Care Home: Emscote House

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What the care home does well People have the information they need to help them decide if the service is what they want. They are able to come and visit and try it out, so that they can see what it`s like for themselves. Before they stay at Emscote House, their needs are fully assessed, so that their care and support can be properly planned. Guests` care is planned with their involvement and the people who know them best. Care plans are detailed and guide staff clearly. This helps to ensure that guests can get the care and support they need in ways they like. While staying at Emscote House people can carry on with their usual day activities, if this is what they want. They are asked about what they want to do each day. They are able to do things they value, go to places they like and keep in touch with the people who are important to them. Staff find out what food they like, so they can have what they want and enjoy their meals. Guests are well cared for, and get the support they need to stay healthy and well. Staff understand people`s diverse cultural, social and care needs. They treat their guests with respect, warmth and friendliness. People can be confident that what they say is listened to, taken seriously and acted upon. Their views are actively sought, so that any issues can be dealt with quickly. Positive action is taken to protect guests from abuse and keep them safe. Emscote House offers its guests a purpose built home in which to stay for respite care breaks. It is furnished and equipped to a very high standard. Facilities and equipment in the home are maintained and upgraded regularly, so that people can enjoy being in a comfortable, safe and homely environment. Guests are cared for by a motivated, qualified, trained and well supported team of staff. Proper checks are carried out on staff before they start work, to make sure they are fit for their jobs. They are properly supervised, to make sure they get the support they need to do their jobs well. The home is very well run. It has a strong, well qualified management team that gets good support from the wider organisation. They regularly ask people what they think about the service, so that it can be developed and improved to meet their needs and wishes. What has improved since the last inspection? There are no outstanding requirements or recommendations from the last inspection. The management team continues to demonstrate a positive attitude, supported with action, to develop the service for the benefit of the people who use it. Regular improvements are made to the environment and equipment, so as to maintain the service`s high standards. Since the last inspection these have included refitting the assisted bathroom, installing ceiling track hoists in the bathroom and some guest bedrooms, refitting the kitchen, providing new furniture in guest bedrooms and the dining room, fitting a new plasma screen TV in the lounge,upgrading sensoryequipment and buying new games, music systems etc. for guests` entertainment. Practice, policies and procedures are kept under regular review. Most recent changes include responding to new legislation (Mental Capacity Act and Deprivation of Liberty Safeguards) to ensure that guests` interests can be properly recognised and protected. Staff training and support is subject to ongoing development. Staff induction training has been re-organised, and the team has also received training to enable them to deal with specific individuals` care and support needs. This ensures that they have the knowledge and skills they need to do their jobs well. Menu planning now takes place each week, so that guests` individual preferences can be accommodated more quickly and effectively. What the care home could do better: No recommendations or requirements have been made by us following this inspection. The service continues to examine its own practice critically, and seek to make improvements to develop it for the benefit of the guests and their families. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Emscote House Emscote Drive Wylde Green Sutton Coldfield West Midlands B73 5NE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gerard Hammond     Date: 2 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Emscote House Emscote Drive Wylde Green Sutton Coldfield West Midlands B73 5NE 01213821463 01213821463 emscotehouse@normanlaud.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Norman Laud Association Name of registered manager (if applicable) Mrs Lesley Pamela Somerfield Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Residents must be aged under 65 years Date of last inspection Brief description of the care home Emscote House is registered to provide accommodation, care and support for up to eight people with learning disabilities, who may also have additional physical disabilities. This is a respite care service, aimed generally at serving the needs of younger adults. The property was purpose built: all respite accommodation is provided on the ground floor of the building, in single bedrooms. Rooms are designed to meet a varied range of support needs. The Home has well equipped standard and specialist (assisted) bathrooms, offering bathing and shower facilities. The kitchen links two roomy dining areas: both these rooms also double as areas for tabletop activities. There are also two Care Homes for Adults (18-65 years) Page 4 of 31 8 8 Over 65 0 0 care home 8 Brief description of the care home well-furnished lounges that include televisions, video / DVD, stereo, and computer games console. The conservatory also offers additional space for games, snooker table, parties and so on. There is an extensive private and enclosed garden to the rear of the property. At the front are shrub borders and parking spaces. The Home is situated at the end of a culde-sac in the residential area of Wylde Green. Local amenities include shops, library, medical centre, places of worship and a range of leisure and recreational facilities. The area is well served by public transport, including rail and bus routes. The service should be contacted directly for current information about fees. