Care Home: Franklyn Lodge 9 Grand Avenue

What the care home does well Residents gave positive feedback regarding the quality of the service received and were pleased with the support given by staff, their accommodation, the meals provided and the annual holiday. A resident that is preparing for supported living praised the help given to him by his key worker and by "Doctor Doris" and said that he would miss them when he left Grand Ave. Residents treat Grand Ave as their home and move around the home as they please. They enjoy spending time in their room relaxing after returning to Grand Ave from the day centre. They each have a comprehensive day care programme, which may include attending day centres or receiving 1:1 support and attention in the house. Residents may also attend clubs, which are held in the evenings or at the weekend. At the weekend they are able to take it easy or take part in activities. The company`s training programme for staff provides a package of training that includes NVQ training, training in areas specific to the client group and training in safe working practices. The training needs of individual members of staff are identified and recorded in personal development plans. Members of staff work together as a team and are knowledgeable about the needs and about the likes and dislikes of individual residents. What has improved since the last inspection? During the key inspection in February 2007 three statutory requirements were identified. Two of the 3 statutory requirements are now met. Overdue internal review meetings have now been carried out. A copy of a valid certificate for the testing of the portable electrical appliances was now available. Since the key inspection in February 2007 the window frames and sills in the home have been replaced. What the care home could do better: During this inspection 4 statutory requirements were identified, 1 of which is outstanding from the key inspection in February 2007. The home needs to ensure that risk assessments are reviewed on a minimum basis of 6 monthly. A discussion with the funding authority is needed so that there is an agreement regarding what repairs are necessary, where the resident has damaged their room, and also to consider what support the resident needs with anger management. Walls and woodwork must be redecorated as necessary, the carpet cleaned or replaced as identified and new seating purchased for the lounge. In one of the bedrooms a curtain rail needs to be securely attached to the wall or a system installed of Velcro tape fitted to the top of the curtain, which then attaches to a strip of Velcro on the curtain rail or wall so that they can easily be repositioned in the event of being pulled down by a resident. CARE HOME ADULTS 18-65 Franklyn Lodge 9 Grand Avenue 9 Grand Avenue Wembley Middlesex HA9 6LS Lead Inspector Julie Schofield Key Unannounced Inspection 9th October 2007 8:05 Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.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 Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.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. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Franklyn Lodge 9 Grand Avenue Address 9 Grand Avenue Wembley Middlesex HA9 6LS 020 8902 3070 020 8903 9860 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) Residential Care Services Ltd Dr Frank Eribo Dr Doris Esohe Ilobi Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th February 2007 Brief Description of the Service: Franklyn Lodge, Grand Avenue, is a care home providing personal care to 6 adults with learning disabilities. At the time of the inspection there were no vacancies. The house is in a quiet residential part of Wembley but close to the Harrow Road and with easy access to the shops on Wembley High Road. There are bus routes along the Harrow Road and there are underground stations relatively close by. The property is a corner plot and the house is slightly elevated from the road with steps in the front garden, leading from the pavement to the front door. There is off street parking for 2 cars and there is parking in the road outside the home. The house consists of 2 floors, ground and first floor, and the office is situated on the ground floor at the front of the house. There is also a resident’s bedroom (with en-suite bathroom), kitchen, staff sleeping in room (with en-suite toilet), open plan lounge and dining area and laundry room on the ground floor. On the first floor there is a bathroom (with toilet), shower room (with toilet), a separate toilet and five residents’ bedrooms (one of which has an en-suite shower room). Details of the fees charged may be obtained, on request, from the manager of the home. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Tuesday in October 2007. During the day 2 visits to the home took place. The first visit started at 8.05 and finished at 10.25am. The second visit started at 3.35 and finished at 6.40 pm. Before the second visit started a visit was made to company offices in Forty Lane to examine staff records and training records. During the inspection visits records and policies & procedures were examined. Case tracking was carried out. A site visit was carried out. The preparation of the evening meal was observed. Discussions took place with manager and members of staff. The Inspector met all of the residents and talked with a small number of residents that were able to give verbal feedback, both as a group and on an individual basis. Care practices were observed. Compliance with the statutory requirements identified in the previous inspection in February 2007 was checked. We would like to thank everyone for their assistance during the inspection. What the service does well: Residents gave positive feedback regarding the quality of the service received and were pleased with the support given by staff, their accommodation, the meals provided and the annual holiday. A resident that is preparing for supported living praised the help given to him by his key worker and by “Doctor Doris” and said that he would miss them when he left Grand Ave. Residents treat Grand Ave as their home and move around the home as they please. They enjoy spending time in their room relaxing after returning to Grand Ave from the day centre. They each have a comprehensive day care programme, which may include attending day centres or receiving 1:1 support and attention in the house. Residents may also attend clubs, which are held in the evenings or at the weekend. At the weekend they are able to take it easy or take part in activities. The company’s training programme for staff provides a package of training that includes NVQ training, training in areas specific to the client group and training in safe working practices. The training needs of individual members of staff are identified and recorded in personal development plans. Members of staff work together as a team and are knowledgeable about the needs and about the likes and dislikes of individual residents. