Care Home: Florfield Home

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What the care home does well The inspector believes that this is a very well run home, and that service users receive high levels of care support. Service users spoken to expressed their satisfaction with the home, one commented that "I like it here." Care plans were of an excellent standard, and there was evidence that the home has sought to maximize service users control and choice over their daily lives. Documentation has been produced in accessible formats, and much work has been done to improve service users ability to communicate. Service users have routine access to the community, including to various social and leisure activities. Food was of a good standard, and the home has sought to meet the equality and diversity needs of service users. Record keeping in the home was of a good standard, as was health and safety management. What has improved since the last inspection? There have been improvements to the home since the previous inspection, and the inspector was pleased to note that all four of the outstanding requirements were found to have been met. Staff have now undertaken training in adult protection issues, and over 50% of the staff team have now successfully achieved a relevant care qualification. Quality assurance systems have been implemented which include seeking the views of service users and other relevant persons. The home has appointed a permanent manager, who has been registered with the CSCI. What the care home could do better: There are some issues that must be addressed, and a total of three requirements have been made in this report. Guidelines must be in place around the administration of medications prescribed on an as required basis, the staffing rota must include the hours worked in the home by the manager and monthly Regulation 26 visits must take place. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Florfield Home 1 Florfield Road Hackney London E8 1DW     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: Robert Cole     Date: 2 4 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 30 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 30 Information about the care home Name of care home: Address: Florfield Home 1 Florfield Road Hackney London E8 1DW 02085331022 02085331023 linda.obeng@clearwatercare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Linda Kesewa Obeng Type of registration: Number of places registered: Clearwater Care (Hackney) Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home The home is registered to provide service for four adults with physical and learning disabilities. The home is operated by Clearwater, which operated similar homes providing care to people with learning disabilities. Florfield home is sited entirely on the ground floor; it has four spacious bedrooms all with en-suite showers and toilets. The communal areas are the lounge, kitchen/diner, bathroom and utility room. The home is situated in the heart of Hackney within walking distance of the Hackney Empire, Hackney museum, local shops and other amenities. Public transport is also easily accessible. 4 4 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 30 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 inspection took place on the 24/11/08 and was unannounced. The inspector had the opportunity of speaking with service users, staff from the home and the homes manager was present for much of the inspection. The inspector also had the opportunity of observing staff as they carried out their duties and in their interactions with service users. The inspection included a tour of the premises, and an examination of records and other documents. Prior to this inspection, the CSCI sent surveys to service users to gain their feedback on the running of the home, two of these were completed and returned to the CSCI. The home completed an Annual Quality Assurance Assessment (AQAA) at the request of the CSCI prior to this inspection. All of this has contributed to Care Homes for Adults (18-65 years) Page 5 of 30 the overall inspection process, and helped to form the judgments made within this report. What the care home does well: What has improved since the last inspection? 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 7 of 30 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 8 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgement of the inspector that prospective service users are provided with sufficient information to enable them to make an informed choice as to move in to the home or not. This information is provided through written documentation and the opportunity of visiting the home. Evidence: The home has a Statement of Purpose and Service User Guide in place. Both of these documents have been produced in a Plain English version, an audio version and also a pictorial version, which helps to make them more accessible to service users, thus meeting needs around equality and diversity issues. The Statement states that Our aim at Florfield Road is that any person who comes to live in the home will have all their needs met on an individual basis. This in turn should ensure that they are happy, contented and fulfilled. The Statement also includes details of the facilities and services provided and of the qualifications and experience of the management and staff team. The AQAA supplied by the home states that the Care Homes for Adults (18-65 years) Page 9 of 30 Evidence: Statement is discussed during staff meetings, to help reinforce what the home is there to achieve, and what its aims and objectives are. The Service User Guide is likewise produced in various formats, and all service users are given their own copy. The Guide includes a charter of rights for service users, such as the right to having privacy respected, to be consulted about daily living arrangements and the right to make choices about their person centred care plan. The Guide also includes a summary of the Statement of Purpose and details of the homes complaints procedure. All