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This is the homes key inspection for the current year 2008-9. We gathered information from a number of places to inform the judgements made in this report. The Manager completed an Annual Quality Assurance Assessment (AQAA) and sent it back to us. This is a self assessment that focuses on the outcomes for people who use the service and provides us with some numerical information about it. At Emscote House, people who use the service are referred to as guests, so we have used this term throughout this report also. We visited the home and spoke with guests, the Manager and other members of the staff team. We directly observed staff giving support to the guests. We looked at records including previous inspection reports, policies and procedures, personal files of people using the service, care plans, staff files and other documents. We also sent out written questionnaires to guests and their families, and to members Care Homes for Adults (18-65 years) Page 6 of 31 of the staff team. Their responses helped us make some of the judgements in this report. Thanks are due to the guests, the management team and staff for their co-operation and support throughout the inspection process. What the care home does well: What has improved since the last inspection? There are no outstanding requirements or recommendations from the last inspection. The management team continues to demonstrate a positive attitude, supported with action, to develop the service for the benefit of the people who use it. Regular improvements are made to the environment and equipment, so as to maintain the services high standards. Since the last inspection these have included refitting the assisted bathroom, installing ceiling track hoists in the bathroom and some guest bedrooms, refitting the kitchen, providing new furniture in guest bedrooms and the dining room, fitting a new plasma screen TV in the lounge,upgrading sensory Care Homes for Adults (18-65 years) Page 8 of 31 equipment and buying new games, music systems etc. for guests entertainment. Practice, policies and procedures are kept under regular review. Most recent changes include responding to new legislation (Mental Capacity Act and Deprivation of Liberty Safeguards) to ensure that guests interests can be properly recognised and protected. Staff training and support is subject to ongoing development. Staff induction training has been re-organised, and the team has also received training to enable them to deal with specific individuals care and support needs. This ensures that they have the knowledge and skills they need to do their jobs well. Menu planning now takes place each week, so that guests individual preferences can be accommodated more quickly and effectively. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have all the information they need to help them decide if this service is right for them. Their needs are fully assessed so that their care and support can be properly planned. They have plenty of opportunity to come and visit beforehand, to make sure the service can meet their needs and is what they want. Evidence: The home has a Statement of Purpose and Service Users Guide: these documents tell people about what the service does and who it is for. The organisation has also produced a DVD and information in other formats to help people who may have difficulty reading. The Manager showed us a copy of the introductory pack that is given to all people who enquire about using the respite care service. This includes a lot of practical information about staying at Emscote House (for example arrangements for booking and cancelling visits, medication, laundry, spending money, advocacy etc.). It also includes the Statement of Purpose and Service User Guide mentioned above, and a copy of the last inspection report. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: Sampling of guests files showed that detailed, thorough assessments of their care and support needs are carried out before they come to stay. This is to make sure that the home can meet their needs, and support them in ways they like. Copies of the assessment form are given to families beforehand, so that they can be actively involved in this process. People are always offered the opportunity to come and visit the home and see what it is like, before making a decision about using the service. Files we looked at showed that people had a number of visits first, so that they could be sure they wanted to come. We sent questionnaires to some of the people that regularly stay at Emscote House. All of them said that they were given enough information about the home, to help them decide if it was the right place for them. Peoples records we examined also included a copy of the contract to provide the service. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have good care plans so that staff know how to support them in ways they like, and to keep them safe Evidence: We looked at peoples personal files to see how their care is planned and managed. Records are well structured and follow the same format. This makes it easier to find important information quickly and easily. The files we looked at contained detailed care plans. These were clearly linked to the initial assessment. These are not whole life care plans because the home is a respite care service. Care plans give staff clear guidance about how to support guests and keep them safe while they stay at Emscote. They include statements about individuals preferences, how they communicate, particular routines, how they like to receive personal care, and behavioural support. The Annual Quality Assurance Assessment (AQAA) shows that plans are reviewed every six months: sampled files contained records of review meetings. These were produced in written and pictorial / symbol format. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Before people come to stay at Emscote House, they are asked about how they would like the room they use to be organised. Care records include a room plan to show what furniture people want and how the room will be laid out. Care plans include detailed risk assessments. These show clearly how people are supported to stay safe. Guests have a designated key worker. They are consulted informally each day and a weekly record kept of discussions. These meetings are used to plan activities, outings etc. people are also given the opportunity to discuss things privately if they wish. People responding to questionnaires said that they made decisions about what they did each day. It was noted that care planning has been developed since the last inspection to take account of the requirements of new legislation. This initiative is to be commended. In keeping with the spirit of the Mental Capacity Act, individuals records now contain information about ability to communicate, to understand, retain, use and weigh up information. Where appropriate, each persons care plan shows where decisions may have to be taken in best interest, if individuals lack capacity to make their own decisions. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People staying at Emscote House are able to take part in a wide range of activities they enjoy, and to be a part of the local community. Staff respect their rights and encourage them to do what they can for themselves, to promote their independence. Their diverse needs, personalities and cultures are recognised. Support is given to maintain important relationships. Guests are asked about what food they like, so that they can have what they want and enjoy their meals. Evidence: Many of the people staying at Emscote House usually attend local colleges and day centres when they live at home. They are supported to continue doing this during respite breaks, if this is their wish. Guests who do not normally have set activity programmes can have a programme structured to meet their needs if they want. As reported above, informal meetings are held each day, so that guests can be consulted Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: about what they wish to do. Staff say that many of the guests who attend activities / education during the day are just happy to relax and unwind when the evening comes around. However, there is a good range of things to do, according to individual preferences. There is a computer for guests to use. This has a selection of joystick and mouse controls, so that people of all abilities can be supported to use it. The home also has a soft play area, including ball pool and a range of equipment for providing additional stimuli for guests with physical disabilities and sensory support needs. There is a pool table, bar football game, table top activities and arts and crafts. One guest was observed making the most of an impressive sensory lights display to supplement her obvious enjoyment of her favourite dance music. A new plasma screen television was being installed in one of the lounges on the day of our visit. A large trampoline has been installed in the garden for those of a more energetic disposition. We also looked at personal records to see what activities guest had done. These showed that people went out to local shops, the pub, cinema and local parks. At Emscote people watched television or DVDs, played cards, listened to music and played football. Responses to written questionaires showed that people are able to do the things they want during the day, in the evenings and at weekends. Acknowledging the particular nature of the service provided at Emscote House, people get the support they need to maintain contact with their friends and families. As noted previously, staying there provides opportunities to meet up with friends and do activities together that cant otherwise be managed. The service, as part of the Norman Laud Association, has a well established presence within the local community. As reported at previous inspections, information around the home is presented in various ways, in recognition of the diverse needs and abilities of people who come to Emscote House. These include pictorial aides, replica Makaton symbols,other easy read / alternative formats, objects of reference and materials in languages other than English. There are pictures and posters on display that highlight disability, equality and diversity issues. There is a bulletin board for posting information about forthcoming events or items of interest for guests. There is a board for displaying photographs of staff, so that guests know who is on duty. The Manager was honest about recognising that some of these measures may benefit a limited number of the people who use the service. However, the positive mindset (about not resting on ones laurels,and continuing to look for ways of doing things better) referred to in the last inspection report continues, and this should be recognised and commended. The Annual Quality Assurance Assessment (AQAA) shows that menu plans are now written every week, so that guests preferences can be accommodated. Food stocks Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: were examined: these were plentiful and included fresh fruit and vegetables. It was noted that packages of food stored in the fridge were labelled with the date of opening. Daily checks of temperatures of the fridge and freezer and cooked food are recorded, as appropriate. This is in keeping with accepted good practice. Personal records gave clear guidance about guests dietary needs and showed that the service is sensitive to peoples cultural requirements (e.g. halal meat only, vegetarian diet,no gelatin etc.). Pictorial aides are available to help people with communication support needs make choices. Records of meals provided clear evidence of variety and choice. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good health and needs are assessed carefully to that suit them best. Guests are administering their medication. and in the correct amounts. personal care while staying at Emscote House. Their make sure their support is planned and given in ways protected by good practice in handling, storing and This means they get their medicines at the right time Evidence: As reported above, we looked at peoples support plans to find out how their care is managed. We saw that their needs are carefully assessed, with their direct involvement as well as the people who know them best. Care plans give staff clear guidance about how people like to be supported. Important areas covered include personal care, moving and handling, and risk assessments to make sure people can be supported to stay safe. Guests can choose their own key workers, and are asked about whether they want support from male or female staff. The people we saw when we visited the home were well dressed in clean clothes, and had clearly been properly supported with their personal care. We were able to observe how staff treated the guests. They spoke to them politely and asked them what they wanted. Support was Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: given in a warm and friendly way, and people looked comfortable and at ease in each others company. We saw a letter that someone who worked at one of the guests day centres had written. It said that staff at Emscote let them know how this person had been (had they had a good night, been unwell, eaten well and so on): it also said that the standard of care given was very good, as if it had been given by the family. As a respite care service, Emscote House is not responsible for health action planning. Guests healthcare needs are assessed prior to admission: identified support is included in their care plans, as required, and agreed with their families / main carers. Support is provided to attend routine appointments if this is requested. The home sends us notifications about any occurrences affecting peoples wellbeing. These show that they know what to do, and take appropriate action to make sure guests get the support they need to keep healthy and well. The home has appropriate policies and procedures in place to make sure that guests medication is