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 6 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 7 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 Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 8 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 People who use this service experience good outcomes in this area. An assessment of the needs of the resident, prior to admission to the home, enables the home to determine whether a service tailored to the individual needs of the resident can be provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection a new resident was admitted to the home, initially on an emergency basis and for respite care. The case file was examined and it was noted that the assessment had been completed after the resident had been admitted to the home. Information had been given to the home by the funding authority. The assessment of need had been completed by a manager and was comprehensive, identifying the needs of the new resident. It confirmed that the resident and their parent had been involved in the assessment of need and it confirmed that the home would be able to provide a respite service and that the company would be able to provide a day care service to meet the needs of the resident. A copy of the placement agreement between the home and the funding authority was kept on file. A care plan was later developed using the information gained during the assessment and from observations of the resident in the home. A member of staff stressed how Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 9 important it was for the family to be involved in the assessment. As the resident could not communicate verbally the family had been able to tell the home what the new resident liked and disliked and what the resident’s dietary needs were. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 People who use this service experience good outcomes in this area. Reviewing the care plan and the placement on a regular basis ensures that changes in the needs of residents are identified and can be addressed. The residents’ right to exercise choice in their daily lives is promoted and respected. Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. Reviewing the risk assessments on a regular basis would identify when changes are needed so that the resident continues to receive appropriate support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three case files were examined. It was noted that 2 of the files contained a care plan from the local authority but this was absent from the file of the resident that had been initially admitted on an emergency, respite basis. The Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 11 manager said that a review meeting, convened by the funding authority, had been arranged for the new resident. Care plan assessments drawn up by the home were included in each of the files and these are available in a userfriendly format. There were minutes of both internal and external review meetings on file. Family members were invited to attend review meetings, if the resident wished. People attending review meetings included the funding authorities, on an annual basis. A statutory requirement had been identified during the previous inspection in February 2007 that overdue internal review meetings are carried out. This requirement is now met. It was observed during the inspection that residents were given information to help them make decisions and exercise their right of choice. Residents confirmed that they received advice and support from their key worker and from “Doctor Doris”, the manager. Each of the residents had a petty cash book and residents had a savings book, unless their family handled their financial affaires. Three cashbooks were examined and they were up to date, with a balance recorded after each transaction. Receipts are kept for items of expenditure and it is recommended that there is a system for numbering receipts to match the number given to the relevant entry. Residents sign to acknowledge receipt of money given to them, where possible. There was evidence on each of the 3 case files examined of risk assessments tailored to the individual needs of the resident. Risk assessments covered activities/behaviour such as traffic awareness, biting clothing, injury to others and knitting when on the transport. The risk assessment included an evaluation of the risks involved, the likelihood of occurrence, the potential conflict with community care principles, how to reduce the risk, a plan of action and the date for review. There was evidence that risk assessments had last been reviewed in 2006. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16, 17 People who use this service experience good outcomes in this area. Taking part in activities, developing new skills and using community resources gives residents the opportunity to enjoy an interesting and stimulating lifestyle. By maintaining contact with their family and friends the resident’s need for company and fellowship is met. Residents are encouraged to become more independent by making decisions and by having their wishes respected. Menus respect the cultural and dietary needs of residents and residents are encouraged to make choices that form part of a pattern of healthy eating. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident has a day care programme and it includes day centre attendance on 3 or on 5 days per week. The resident that attends a day centre on 3 days during the week has activities arranged either inside or outside Grand Ave for the remaining 2 days. On the day of the inspection 5 of the 6 residents Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 13 attended a day care provision. On return from their centres 2 of the residents agreed that they had enjoyed their day. Residents confirmed that they used resources and facilities in the community including shops, restaurants, cinema and leisure centres. Staff rotas are arranged so that residents are provided with an escort, as required. Residents have the use of vehicles owned by the company or they may use public transport or taxis. The company has 2 large 14 seater mini buses. All the residents’ names’ are entered on the electoral roll and residents have the choice of voting at elections. One of the residents was at home on the day of the inspection and said that he had 1:1 support from the manager on 2 days of the week. He said that he really liked these 2 days and that they went out when the weather was good. Another resident said that she liked to knit or sew or to write in the evenings. She was 1 of 2 residents that said that they liked watching the “soaps”. Other activities inside the home include dominos, watching videos, reading the paper or arts and crafts sessions. Residents may also attend clubs in the evenings or at the weekend. Residents said that they had enjoyed the annual holiday that had been arranged for them. Two of the residents said that members of their family came to visit them at Grand Ave. They agreed that the members of staff on duty made their relatives feel welcome and said that visits could take place in the lounge or in their rooms. A resident said that when it was their birthday their birthday party had been held in the company’s day centre and the resident’s family had been invited. Residents also confirmed that they went to visit their families and stayed overnight with them. One resident stays with their family each weekend. One of the residents said that he was going to move into more independent living and that he was in the process of looking at accommodation. The manager and his family were supporting him during this process. Residents are encouraged to do things for themselves and to help with the daily routines in the home. It was noted that during the preparation for the evening meal one resident was preparing the squash and another was setting the table. After the meal was finished a resident would clear the table while another resident helped with the washing up. Each of the residents is expected to help to keep their room clean and tidy and to help with their laundry. Residents have opportunities for making choices and their wishes are respected. They can choose when to go to bed and when to get up, what clothes to wear, whether to take part in activities, what to eat and whether to relax in their room or to socialise with other residents. Menus were examined and they demonstrated a varied and wholesome diet, with dishes to meet the cultural needs of residents. A member of staff confirmed that within the staff team there were members with the knowledge Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 14 and ability to prepare African-Caribbean and African dishes. During the inspection an evening meal was being prepared. It consisted of corned beef, rice, broccoli and carrots. One of the residents was having fish instead of corned beef because this was her choice. When the meal was served it smelt and looked appetising and portions were generous. There was a large bowl of fruit on the dining table for residents to help themselves from, when they wished. The daily log books for each resident record what the resident has eaten. Staff training records confirmed that each member of staff had undertaken food hygiene training in 2006. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 People who use this service experience good outcomes in this area. Residents receive assistance with or prompting with personal care in a manner, which respects their dignity. Residents’ health care needs are met through access to health care services in the community. The health and well being of residents is promoted through support with taking their medication at the time and in the dosage directed by the GP. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During a discussion regarding the rota the manager confirmed that there is always a female member of staff on duty, during the day and sleeping in at night so that female residents receive personal care from a member of staff of the same sex. Assistance with personal care is provided discreetly and respects the dignity of the resident. Residents were clean and tidy and smartly dressed. Both female residents had attractive hairstyles and one of the residents named the member of staff that had plaited the resident’s hair. It was noted during the site visit that staff knock on the bedroom door before Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 16 entering or wait for the resident to invite them into the room. One of the residents is deaf and communicates by signing and another resident communicates verbally and by using some Makaton signs. The members of staff on duty were able to respond appropriately to each of these 2 residents. The manager said that she had recently undertaken training in communication skills and in the use of Makaton. The home has a system of key working. There was evidence on the 3 case files examined that residents had access to health care services in the community, including appointments with the GP, dentist, optician and chiropodist and residents confirmed that they were supported by staff when attending. Residents also had access to screening services e.g. blood tests and preventative medicine e.g. flu jabs, if they wished. Residents had out patient appointments with the psychiatrist for medication reviews etc and appointments for other services e.g. the eye clinic. Specialist services are requested when this is needed and there was dietary advice on one of the case files. The storage of medication was safe and secure. The medication records were examined and it was noted that these were up to date and complete. Medication had been appropriately administered prior to the inspection, corresponding with the day of the week and the time of day that the inspection took place. The home follows a policy of 2 members of staff being responsible for the administration of medication. One member of staff administers the medication and the other member of staff verifies that the procedure has been correctly carried out. Both members of staff initial the records. This system was observed during the inspection and it was noted that residents were given their medication in private and on an individual basis. Care was taken to remind a resident of the importance of eating food before taking a particular type of medication. None of the residents self-administer their medication. There were medication policies and guidelines in place to support staff in both administering and recording medication. Training records confirmed that all staff members administering medication received training in 2005. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 People who use this service experience good outcomes in this area. The rights of residents are protected by a clear and simple complaints procedure. An adult protection policy and protection of vulnerable adults training for staff contribute towards the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the complaints procedure was on display in the home. The simple procedure included timescales for each stage of the procedure and referred complainants to the directors of the company, if the home’s manager could not resolve matters. Information regarding access to other agencies e.g. the CSCI was included, with the address and telephone number of the local office. The manager said that no complaints have been recorded since the last inspection. The suggestions box is now kept in the office. A resident confirmed that if there were something that he was not happy about he would speak to the manager or to his key worker. There is a procedure in place in the home and they have a copy of the local authority interagency guidelines in the event of abuse. Each resident’s case file contains a leaflet which summaries the local authority’s multi agency policy and procedures in the event of abuse. The manager said that no allegations or incidents of abuse have been recorded since the last inspection. There was evidence that staff have attended training in protection of vulnerable adults Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 18 procedures and an external trainer carried this out. The manager confirmed that all staff attend “refresher” training in respect of key aspects of their duties, including protection of vulnerable adults. Staff have also received training in supporting residents with challenging behaviour. A resident confirmed that if there were something that he was not happy about he would speak to the manager or to his key worker. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 People who use this service experience adequate outcomes in this area. Residents enjoy a “homely” environment in which to relax although some repairs and refurbishment are required. Residents live in a home where standards of cleanliness are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A statutory requirement was identified during the previous key inspection that the curtain rail in one of the bedrooms is securely attached to the wall or a system of Velcro tape is fitted to the top of the curtain, which then attaches to a strip of Velcro on the curtain rail or wall so that they can easily be repositioned in the event of being pulled down by a resident. Since the key inspection new double-glazed windows and sills have been fitted and although a new curtain rail was fitted in the bedroom it has again become detached from the support brackets. Therefore the requirement remains outstanding. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 20 A site visit took place during the inspection and it was noted that although most bedrooms were in a good state of repair a resident confirmed that they had damaged the door to their room, the plaster on the wall outside their room and the wardrobe doors and the drawer fronts inside their room. The wall underneath one of the windowsills in a bedroom needed decorating and the walls and woodwork of the staircase needed painting. The carpet is starting to wear on the stairs and to become detached from the grippers. The carpet on the landing is stained and the carpet immediately inside the front door is worn. There is a gouge in the wall in the dining area where the door handle has scraped. The corners of the walls in the dining area have chips in the paintwork. A chair in the lounge has holes in the material covering the arms and the material on the base of the settee is worn. During the site inspection it was noted that the areas seen were clean and tidy and free from offensive odours. It was noted on the training plan for the home that all staff have undertaken training in infection control procedures in 2006. The laundry room is situated on the ground floor. The washing machine does not have a sluicing cycle as the manager said that none of the residents have problems with continence. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 People who use this service experience good outcomes in this area. NVQ training enhances the general skills and knowledge of carers and contributes towards the quality of service that the residents receive. The rota demonstrated that there were sufficient staff on duty to support the residents and to meet their needs. Recruitment practices, which include checks and references, protect the welfare and safety of residents. Residents are supported by staff that have access to a comprehensive range of training courses, enabling them to meet the residents’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the training plan was provided and it records the NVQ training undertaken by the 3 carers and the deputy manager working in the home. Two of the 3 carers have completed NVQ level 2 training and the third person is due to commence training shortly. The deputy manager has completed their NVQ level 4 training. Therefore the home has met the minimum target of 50 of carers working in the home achieving an NVQ level 2 or 3 qualification. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 22 There was evidence that staff had received training in supporting residents with challenging behaviour and in autism awareness. A copy of the rota was available. During the week 3 members of staff (this may include the manager) are on duty in the mornings between 7am and 10am and 2 members of staff are on duty in the afternoons/evenings between 3pm and 10pm. Two members of staff sleep in at night, but are on call, and 1 member of staff is always female. Staffing levels at the weekends are adjusted if a resident(s) stays overnight with their family or according to the activities that residents take part in. If only 1 member of staff is needed for sleeping in but on call duties the member of staff is always female. Staffing levels are sufficient to meet the current needs of residents and to support residents taking part in activities in the community. The staff team reflects the gender composition of residents and