service users have been provided with a written contract/statement of terms and conditions. These include the rights and obligations of both parties, and details of fees payable, detailing what is included in the fees, and what is extra. Contracts have been signed by service users (or their representative where appropriate) and the homes manager. The home has a clear admissions procedure in place, which covers both planned and emergency admissions. The procedure states that pre admission assessments should be carried out for any prospective service users, and that they should be given the opportunity of visiting the home before making a decision as to move in or not. Of the three service users currently living at the home, two have moved in since the last inspection. Transition plans were in place which evidenced that they had indeed being given the opportunity of visiting before moving in, including for overnight stays. Pre admission assessments had been carried out, these were of a good standard. Assessments covered needs around mobility, personal care and social and leisure needs. Care Homes for Adults (18-65 years) Page 10 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that the home has made considerable efforts to ensure that service users have as much control and choice over their lives as possible. Care plans are of an excellent standard, and service users are able to be involved in the day to day running of the home. Evidence: Individual care plans are in place for all service users, these are based upon the initial assessments carried out by the home and the placing authorities care needs assessment. Those involved in drawing up and reviewing care plans include the service user, their advocate, care manager, keyworker and the homes manager. Care plans are reviewed on a monthly basis, and each service user has an annual review in conjunction with their placing authority which feeds in to the care planning process. Plans are clear, detailed and comprehensive, and person centred and of a very good standard. Plans have been written in the first person, from the point of view of the Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: service user, for instance one plan states I am able to choose what I want to eat if I am shown different foods. I use facial expressions to show what I like and dont like. and I see my friends at a disco, I invite them to my birthday party. Plans are in place on personal care, communication needs, physical health and emotional wellbeing, as well as social and leisure needs and equality and diversity issues. Care plans clearly set out what goals and objectives service users need support with, and how the home is able to provide this support. Plans have been signed by staff to indicate their knowledge and understanding of them, and by service users (or their advocate) to indicate their agreement and involvement with the plan. Risk assessments are in place for all service users, and as with are plans, these are of a very good standard. Assessments set out in detail what risks service users face, and what the home is doing to manage and reduce these risks. Risk assessments make clear that service users are supported to take risks if they so choose. For example, it has been identified that two service users very much enjoy going swimming, but as they both have epilepsy this poses a risk. A detailed risk assessment has been implemented, which allows this activity to take place, which greatly reduces the risks involved. For example the assessment makes clear that the service users require two to one support when in the pool, and the pool life guard is informed in advance of the situation. Other risk assessments in place cover mobility, accessing the community, smoking and using public transport. Assessments are reviewed on a monthly basis. Through observation and discussions there was evidence that service usurers have a large measure of control over their daily lives, for example when to get up and go to bed, what to eat, what clothes to wear etc. For example service users were observed to help themselves to cups of tea as they chose and to move freely around communal areas of the home. One service user commented in the survey issued to them by the CSCI that I make pancakes and cups of tea, I also wear what I want to, and choose what I want to do and where I want to go. The inspector was impressed with the steps the home has taken to aid service users communication, and therefore increasing their ability to make choices and decisions over their daily lives. For instance, the home has worked with speech and language therapists to develop object of reference programs for service users, and picture books have been implemented to provide choice around food and activities. As mentioned previously, documentation has been produced in various formats to help make it more accessible to service users. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: There was evidence that service users are given the opportunity of being involved in the day to day running of the home. The manager informed the inspector that service users are involved in the recruitment and selection of new staff to the home. Service users are involved in choosing the homes decor and furniture, for example a new sofa has recently being purchased which service users were able to choose. The home has one vacancy at present, and the manager informed the inspector that the new service user will be able to choose the decor for their bedroom. The home holds monthly service user meetings, which are minuted. Minutes evidenced discussions on activities, menus and holidays. In addition to these meetings, each service user has a monthly one to one meeting with their keyworker, which provides them with the opportunity to discuss any matters of concern or interest to them. Minutes are kept of these meetings, and their was evidence that issues discussed at these meetings are followed up. For example, at a recent meeting one service user said they would like some shelves put up in their