properly managed. The letter for booking each respite stay includes necessary information about each persons current medication. It is standard practice in the home to check in all medication as soon as a guest arrives. This is to ensure that that everything is as it should be, and that all medicines to be administered are present and correctly labelled. This is cross-checked with information in the letter and medication instructions. These audits for checking medication in (and out) of the home are done by two people and the record doubly signed. Double checking / signing is also completed at the beginning / end of each shift. This helps to minimise the risk of errors being made, and is good practice. We looked at the Medication Administration Record (MAR). This included sample signatures of staff responsible for giving medication. Information about prescribed medication, epilepsy management plans and written protocols for PRN (as required) medicines were also available. This is to make sure that staff have clear guidance about when and how to give peoples medicine safely. Staff also do competency checks every six months, to ensure good practice. The Medication Administration Record had been completed appropriately. We looked at the medication store: it was clean, tidy and secure. There are separate storage facilities and records for controlled drugs, as required. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their concerns are listened to, taken seriously and acted upon appropriately. They are protected from abuse, neglect and self-harm. Evidence: Previous inspection reports show that Emscote House has a very open complaints culture, and this continues to be the case. This means that the service is positive about hearing what people have to say, so that infomation gained can be used to improve things, if necessary. The complaints policy and procedure is prominently displayed, and available in other languages and formats. There is a post-box by the front door, and forms available so that people can make any comments they wish about the service. In addition to the complaints procedure, the home has the grumbles book for people to record any concerns about things they dont want to raise formally. Everyone responding to our surveys said that they knew how to make a complaint. Replies also confirmed that the information pack given to them contains copies of the policy and procedure. We have not received any complaints in respect of this service. We looked at staff records to make sure that action is taken to check that people working at the home are fit for the job. We saw that important checks with the Criminal Records Bureau had been made before people started work, and that recruitment practice is robust (see Staffing below). This is important to help ensure Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: the safety of people using the service. The home has an appropriate safeguarding (adult protection) policy in place. Action taken in response to allegations has shown that the service knows what it has to do to protect vulnerable people from abuse, and follow procedures properly. Staff have received adult protection training. We talked to staff on duty about this. They were able to show that they know about the different ways that people can be abused. They are sensitive to the kinds of things that might suggest that abuse is likely or has happened. This is particularly important because they work with people who may not be able to tell them this directly. They were also able to say what action they must take if they suspect or witness abuse. Staff are also scheduled to do training about the new Deprivation of Liberty Safeguards, following up the action already taken in response to the implementation of the Mental Capacity Act. This shows that the service is proactive about keeping up to date with legislation and encouraging best practice. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Guests are able to enjoy a comfortable and homely place when they stay at Emscote House. It is very well equipped to cater for people with a wide range of support needs. The home is safe, well maintained and clean. Evidence: We went around the home in the company of the Manager. Emscote House is a purpose built facility, equipped to cater for people with a wide range of support needs. As reported above, the layout and furnishing of rooms can be flexible, according to what people want. Some rooms have now been fitted with ceiling tracking hoists. This makes moving and handling of people with significant mobility problems safer and easier. One room is fitted with padding, to protect people who may fall or injure themselves. The Manager advised that there are plans to provide equipment to fit another room like this, to meet increasing demand for this facility. The high number of people now using this service places additional wear and tear on the buildings fixtures and fittings. Some of the bedroom furniture is now looking a bit tired. However, the Manager was able to show that new wardrobes, cabinets and chairs are on order, with delivery expected soon. This means that the very high standard of accommodation and furnishing available at Emscote will continue to be maintained, for the comfort of the guests that use it. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: There are ample toilets and bathrooms for peoples use. These include standard facilities for those able to manage independently, and assisted provision for guests requiring support. The assisted bathroom has a new Parker bath, new ceiling track hoist and new flooring. Toilet facilities are fully accessible, with grab rails fitted. The kitchen has been refitted, and the flooring is scheduled for replacement shortly. As previously reported, shared spaces in the house are very adaptable and multifunctional. We mentioned some of these things earlier in our report under Lifestyle. There are two dining areas that double as activity rooms. One of these houses a soft play area,including ball pool and sensory lighting. There is storage for art and craft materials and other table-top activities. There is also a large conservatory: this has the computer, pool table and other games in it. It also gets used as a quiet space, and for parties. The communal areas of the home look out onto the large, private and enclosed garden at the rear of the house. A new trampoline has been installed there since the last inspection. There are areas to sit out and enjoy being outside, when the weather allows. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team is well motivated, qualified, trained and supervised. This means that they have the knowledge and skills and get the support they need to do their jobs well. Evidence: We talked to staff and looked at their records. This was to see how they had been recruited, what qualifications and training they had, and to find out how well they are supported. Files we looked at contained all of the required documents. These included proof of staff identity, completed job applications with full employment histories, two written references, evidence of checks with the Criminal Records Bureau, and declarations of physical / mental health. Files also contained staff photographs, copies of their interview questions and responses and certificates for training they had done and qualifications gained. These show that the service takes care over the way that it selects and recruits staff, to make sure they are suitable to work in the home. The service has a good record of commitment to training and developing its workforce. Nineteen out of the twenty-one staff hold qualifications at NVQ level 2 or above. The Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: other two staff are working towards this. Seven of the care staff have already gained qualification at Level 3, with another two working towards this (see next section for management team information). A training and development plan is in place. The training matrix displayed on the office wall shows that the training programme is well structured and delivered regularly. Staff responding to our surveys, and those we spoke to, all said that they had regular opportunities for training. Staff records also included evidence of a structured induction programme. One of the management team has taken prime responsibility for organising this. She has put a new system in place since the last inspection. All of the staff responding to our surveys said that they felt that the induction they received covered the things they needed to know to do their jobs when they started. The new induction system seeks to develop knowledge and skills through peer group learning and shared experiences. This makes the most of the diverse talents possessed by the individuals making up the team. Available records also showed that staff receive formal supervision on a frequent and regular basis, generally every month. The staff we spoke to and those responding to questionnaires confirmed that they were able to meet with their manager regularly for support and to discuss their work. The service has received an award Excellence in Supporting Workforce Development from the Adult Care Training Partnership. Staff present themselves very positively: they appear well motivated, work well together and are commited to providing a good service for the people in their care. They show their understanding of peoples needs and wishes,and treat guests with warmth and respect, so that they can enjoy their time in Emscote House. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy the benefit of a service that is very well run. It continues to be highly valued by the people who use it and their families. Essential equipment checks and maintenance get done regularly. This helps to ensure that Emscote House is a safe place for people staying and working there. Evidence: We spoke with the Registered Manager and other members of the homes management team, as well as members of staff on duty. In keeping with the rest of the care team, the senior staff at Emscote House are similarly well trained and qualified. The Manager holds qualifications at NVQ level 4, the Registered Managers Award (RMA) and NVQ Assessors awards (D32 & 33). All three Deputy Managers are also qualified to NVQ level 4; one of them has a Psychology degree as well and is currently working towards an Open University degree, studying Autism. The management team gives the service a strong lead, and works well together. They support each other well, making the best use of their complementary skills and experience. Staff said that managers are approachable and supportive. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: We looked at the services policy and procedure file. We saw that the range of policies was comprehensive, and that these have been kept under review. We spoke earlier in this report about service developments to do with the Mental Capacity Act and Deprivation of Liberty Safeguards. These actions show that the service continues to work at keeping up to date with new legislation, and developing its practices accordingly. The organisations Trustees and Chief Executive are actively involved in the running of the service. As required by regulation (Regulation 26, Care Homes Regulations 2001) a formal visit is completed each month, and a written report of the visit produced. This forms an integral part of the quality assurance and monitoring of the service. The home also sent out customer satisfaction surveys to families using the respite care service. The information gained from these has been analysed and feedback given in the organisations latest newsletter. We also sent out some questionnaires to people who use the service. Comments we received were very positive. These included: I am very happy with my daughter staying at Emscote House. They treat her with respect, they support her needs very well, they communicate very well. I really enjoy my time at Emscote when Im there and like to see all my friends Emscote House always welcomes (N), so he feels like he is going on holiday! I love it, it is good I like some of the other people there, I used to go to school with them, and thats nice. He took to it like a duck to water - he loves going. The service offered is clearly valued by those who use it. Another response we received said:As a parent of a young person with special needs I can only say how pleased I am my son visits Emscote House. Its very worrying when your child has respite because you know you need this break but you feel guilty and apprehensive. The staff at Emscote have always looked after my son well and he is so happy to go, he gets his own bag together - sometimes when he isnt even in respite!. Another person wrote, They are great people,and they really do care. Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: We looked at the records the home keeps about health and safety matters. The fire alarm and fire-fighting equipment had been serviced and tested regularly. Fire evacuation drills have also been carried out. Portable appliance testing of electrical equipment has been done and gas appliances serviced. Other tests and servicing of essential equipment around the home has been routinely completed as required. Cleaning materials and other potentially harmful substances are stored securely. These things show that care is taken to make sure that the home is a safe place to stay. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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