includes staff that reflect the cultural heritage of residents. While at the offices in Forty Lane 2 staff files were examined. It was noted that each file contained passport details including a photograph of the member of staff. Application forms (including a declaration of health) and a contract were on file. There were 2 satisfactory references and evidence of a satisfactory enhanced CRB disclosure being obtained. Right to reside/work had been established, where necessary. A copy of the training plan for Grand Ave, covering the period 2007 to 2008, was supplied by head office. The plan listed the names of the five members of staff (including the manager) working in Grand Ave and there was an up to date record of training courses attended. The plan included both statutory training and additional courses, which enabled staff to fulfil the aims of the home and to meet the needs of the residents. Staff files contained copies of training attendance certificates and it was noted that staff had attended courses in respect of safe working practices e.g. fire safety, infection control, food hygiene, first aid, medication etc. They had also attended courses to enable them to support residents e.g. autism, challenging behaviour, epilepsy and protection of vulnerable adults. A copy of the Personal Development Plan was available. This is used in the appraisal process and includes an identification of training needs. It has recently been expanded to provide the company with information regarding the effectiveness of training courses. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 People who use this service experience good outcomes in this area. By establishing good working practices and monitoring the quality of care in the home the registered manager promotes a safe and enjoyable environment for residents. Service satisfaction questionnaires, meetings and individual discussions with residents help to monitor the quality of the service provided to residents and contribute towards the development of the service. The training that staff receive in safe working practice topics enables them to safeguard the health, safety and welfare of the residents. Regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 24 The manager has completed her NVQ level 4 and RMA. She has worked for the company in a managerial role both at Grand Ave and at another of the company’s care homes, for adults with learning disabilities, prior to this. Since the last key inspection in February 2007 she has undertaken training to update her skills and knowledge i.e. a 2-day Makaton course and a 2-day course in communication skills. Copies of the reports of the Regulation 26 visits that take place on a monthly basis are kept in the home. The company is in the process of carrying out an evaluation of the service provided by each of its care homes. The information is being analysed for some of the care homes and a copy of the evaluation form and the summary of the results were made available. A discussion took place with the member of staff at head office regarding how the information received was to be used and an example was given of how the information could change future practice. Feedback is also given by residents on a day-to-day basis in the home, either verbally or by non-verbal forms of communication etc. It was noted that residents liked to come and sit in the office with the manager or with members of staff and just sit with them or talk with them. Review meetings, meetings with key workers and discussions with the manager are all opportunities for residents (and/or the resident’s relatives) to give comments regarding the quality of the service received. A statutory requirement was identified during the previous key inspection that a copy of a valid certificate for the testing of the portable electrical appliances is forwarded to the CSCI. A certificate dated the 1st February 2007 was made available and so this requirement is now met. Staff have received training in safe working practice topics including “refresher” training in first aid and fire safety, which took place in 2007. There was a valid certificate for the testing/servicing/inspection of the electrical installation, the Landlords Gas Safety record, the portable electrical appliances, the bacteriological analysis of the hot water system, the emergency lighting and fire alarm systems and the electrical installation. Fire extinguishers had been serviced in April 2007. Records demonstrated that the fire alarms and smoke detectors are tested on a weekly basis and that a fire drill, including an evacuation of the home, is also carried out on a weekly basis. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 26 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA9 Regulation 14(2) Requirement The registered person must ensure that risk assessments are reviewed on a minimum basis of 6 monthly so that the risk assessments continue to safeguard the resident. Timescale for action 01/01/08 2 YA24 12(1) The registered person must 19/11/07 arrange to have a discussion with the funding authority regarding the room where the resident has caused damage to agree what repairs are necessary and to discuss what support the resident needs with anger management. The registered person must 01/03/08 ensure that walls and woodwork are redecorated as necessary, that the carpet is cleaned or replaced as identified and that new seating is purchased for the lounge to assure residents of smart and attractive surroundings. . The registered person must 01/12/07 ensure that the curtain rail is securely attached to the wall or a DS0000017452.V348495.R01.S.doc Version 5.2 Page 27 3 YA24 16(2) 4 YA24 16(2) Franklyn Lodge 9 Grand Avenue system of Velcro tape is fitted to the top of the curtain, which then attaches to a strip of Velcro on the curtain rail or wall so that they can easily be repositioned in the event of being pulled down by a resident so that the resident is to assured of smart and attractive surroundings. (Previous timescale of the 23rd April 2007 not met). 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 YA7 Good Practice Recommendations That there is a system for numbering receipts to match the number given to the relevant entry in the resident’s cashbook. Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Franklyn Lodge 9 Grand Avenue DS0000017452.V348495.R01.S.doc Version 5.2 Page 29 - 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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