bedroom. The manager said that these have now being ordered, and should be at the home in the near future. The home has a confidentiality policy in place which makes clear under what circumstances a confidence may be broken in the health, safety and welfare interests of service users and others. Staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to confidentiality. Confidential records are stored securely, and staff and service users can access their records as appropriate. Care Homes for Adults (18-65 years) Page 13 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgment that the home supports service users to live valued and fulfilling lives. service users are involved in a wide variety of social and leisure activities, and have regular access to the community. Food was of a good standard. Evidence: No service users are currently involved in any employment. One service user goes to college, where they are involved in a pottery class. Two service users attend day services, where they are involved in daily living skills such as cooking, budgeting and road safety. They also visit places of interest through the day services, such as the cinema and Madame Tussuads. One service user was at their day service on the day of inspection. Activity programs are in place for service users as part of their care plans. These Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: indicated that service users have access to a wide variety of social and leisure activities. Service users are members of a sports club, where they go cycling and canoing, and on the day of inspection two service users went swimming. Other regular activities include going to football matches, the cinema, pubs, restaurants, discos and day trips, for example to Southend. All service users are offered an annual holiday, this year they have been to Blackpool. Service users showed the inspector photographs from this holiday, and said that they had very much enjoyed it. A service user informed the inspector I went to Blackpool, it was nice. Service user meetings indicated that service users had been involved ion choosing this destination. One service user commented At the weekend I go to the pub or discos or friends. I also go bowling and shopping. In house service users have access to a variety of activities, including television, DVDs music, games and puzzles. Staff were observed to support service users with various craft activities during the course of the inspection, for example helping a service user with a montage, and painting. Examples of service users works of art where on display within the home. One service users bedroom has been equipped with some sensory equipment. Staff also support service users with gentle exercise, foot spa, massage and card games. Service users have access to the local community, visiting banks, post offices, shops, the library, parks, markets and cafes. Service users have access to public transport, including trains and taxis. Visitors are welcome to the home at any reasonable time, and service users can see visitors in private if they so wish. Service users also have access to the use of a telephone. Records are maintained of menus, these indicated that service users are offered a varied, balanced and nutritious diet. The home provides traditional British and Caribbean food, thus helping to meet service users needs around equality and diversity issues. Service users are involved in buying food, and helping to prepare meals, and are able to help themselves to drinks and snacks. Mealtimes were observed to be relaxed and unhurried. The home has being working with the local authority to gain advice around healthy eating. The kitchen was clean and tidy, and records are maintained of fridge and freezer temperatures. However, it was noted that one of the food cupboards in the kitchen was kept locked. A member of the care staff informed the inspector that this was the usual practice. This was brought to the attention of the homes manager, who said that it should not be kept locked. The homes manager was seen to address this issue appropriately on Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: the day of inspection, therefore no requirement has been made. Care Homes for Adults (18-65 years) Page 16 of 30 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. It is the inspectors judgement that the home is generally meeting the health and personal care needs of service users. Service users are able to manage their own personal care as much as possible, and have access to health care professionals as appropriate. Evidence: Care plans make clear that service users are supported to manage their own personal care as much as possible. Service users have a choice of a bath or shower. Service users are able to choose their own clothes to wear, and all were appropriately dressed on the day of inspection. Health Action Plans are in place for all service users. These are of a good standard, setting out how the home is able to meet individuals health needs, for example around diet, exercise and skin care. The home carries out routine health checks, for instance service users are weighed monthly, and those service users who have epilepsy are checked regularly through the night. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: All service users are registered with a GP, dentist and optician. Records are maintained of medical appointments, including details of any follow up action required. These evidenced that service users have access to health care professionals as appropriate, including physiotherapists, speech and language therapists and chiropodists. One service user uses continence products, after an assessment by the NHS continence advisory service. Used continence products are disposed of appropriately. The home has a comprehensive medication policy in place, and all staff undertake training before they administer medication. No service users currently self medicate or are on any controlled drugs. Medications are stored securely in a locked cabinet inside the office. Records are maintained of medications that enter the home and of those that are returned to the pharmacist. Medication Administration Records are maintained, those examined by the inspector were accurate and up to date. One service user has been prescribed PROCYCLIDINE tablets on an as required basis. However, there were no guidelines or protocols in place on when this must be administered. In order to ensure that this (and other) as required medications are administered as appropriate, clear guidelines must be in place on their administration, which have been drawn up with advice from the prescribing practitioner. Care Homes for Adults (18-65 years) Page 18 of 30 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. It is the inspectors judgement that the home has taken reasonable steps to help ensure that service users are safeguarded from the risk of abuse. Appropriate policies and procedures are in place, and staff undertake training in adult protection issues. Evidence: The home has a complaints procedure in place, a copy of which was on display within the home. The procedure includes timescales for responding to any complaints received. The procedure is discussed with service users in the one to one meetings with their keyworkers, where they are encouraged to discuss any issues of concern to them. Surveys completed by service users indicated that they have a good understanding of whom they could complain to if they so wished, one wrote I can speak to the home manager or my keyworker. The home has a complaints log, although the manager informed the inspector that no complains have been received since the previous inspection. The home has a copy of the local authorities adult protection procedures, and also its own policy on safeguarding adults. Staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to adult protection issues. All but one of the staff working in the home have undertaken training in adult protection. The manager informed the inspector that it as planned that this remaining staff member would have this training in the near future. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: The home keeps money on behalf of service users, this is kept in a locked cabinet. All service users have their own bank accounts. Records and receipts are maintained of financial transactions involving service users monies, and monies are counted and checked at the beginning of every shift. Care Homes for Adults (18-65 years) Page 20 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It s the judgement of the inspector that the home is suitable to meet its stated purpose with regard to the physical environment. Service users have access to adequate communal and private space, and the home is well maintained both internally and externally. Evidence: The home is situated in the London Borough of Hackney, close to shops, transport networks and other local amenities. It is a purpose built ground floor home, which is suitable to meet the needs of service users with physical disabilities. The home is in keeping with other properties in the area. The home was well maintained, both internally and externally. Communal areas consist of a kitchen/dining room and a sitting room. The home does not have its own outdoor space, although it is closely located to several parks. Furniture and fittings in the home were domestic in character, and of a good standard. The home was pleasantly decorated, and presented as having a homely atmosphere. Service users were observed to move freely around communal areas. All bedrooms have ensuite toilet and bathing facilities. In addition to this there is a Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: communal bathroom/toilet. This was clean, tidy and free from offencive odour. It had a working lock, which included an emergency override device. All service users have their own bedroom. These have been decorated to service users personal tastes for example with family photographs and souvenirs of holidays. Bedrooms were clean and tidy, and contained adequate furniture, including table, chair, chest of draws and a wardrobe. Bedrooms meet National Minimum Standards on size requirements. All bedrooms contained central heating,and had adequate natural light and ventilation, bedding, curtains and carpets in bedrooms were well maintained, and domestic in character. One service user informed the inspector I have a very nice room. Various adaptations are in place to help make the home accessible to service users with physical disabilities, thus helping to meet needs around equality and diversity issues. As mentioned, the home is built over one floor, and corridors and door frames are wide enough to allow service users who use wheelchairs to move around freely. Toilets have handrails fitted, and baths and showers have been adapted to make them accessible to service users. The home has taken reasonable steps to help prevent the spread of infection. Laundry facilities are appropriate in sale to the size of the home, and hand washing facilities are situated throughout the home. COSHH products are stored securely. Protective clothing such as aprons and gloves are available to staff. Care Homes for Adults (18-65 years) Page 22 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that the home is staffed in sufficient numbers to meet the needs of service users. Staff are suitably qualified and experienced to carry out their duties, and demonstrated a good understanding of the needs of service users. Evidence: The home provides 24-hour support, including waking night staff and an emergency on-call procedure. The home had a staffing rota on display. This accurately reflected the care staff who were working in the home on the day of the inspection. However, the rota did not indicate when the manager works in the home. So that staff and service users are aware of when the manager is due to work in the home, and to indicate that they spend sufficient time in the home to carry out their duties, it is required that the rota contains the details of the hours worked in the home by the