Care Home: Finchley House

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What the care home does well The manager, staff and service users at this home work hard to make this home interesting and a good place to live. Although the manager has recently reduced her hours, so that she works four days a week instead of five, there is always someone who is well experienced in charge of the home. A senior member of staff and an assistant senior have been employed to support the manager and to manage the home in her absence. Service users therefore always have someone in charge of the home who knows the job well. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 6Service users are supported to learn about their rights and what is expected from them. Information about the home and how it is to be run is supported with pictures so that anyone who finds the written word difficult to understand can see what the information means from the illustrations. The home is kept clean, is attractively decorated and has good quality furniture. Staff support service users to choose the colours they want their bedrooms to be and the sort of furniture they want in them. This means that service users have a pleasant and comfortable place to live and their bedrooms are the way they want them to be. Some of the staff have worked at Finchley House for a long time and know the service users well. All of the staff are taught how to support and care for people with learning disabilities. Staff and service users get on well together and when visitors come they are made to feel very welcome. This helps to make the home a happy place to live. Staff work hard to help people living in the home take part in different activities that they choose. Some of these activities include cycling on special bikes for people with disabilities, 10 pin bowling at the local bowling alley and going on holiday to different places in England and abroad. Service users are encouraged to take an important part in running the home. Staff support them to keep their rooms tidy and the home clean. Service users are always told what is happening in the home. Staff listen to service users and discuss with them their ideas about how the home should be run. Care plans include good information that tell staff how a person likes to be supported. Care plans are also developed in words and pictures so that service users know what is written about them. Meetings take place between service users and anyone else the service user wants to be there, to discuss life at Finchley House and to make sure that the service user is still happy with their life there. Service users and staff have developed a report with words and photographs to describe what was discussed in these meetings. This describes the service user`s present lifestyle, the things they want to continue to do and any new things they want try. This is written in an easy way to understand. What has improved since the last inspection? More information is now written in the agreements between service users and the home so that service users know the full cost of the fees to be paid for their care. Medication procedures in the home have now improved. When medication is received into the home, the date and the amount that was received and the signature of the person who received is now recorded on the medication record sheet. This further protects service users from possible mistakes being made. In the past the home has found it difficult to keep staff at Finchley House, however over the past 12 months this has improved. Receiving the necessary support and training has helped staff to feel more valued and are staying longer. This is good for the service users as they receive care from people who they have developed good relationships with and who know them well. Staff have attended special training with the local council to learn about the steps to take and who to contact, if they see or hear about something happening that might hurt a service user or make them feel unhappy. The Fire Service was invited to carry out an inspection of the home, so that they could check that the fire procedures and the fire fighting equipment in place would keep service users and staff safe in the event of a fire. They were pleased with what they found. The laundry has recently been refurbished. A new good quality washing machine and tumble drier have been purchased and the space around them now allows service users to safely enter this area to help with their laundry. New flooring has been laid in the entrance, hallway and dining room and a new carpet has been laid in the lounge. This makes these areas look very attractive. What the care home could do better: The flooring in the kitchen is coming away at the join and should be addressed as soon as possible so that it does not become loose and cause service users or staff to trip. So that staff know how to deal with someone who has an epileptic seizure, they should receive training in relation to this from someone they can ask questions of if they do not understand anything that is being said. CARE HOME ADULTS 18-65 Finchley House 57 Brandling Street Roker Sunderland SR6 0LP Lead Inspector Elsie Allnutt Key Unannounced Inspection 9th September 2008 09:30 Finchley House DS0000015744.V371822.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 Finchley House DS0000015744.V371822.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. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Finchley House Address 57 Brandling Street Roker Sunderland SR6 0LP 0191 510 8448 0191 510 8448 finchleyhouse@c-i-c.co.uk www.c-i-c.co.uk. Community Integrated Care 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) Jaqueline Gannon Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Finchley House DS0000015744.V371822.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 category: 2. Learning disability - Code LD - maximum number of places: 6 The maximum number of service users who can be accommodated is: 6 15th September 2006 Date of last inspection Brief Description of the Service: Finchley House was purpose-built as a residential care home in 1993. The property is owned and maintained by Three Rivers Housing and Community Integrated Care (CIC) delivers the service. The home is built in a residential area in the Roker area of Sunderland and is amongst other housing which pre-dates the home. It is within walking distance of the sea front, shops and local amenities, such as a post office, hairdresser and pubs. The home is registered to provide care for 6 adults who have learning disabilities and additional physical disabilities. Four of the service users rely on the use of wheelchairs for mobility and are encouraged to be independently mobile around the house. A team of staff support the service users to live a full and active lifestyle and a mini bus owned by the home is available to access the local community. Local public transport is also used, The security of the building has been enhanced through the installing of security lighting. The home has developed a Service User Guide that informs prospective service users about the service, the aims and how these are met. A copy of the recent inspection report is available in the home for anyone to read. The fees charged by the home range between £879.56 and £1042.63 per week. Finchley House DS0000015744.V371822.