person’s care file so that up to date information is available for the person and staff team. Key workers should carry out monthly reviews with people who live in the home so that an up to date record is available on how they have been during the previous month. Evidence that CRB disclosures have been obtained for the directors who visit the people who live in the home should be maintained to show that these checks have been made to protect the people who live in the home. People who live in the home should be involved in recruiting new staff so they can have a say on who is employed to support them. A quality assurance survey should be carried out to obtain up to date views about how the home is running from the people who live there, their relatives and professionals who work with them. This will ensure that their views can be taken into account when planning future developments at the home. The fire alarms should be tested weekly to make sure that the people who live in the home and the staff who work there continue to be safe. 2 YA6 3 YA6 4 YA34 5 6 YA34 YA39 7 YA42 Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Area Office Unit 1, Level 3 Tustin Court Port Way Preston PR2 2YQ 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 Emmie Dixon Home DS0000006596.V367481.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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