manager. Through observation and discussion there was evidence that staff have built up good relations with service users and that they have a good understanding of their individual and collective needs. In answer to the questions on the survey Do the staff treat you well? and Do the carers listen and act on what you say. a service user responded Always. Staff were seen to interact with service users in a friendly and Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: respectful manner, and positive examples of staff interactions with service users were witnessed throughout the day, such as supporting service users with activities, and offering choices over meals. The AQAA supplied by the home indicates that the home has all necessary employment related policies in place, including on equal opportunities and recruitment and selection. The inspector was pleased to note that service users are supported to take part in the recruitment process for new staff. The inspector checked several staff employment files at random. These were found to contain evidence of required checks being carried out, including CRB checks, references and proof of ID. Seven of the nine care staff employed at the home have achieved an NVQ Level 2 in Care or equivalent qualification, over the 50 minimum required by National Minimum Standards. All staff undertake a structured induction programme on commencing working at the home, this includes the values of the home and the philosophy of care, along with information on individual service users. Staff have access to training, and records are maintained of this. Recent training has included food hygiene, challenging behaviour, person centred planning, infection control and fire safety. All staff receive regular supervision, and have an annual assessment of their performance and development needs. Staff are provided with a copy of their job description. Care Homes for Adults (18-65 years) Page 24 of 30 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. It is the inspectors view that this is a very well run care home, and that systems are in place to help ensure that service users receive high levels of individual care and support. Evidence: The homes manager has eleven years experience of working in care, including three years in a managerial capacity. They have achieved an NVQ Level 4 in Care, and are currently working towards the Registered Managers Award. The home also has a deputy manager and a senior support worker to assist in the running and administration of the home. Staff and service users were seen to interact with the manager in a relaxed manner. There was evidence that the manager has built up good relations with health and social care professionals. The manager has demonstrated a commitment to equal opportunities for example through staff selection and valuing service users as individuals through the person centred approach to the delivery of care. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Record keeping in the home was of a very good standard, and confidential records are stored securely. The AQAA supplied by the home indicates that it has all necessary policies and procedures in place in line with National Minimum Standards. Those checked by the inspector, including medication, adult protection and admissions were all of a satisfactory standard. Care plan reviews, service user meetings and staff supervision all contribute to the quality assurance systems in the home. Copies of previous inspection reports were available to view in the home. However, there was no record of any Regulation 26 visit taking place since July 2008. The manager informed the inspector that a visit had taken place in August, but that the home had not yet received a copy of the report. The manager also said that there had been no further Regulation 26 visits since August. To help ensure that the home continues to run effectively and in the best interests of service users, it is required that monthly unannounced Regulation 26 visits take place, and that a copy of the report of this visit is retained within the home. Despite this, other quality assurance processes are in place. A senior manager from the organisation that runs the home carries out a thorough audit of the home every six months, this audit includes looking at care practises along with the physical environment. Surveys are issued to service users and social and health care professionals to gain their feedback on the running of the home. Completed surveys seen by the inspector contained positive feedback. Fire exits are clearly signed and were free from obstruction. Fire extinguishers are situated around the home and were last serviced on the 4/7/08, as were the fire alarms. These are tested by the home on a weekly basis, and regular fire drills are held. The home had in date safety certificates for PAT testing, gas safety and electrical installation. Hot water and fridge/freezer temperatures are checked. The home has in date employers liability insurance cover in place. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 1 20 13 The registered person must ensure that clear guidelines are in place around the administration of medications prescribed on an as required basis. To help ensure that medications are administered as appropriate. 31/12/2008 2 33 17 The registered manager must ensure that the staffing rota contains details of the hours worked in the home by all staff, including the manager. To demonstrate that the manger spends a sufficient amount of time in the home to carry out their duties. 31/12/2008 3 39 26 The registered person must ensure that monthly unannounced Regulation 26 visits take place, and that a copy of the report of these visits is retained within the home. 31/01/2009 Care Homes for Adults (18-65 years) Page 28 of 30 To help ensure that the home continues to be able to meet the needs of service users. 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 29 of 30 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. 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