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 3 star. This means the people who use this service experience excellent quality outcomes. Before the visit: We looked at: • Information we have received since the last visit. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 9th September 2008. During the visits we: • • • • • • Talked with people who use the service, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager what we found. What the service does well: The manager, staff and service users at this home work hard to make this home interesting and a good place to live. Although the manager has recently reduced her hours, so that she works four days a week instead of five, there is always someone who is well experienced in charge of the home. A senior member of staff and an assistant senior have been employed to support the manager and to manage the home in her absence. Service users therefore always have someone in charge of the home who knows the job well. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 6 Service users are supported to learn about their rights and what is expected from them. Information about the home and how it is to be run is supported with pictures so that anyone who finds the written word difficult to understand can see what the information means from the illustrations. The home is kept clean, is attractively decorated and has good quality furniture. Staff support service users to choose the colours they want their bedrooms to be and the sort of furniture they want in them. This means that service users have a pleasant and comfortable place to live and their bedrooms are the way they want them to be. Some of the staff have worked at Finchley House for a long time and know the service users well. All of the staff are taught how to support and care for people with learning disabilities. Staff and service users get on well together and when visitors come they are made to feel very welcome. This helps to make the home a happy place to live. Staff work hard to help people living in the home take part in different activities that they choose. Some of these activities include cycling on special bikes for people with disabilities, 10 pin bowling at the local bowling alley and going on holiday to different places in England and abroad. Service users are encouraged to take an important part in running the home. Staff support them to keep their rooms tidy and the home clean. Service users are always told what is happening in the home. Staff listen to service users and discuss with them their ideas about how the home should be run. Care plans include good information that tell staff how a person likes to be supported. Care plans are also developed in words and pictures so that service users know what is written about them. Meetings take place between service users and anyone else the service user wants to be there, to discuss life at Finchley House and to make sure that the service user is still happy with their life there. Service users and staff have developed a report with words and photographs to describe what was discussed in these meetings. This describes the service user’s present lifestyle, the things they want to continue to do and any new things they want try. This is written in an easy way to understand. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? 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 Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 9 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 Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good multidisciplinary preadmission assessments demonstrate service users’ needs and aspirations and assist the home to make informed judgements as to whether their needs can be met. EVIDENCE: The home receives a full assessment of need from the referring agency prior to anyone moving in. These are comprehensive and in good detail. The home also carries out there own assessment at this stage and both records are kept in individual service users’ care files. One service user has recently moved into the home and records shows the work carried out prior to the move. Staff from Finchley House made several visits to meet the former carers and to the person’s home to discuss the care and support needed. In addition to this the service user made several visits to Finchley House to meet the people living and working there. This gave them a good idea about what it was like to live at the home. During this time the service users already living at the home had an opportunity to get to know the person and their compatibility was assessed. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 11 As a result of doing this and receiving detailed information about the person, the transition process was smooth and effective. Also prior to moving in, the home worked closely with healthcare professionals to ensure that all the equipment needed for support was in place. Risks were identified and risk strategy plans put in place to ensure that the person was supported appropriately and safely. Occupational therapists and physiotherapists gave advice regarding the special equipment needed. The assessment process is ongoing for all service users and care plans are monitored and adjusted according to service users’ changing needs and aspirations. Each service user is given a contract stating the home’s terms and conditions of their stay. In an effort to make the document accessible to service users, a copy of the document is written using basic words and illustrated with pictures. This document is signed by the service user or their representative and includes the full cost of the fees charged. A separate document includes a signed agreement regarding how the service users’ mobility allowance is to be paid towards the cost of running the home’s vehicle. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans, that are the outcome of ongoing assessment, guide staff to appropriately support service users’ care needs, promote their independence by safely addressing risks and enable staff to support service users to make choices about their lives. EVIDENCE: The care planning system is currently under review. The new process is in place for a service user who has recently moved into the home and plans are in place for all other care files to be transferred into this system. The information recorded in all of the care plans is current and clearly guides staff to effectively address the individual service users’ personal, social and emotional care needs. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 13 Service users are empowered to lead their care plans. They are written with a person centred approach and they are illustrated with pictures so that service users have access to what is written about them. The staff team have worked hard to develop an effective care planning system. This is well organised and to make it easy to access, information is divided into different files, for example there are separate Healthcare, Support and Financial Plans. Each service user has an individual plastic box where the separate files are kept. The boxes have the photograph of the individual service user on the front. Staff follow clear guidelines recorded in the care plans regarding the different aspect of support needed. These clearly inform staff about the level of support needed and they are focussed on promoting independence. Following set guidelines ensures that a consistent approach to care is achieved. For example, for service users who demonstrate challenging behaviour, guidance is in place for staff to follow and as an outcome everyone takes the same approach that enables the behaviour to be effectively managed. Risks are identified and addressed appropriately. Risk management plans are put in place to reduce the risk of harm to the service user, while promoting independence and these are an integral part of the care plan. A key worker system is in place that works effectively and gives consistency to service users. Key workers and service users are matched sensitively for compatibility. Service users spoke positively about staff members in general. The key worker is responsible for making sure that the information recorded about individual service users is kept up to date, monitored and reviewed. The key worker monitors the care plans monthly and annual reviews take place, when people involved in the service users’ lives are invited to discuss the plan of care and any other issues about the placement. All staff have received training regarding person centred planning and the records and the way care practices are carried out reflect this. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to live appropriate and fulfilling lifestyles, both in their own home and the local community, while at the same time they are supported to maintain relationships with family and friends. Furthermore meals are healthy, nutritious and attractive and are prepared to meet service users’ individual dietary needs. EVIDENCE: Service users have individual weekly activity programmes that are recorded in their care plan and a copy is also displayed in individual bedrooms. These are flexible but act as a structure to the individual’s week. The activities are developed as an outcome of person centred planning and as a result of a process within this known as “Community Mapping”, where Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 15 service users’ individual likes and preferences are matched with different and varied facilities in the community. One person who loves pop music has recently attended a pop concert in Glasgow, where they stayed overnight in a hotel with two carers. Staff have a good understanding of person centred planning and have used their training with a positive approach to service users and their chosen lifestyles. Service users are supported to try new experiences and for one this resulted in going swimming for the first time and for another a visit to the theatre. Service users were happy to discuss the holidays that they had enjoyed this year. These include visits to Ayre in Scotland, Blackpool and Drayton Manor in Staffordshire. Plans are in place to visit destinations abroad in 2009. Service users have individual bus and metro passes so that they can use the local public transport as well as the home’s own transport. This gives a greater choice and experience when travelling to different destinations. All daily activities, household chores and choices are recorded in the individuals care files. Service users’ likes and dislikes are recorded in the individual plans and their individual choices and decision making is supported and recorded in the monthly keyworker meetings. The service users’ families and any outside agency that may be involved in the individual’s care are also involved in decision making processes in the annual reviews. Service users and staff have attended Makaton training, together with the SALT team (Speech and Language Therapy,) so any communication barriers can be improved. Family and friends are actively encouraged and supported to be part of the service user’s life and they are free to visit the home at the service users’ convenience. Service users are also supported to visit their families’ and friends’ homes and to keep in contact with those who may live abroad. The home is run and organised to promote the recognition of respect, privacy and the rights of service users. Staff working practices reflect this. Service users’ rooms are respected as their private space and they move around the building with confidence, demonstrating ownership of their surroundings. A varied, nutritious menu is offered at the home that caters for individual preferences and needs. The menus have recently been updated and everyone Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 16 has the choice from two different meals each day. The menus are designed around healthy eating and they are supported with advice from a dietician. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ personal and healthcare needs are met in a flexible but consistent manner, reflecting a healthy lifestyle. The medication arrangements in place are appropriate to the needs of service users, promoting their health and welfare. EVIDENCE: Staff support service users individual healthcare needs by assisting them to visit local GPs and attend hospital appointments. The outcomes of such visits are recorded in the individual Healthcare Action files along with other healthcare information. Staff find these files useful in the event of a service user being admitted into hospital or attending a hospital appointment. The information needed by healthcare professionals is directly at hand. Staff interact with service users sensitively and competently, supporting them with personal tasks in a discreet and respectful manner. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 18 Staff receive training regarding issues surrounding learning disability and other related disabilities, however although there is a training video regarding epilepsy that staff watch “in house”, there has been no formal training offered in this. Epileptic seizures are something that all staff at some stage deal with in the home. Staff attended formal training regarding this last year and further training is currently being arranged for the new staff. The manager has recently used a video training package to inform and refresh staff knowledge and skills needed when dealing with epileptic seizures. Comprehensive guidelines in a service user’s care plan clearly guide staff to support a service user who experiences seizures and this practice, which was observed, is carried out in a calm and competent manner. A special mattress mat with an alarm that sounds when the person has a seizure is available and helps to protect the person from possible harm during the night. A specialist nurse has trained staff regarding the administration of food and medication via a PEG (Percutaneous Endoscopic Gastrostomy) tube and in relation to the importance of infection control when dealing with this. Guidance in individual care plans clearly guide staff with this process, minimising any identified risks. Staff work with healthcare specialists in an effective way, following their guidance and advice consistently, with positive outcomes for service users. Feedback is given to the healthcare specialist who may adjust or further develop the guidance given. A physiotherapist, who had been called out by the home as an urgent visit, visited a service user who was having great difficulty with their mobility, while at the same time was experiencing discomfort. Great care was given by the carers to note the advice given and to share the information with the staff on duty, while at the same time staffs’ actions were explained to the service user. Staff not only supported the service user physically but also emotionally, assuring them that things would be fine and attempting to divert their attention away from the discomfort. Specialist advice has been sought regarding pressure care. One care plan demonstrates how preventative measures are in place for one service user who is at risk of pressure sores developing. Risk management plans that are an integral part of the care plan guide staff in relation to this. The home has the necessary equipment to support service users with their individual physical needs. Bathrooms have special bathing equipment, Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 19 including a bath that adjusts in height and hoists and slings that are specially allocated to individuals. Guidelines in care plans guide staff in there use. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Recent mistakes made by staff in the home during the administration of medication have been seriously addressed and all staff have now received training in the administration of medication. Medication records are fully completed, contain required entries and are signed by appropriate staff and the manager monitors compliance with the home’s procedures. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place in the home to help protect service users from abuse and to seriously address complaints and concerns about the service. EVIDENCE: The home has a comprehensive complaints procedure that is in picture format in an attempt to make it more accessible to the service users. Service users have varied ways of communicating their needs and this information is clearly recorded in individual care plans. It is with this knowledge that staff are able to see the signs when service users are not happy or are showing concern about something. The outcome of such observations is recorded in individual care files and acted upon. The home has a “gender sensitive” policy that protects service users’ dignity and privacy. The two ladies who live here both receive personal support from female staff. There is a mix of male and female staff in the team and rotas reflect a good balance. Staff receive training regarding the local authority’s safeguarding adults procedures and are able to confirm the action they would take if an abusive incident was observed or reported to them. Staff are confident that anyone who “blows the whistle” regarding bad practice are supported well by the service. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 21 A copy of the local authority’s guidelines on the Safeguarding Adults Policy is kept in the home for staff to refer to. There has been one incident reported in the home that resulted in the home making an alert to the local authority’s Safeguarding Adults Team. This was addressed appropriately by the home and a satisfactory outcome achieved. The home has proved that abusive practice will not be tolerated. Some service users who live at this home occasionally demonstrate challenging behaviours and so that staff have the knowledge and skills to address this appropriately, they receive training in relation to this. There is a clear system in place for recording service users’ finances. Service users money is stored individually and records and receipts of purchases reflect how money is spent. In addition to this each service user has a bank account where any money paid to them is deposited. Service users access this with support. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 22 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is homely, comfortable, clean and decorated and furnished to a high standard. It provides service users with spacious, private and communal spaces that are safe. EVIDENCE: The house is well decorated and well maintained. As a result of service users using wheelchairs and being encouraged to be independent, the maintenance of the internal walls and paintwork of the home is often challenged. As a result of regular attention such areas are kept in good condition, however there is one area in the dining room that is showing signs of scratches from wheelchairs. This area is currently being dealt with and thought is being given to how the area could be further protected. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 23 The home is comfortable and safe for the people who live here. Service users are supported to keep their bedrooms individually decorated with personal furnishings that reflect their personalities. Special appliances are available where necessary. A high/low bed allows the service user to be transferred from a wheelchair to bed safely and independently. A new bed is on order for another service user whose changing needs dictate that a special bed is now needed. The home seeks the advice of an occupational therapist who assesses such needs and makes referrals for new appliances. Access into and around the home is good and service users can access the surrounding gardens independently. Attractive potted plants surround the building and this makes the entrance to the building look attractive, while at the same time promoting a positive image of the people who live here. There are further plans to enhance this area with the planting of trees and shrubs around the outer wall. The kitchen area is safely accessible and has a high/low bench so that all service users whether reliant of the use of a wheelchair or not, can assist in the preparation of meals. Most of the kitchen appliances are new and are big and robust enough to withstand the regular use of the number of service users who live here. The flooring in this area however is starting to come away at the seams and needs attention as soon as possible, before it becomes a hazard to service users and staff. Bathrooms are fitted with specialist bathing facilities and lifting equipment that meets the needs of the service users. The specialist equipment is regularly maintained and this promotes the safety of the service users and staff. The laundry is appropriately furnished and equipped so that service users can safely access it and the facilities. The home is kept clean and tidy and reflects good and effective cleaning routines. Staff receive training regarding infection control. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 24 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): 34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment & selection procedures and regular training opportunities ensure that service users are appropriately supported and protected by a competent and qualified staff team. EVIDENCE: The home has developed a new recruitment policy that incorporates issues surrounding equality and diversity. There is now no age limit stated for staff and the job description allows maximised suitability in the selection process along with C.R.B. and P.O.V.A. checks. The induction through E Learning ensures that staff are aware of their role and responsibilities and the GSCC (General Social Care Council’s) Code of Pratice ensures that staff are aware of the values and attitudes needed when working with service users. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 25 Staff are supported and valued, receive supervision and training and as an outcome are able to meet the needs of the service users. Staff stated that they are happy working at the home and enjoy working with service users and supporting them to achieve their goals. Staff interact sensitively and competently with service users. A new structure of management that includes the manager, a senior and an assisting senior has allowed issues raised by staff to be dealt with directly and has improved motivation within the staff team. Staff retention has improved and the staff are more qualified in delivering a good service. Vacancies that arise are filled quickly and the use of agency workers has minimised to a reasonable level. Staff are up to date with mandatory training and the majority are qualified in NVQ 2 and some are now working towards NVQ 3. They share their knowledge with each other for the benefit of the service users and work effectively as a team transferring their knowledge to their work practice. The home follows the company’s robust recruitment procedures and staff files include, completed application forms, 2 references and satisfactory CRB checks. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 26 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager and senior staff team provide excellent leadership and run a service that has effective monitoring systems that are focussed on the best interests of the service users. EVIDENCE: The registered manager has had many years experience as a manager and is fully qualified. She has achieved the Registered Managers Award (RMA) and NVQ 4 in Care and has the appropriate allocated time to carry out her managerial duties. She is a Moving and Handling Facilitator and a Fire Trainer and has attended a three-day induction course for Foundation Training Analysis. So that the staff Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 27 team is effectively led, the manager regularly attends training related to good care practices and keeps up to date with changes in legislation. A senior member of staff and an assistant senior supports the manager and in her absence leads the staff team and manages the home. Both have achieved NVQ 3 and are registered to do a Leadership Skills Course that will equip them with the skills needed in their role. This ratio of senior staff means that there is a senior member of staff on duty every day. The manager uses an open door approach to ensure staff can air views and concerns at any time, in a confidential and positive environment. Staff are empowered to be an active part of the development of the service and in so doing feel valued. Individual duties are delegated to staff giving them responsibilities related to their interests and skills. As a result staff work well as a team and this creates a consistent approach to care. A diagram on the wall of the home identifies the service plan for the year, illustrating how the aims and objectives for the year are to be met in the form of a “pathway”. As objectives are accomplished this is mapped on the path. This is a good way to keep service users and staff involved in and informed about how the aims and objectives of the yearly plan are accomplished. There is a good quality assurance system in place, the outcomes of which are recorded. The system is monitored internally monthly by the manager and service manager and annually by an external person. This ensures that the home’s policies and procedures are put into practice and that the service is led in the best interests of the service users. The individual policies are systematically reviewed and updated where necessary during which time they have been developed into picture format to ensure that they are accessible to service users. Completed surveys inform the manager of the service users and their relatives/advocates service satisfaction and there is a “suggestion box” to encourage both service users and staff to air their views and ideas. The manager has produced a Business Plan that includes a Five Year Improvement Plan for the home. This also is in picture format and simple language that service users can access and understand. Staff are aware of health and safety issues and carry out their roles accordingly. Finchley House DS0000015744.V371822.R01.S.doc Version 5.2 Page 28 Records in the fire log and accident book are satisfactory. Finchley House DS0000015744.V371822.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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X 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 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 3 X Finchley House DS0000015744.V371822.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations It is strongly recommended that the flooring in the kitchen that is coming away from the join is addressed as soon as possible so that this area does not become a hazard to service users and staff. It is strongly recommended that all staff who have not already done so, receive training regarding epilepsy from a trained person who has expertise in this area. The video training pack should continue to be used in addition to this and as refresher training. 2 YA35 Finchley House DS0000015744.V371822.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 Finchley House DS0000015744.V371822.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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