Care Home: Futures

What the care home does well Futures provides a service that recognises the individuality of people who live there. Staff are able to provide support for people in a way that meets their complex needs. The personal and healthcare needs of people living in the home are met and relevant healthcare professionals are consulted where appropriate. Pre-admission assessments and care plans are written in a way that places the focus of care on the individual and there is sufficient detail to ensure that people living in Futures receive care in the way that they need and want. Futures provides a comfortable, homely environment for people living there. Throughout the home the furnishings are of a high standard and bedrooms are decorated to reflect individual tastes. The aids and adaptations that are available help ensure the complex needs of individuals are met and they are able to maintain a degree of independence. What has improved since the last inspection? This is the first inspection of the service since it was registered with us at the Commission. What the care home could do better: The storage of medication could be improved to include the provision of a controlled drugs cabinet in line with recent changes to legislation around the storage of controlled drugs. CARE HOME ADULTS 18-65 Futures Futures 162 Church Road Brightlingsea Essex CO7 0QU Lead Inspector Ray Finney Unannounced Inspection 28th August 2008 09:30 Futures DS0000071766.V370749.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 Futures DS0000071766.V370749.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. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Futures Address Futures 162 Church Road Brightlingsea Essex CO7 0QU 01206252060 01206252060 futures120@btinternet.com 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) Futures Care Homes Limited Sally-Anne Edwards Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD 2. Physical disability - Code PD The maximum number of service users who can be accommodated is: 10 This is the first inspection for this new service. Date of last inspection Brief Description of the Service: Futures is a large detached property situated in a residential area of Brightlingsea, near Colchester. The property has been adapted to accommodate ten adults with learning disabilities and/or physical disabilities. There are six bedrooms downstairs and four upstairs. Five of the downstairs rooms have en suite facilities and have aids and adaptations including overhead tracking for people who require the assistance of a hoist. The remaining four bedrooms have basins and vanity units. There is a bathroom on the ground floor with a specialist electric bath and there are two shower rooms upstairs. Communal areas include a modern lounge/diner with large flat-screen, wallmounted television and a fitted kitchen with adaptations to make it suitable for people with physical disabilities. To the rear of the property is a small, secure garden and to the front is an area that is paved for car parking. The service supports younger adults with complex needs to live in an ordinary home environment. The home charges between £1,090.00 and £1,600.00 a week for the service they provide. This information was given to us in August 2008. Information about the home can be obtained by contacting the manager. Inspection Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 5 reports are available www.csci.org.uk from the home and from the CSCI website Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A range of evidence was looked at when compiling this report. Documentary and computer held evidence was examined, such as care plans and personnel files. An Annual Quality Assurance Assessment with information about the home was completed by the manager and sent to us when requested. Throughout the report this document will be referred to as the AQAA. A visit to the home took place on 28th August 2008 and included a tour of the premises, discussions with the manager, members of staff and a visiting healthcare professional. The people living in Futures have complex needs and are unable to communicate verbally, although we were able to have some communication based around facial expressions and gestures. Observations of how members of staff interact and communicate with people living in the home have also been taken into account. On the day of the inspection the atmosphere in the home was relaxed. were given every assistance from the manager and the staff team. We What the service does well: What has improved since the last inspection? This is the first inspection of the service since it was registered with us at the Commission. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 7 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. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Through the comprehensive admission process, people choosing to live at Futures can be confident that their needs will be met. EVIDENCE: Futures was registered with the Commission in March 2008. As part of the registration process, the service’s Statement of Purpose and Service User Guide were examined. Both documents met the required standard and contained appropriate information to ensure people wishing to move in to the home and their representatives have sufficient information about the service to decide if it would meet their needs. Futures provides people who may wish to move in with an information pack, which includes the home’s Statement of Purpose and a DVD about the home. The pack contains detailed information about the services provided. The AQAA states, “Our policy is that a transition process is used to ensure the service users are making the right choice, ensuring that, where appropriate, the Mental Capacity act is followed”. At the time of the inspection there were two people living in the home, both of whom had taken up residence in the previous week. The manager was able to Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 10 demonstrate a good understanding of the importance of a robust assessment process, particularly as people living in the home have complex needs. The pre-admission assessments examined were comprehensive and included a summary of the person’s history before moving to Futures and also identified people’s individual needs as well as their preferences. Areas covered in the assessments include physical health, exercise and diet, emotional and psychological needs, physical and sensory needs, mobility, how the person interacts with others, leisure time, personal relationships, work and education, domestic skills, community life, behaviour, personal hygiene, dressing and continence needs, finances and communication needs including understanding, speaking and signing. People’s records also contained a local authority ‘Com 5’ assessment document. Records examined confirm that people living in Futures have Individual Placement Contracts in place. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Futures receive good quality care, which is based on their assessed and identified needs. EVIDENCE: The home is using an computerised system called ‘Residata’ for managing and recording care plans and other data and at the time of the inspection the manager was in the process of transferring information on to the system. The care plans for both the people living in the home were examined. These were written in a person centred way from the individual’s perspective and contained sufficient detail to ensure staff had appropriate information to provide a good standard of care. There are a wide range of care plans covering areas as diverse as body temperature, communication, hygiene, mental well-being, mobility, nutrition, pressure sores and maintaining a safe environment. The care plans record the Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 12 situation as it is now, what are the objectives they are trying to attain for the person and detailed actions of how to meet their particular needs. The manager was able to demonstrate a good knowledge of the needs of both people who had recently moved to the home and explained that in the first few weeks they would be continually re-assessing and reviewing those needs as people settle in. Observations of interactions between staff and people living in the home show that staff encourage them to make decisions. The complex needs of the client group mean that they receive one-to-one support, therefore staffing levels are good and this maximises the time staff have got to listen to service users and support them in making choices. One person was observed to use a system of signing called Makaton to communicate with staff. The manager stated in the AQAA that they communicate with people living in the home and their representatives to ensure they are meeting their needs and they are planning to, “Get involved with Speech and Language, put ourselves forward for ICE [Inclusive Communication in Essex] training”. Records examined show that there were a range of comprehensive risk assessments in place, covering outings, manual handling, pressure sores and nutrition. The risk assessments clearly record what actions need to be taken to reduce the identified risk. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Futures can expect to enjoy a lifestyle that meets their wishes and interests. EVIDENCE: People living in Futures are not able to access paid employment because of their complex needs. However, the home supports people living there to take part in a range of activities. The manager explained that one-to-one staffing will ensure that people are able to access courses or other activities of their choice. Records show that one person will be going to college for courses on ‘Sensory Cooking’ and ‘Communication’. The manager stated in the AQAA that they, “promote independence and give informed choices”. The manager demonstrated a commitment to ensuring that people living in Futures take an active part in the local community. On the day of the inspection a new vehicle was delivered with aids and adaptations to make it Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 14 accessible for people with complex physical needs so that they can easily access community activities. The home ensures family links are maintained and this is well documented in the records that were examined. The manager said that both the people living in Futures have active support from relatives. As they have recently moved in to the home, relatives are visiting regularly to help with the transition process. Pre-admission assessments contain details of family involvement and the manager was able to demonstrate that information provided by service users’ families is taken into account when planning care. The manager stated in the AQAA that they will support people living in the home to, “keep relationships with friends and families”. People living in Futures have complex needs and some difficulties with communication, therefore they are unable in the main to discuss their likes, dislikes and wishes. The manager explained that a thorough assessment process with input from relatives means they are quickly developing a good understanding of what people like and dislike by their reactions and their individual ways of expressing pleasure or dislike. This information helps staff ensure people’s choices are taken into consideration. The manager demonstrated ‘picture boards’ that she is in the process of developing to help with communication, such as pictures of food and menus to ensure people are able to make choices about their meals. One person’s care plan contains details such as, “I will let you know when I want to go to bed” and how they will communicate that to staff. Observations on the day of the inspection showed that there are very positive interactions between members of staff and people living in the home. The manager said that as people have only moved in recently the staff team are working with them to start to try to involve people in the day to day running of the home. The modern kitchen has appliances that can be lowered electronically to enable wheelchair users to take an active part in meal preparation. On a tour of the premises, food stocks were seen to be plentiful and of good quality, including fresh fruit and vegetables. Futures DS0000071766.V370749.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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can expect their personal and healthcare needs to be identified and provided with the support to ensure these needs are met as they would wish. EVIDENCE: Records examined show evidence of the way service users prefer to have personal care carried out. As documented earlier in this report, care plans are written in a person centred way from the individual’s perspective and contain sufficient detail to ensure staff have appropriate information to provide a good standard of care. The care plans contain clear guidelines for staff about how people want their personal care carried out. There are ample bathing facilities to ensure that people living in Futures may be assured of privacy when receiving personal care; five of the six downstairs bedrooms have en suite bathing facilities and there is also a well equipped bathroom downstairs and two shower rooms upstairs. There is a mixture of male and female staff on the rotas and personal care is carried out where possible by staff of the same gender. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 16 People living in the home were unable to express opinions about the care they receive, but our observations confirm that people were relaxed and appeared happy in their interactions with staff providing their care. Information about people’s individual medical and healthcare needs were well documented in the records examined. The manager was able to demonstrate a comprehensive knowledge and understanding of people’s needs in relation to health. There was ample evidence in people’s personal records of input from a range of healthcare professionals, including community nursing services and G.P. Records examined show that there are Health Information files in place containing detailed ‘Health Action Plans’. There are a range of documents for recording health related issues including epilepsy monitoring charts and charts for observing skin condition to detect any signs of possible pressure sores. The ‘Prevention of Pressure Sores’ documents use an established assessment tool, the Braden Risk Assessment Scale. One care plan examined contained details of suggested home activity “to promote flexibility and physical mobility”. The document included photographs and diagrams to guide staff in the correct way to support the person with the activity. The manager stated in the AQAA that they, “Ensure Service users have the facilities and equipment required for them to maximise their privacy, dignity, independence and to be able to have control over their lives”. Another care plan relating to the routine to be followed for Hydrotherapy contained step-by-step instructions to guide staff. The Hydrotherapy exercises were designed following a professional assessment from the physiotherapist and give a rationale for why the exercises need to be carried out. There is a seizure management plan in place around epilepsy with clear instructions for staff about how to manage seizures and descriptions of the type of seizures that individuals experience. There are epilepsy monitors in place so that staff will be alerted promptly if anyone has a seizure in the night. The manager said that staff are to receive relevant training around emergency procedures to follow and medication to be administered in the case of ‘status epilepticus’ or uncontrolled seizures. This training is to be delivered by the community nurse specialist for epilepsy and until this training is delivered there is a protocol to be followed around calling the emergency services. The community nurse spoken with on the day of the inspection was positive about the home’s ability to meet people’s healthcare needs. On the day of the inspection medication records and storage were examined. There are currently no service users living in the home with the capacity to self medicate. Care plans examined contained relevant information about prescribed medication, including ‘Administration of Medication’ management Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 17 plans. Medicine Administration Record (MAR) sheets were completed appropriately and contained individual photographs. The manager explained that they have put a ‘double signing’ procedure in place to minimise the risk of errors in administration of medication. Procedures and practices around the administration of medication are good. The cupboard used for storing medication is secure and large enough to accommodate all the prescribed medication. There were no controlled drugs in use at the time of the inspection. However, there is no cupboard for the storage of controlled drugs that meets current requirements, should anyone living in the home be prescribed medication that requires this kind of secure storage. Consideration should be given to how medication storage could be improved, in particular the provision of an appropriate facility for the storage of controlled drugs so that they meet the requirements of recent changes to legislation. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 18 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. EVIDENCE: Futures has a comprehensive complaints policy and procedure in place. The policy meets the required standard and contains appropriate information to ensure people who use the service and their representatives have a clear route to follow if making a complaint. On the day of the inspection the manager was able to demonstrate an awareness of the importance of dealing with complaints promptly and appropriately. There have been no recorded complaints but there is an appropriate process in place for documenting any complaints that may be received. The manager explained that she is also devising a feedback form to be available in people’s individual rooms so that people living in the home and visiting relatives can document any concerns or compliments. Staff spoken with on the day of the inspection understood their responsibilities around safeguarding people (previously called Protection of Vulnerable Adults or POVA). Personnel records contain evidence that all staff undergo Criminal Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 19 Record Bureau (CRB) checks before commencing employment and staff have received safeguarding training. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 20 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can enjoy living in an environment that suits their lifestyle and which is homely, well maintained and clean. EVIDENCE: A tour of the premises confirmed that the home provides a safe, wellmaintained environment for the people who live there. Futures is a spacious property with ramped exits and wide doorways suitable for wheelchair users. The home is decorated throughout to a high standard with ample space in communal areas. Futures has ten single bedrooms, six on the ground floor and four upstairs. Five of the six rooms on the ground floor have en suite facilities and the remaining rooms have washbasins and vanity units. There is a large bathroom on the ground floor containing a new Arjo Maribou electric bath. Upstairs there are two large shower rooms, set up as wet-rooms. The manager stated in the AQAA, “We ensure that Service users needs will be met through a thorough Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 21 assessment, which takes into account the physical design of Futures as well as ensuring that we can meet the individual’s holistic needs”. Bedrooms are all light and airy with large windows overlooking the grounds or surrounding areas. The unoccupied bedrooms have been decorated in neutral colours so that people can decorate to their own taste when they move in. Unoccupied rooms are unfurnished until people are ready to move in so that they can either bring their own personal furniture or choose what they want, which will then be purchased by the provider. The individual rooms that are now occupied contain ample evidence of personal possessions. All bedrooms contain a call bell, television aerial and sky connections, telephone and computer broadband points, low temperature touch radiators, thermostatic controlled water delivery systems, fire alarm door closure systems and door locks. The five rooms on the ground floor are specifically designed and set up for people with a physical disability and include overhead hoisting systems, sliding doors into the shower and low level surfaces to allow people in wheelchairs to be as independent as possible. The main communal room is a spacious, modern lounge/diner containing high quality furnishings, including a large wall mounted television and separate music system. French doors lead out on to a small, partly-paved garden area which is secure. At the time of registration the manager said that people will be encouraged to decide what style they want in the garden. There is also a small gated area to the front of the building which they plan to use to create a sensory garden. The kitchen has been well thought out with features that will make it ‘user friendly’ for people with special needs including wheelchair users. It has an induction hob that cools down rapidly when saucepans are removed to minimise risks of burns and also a low-level convection microwave so that wheelchair users who cannot use the main oven can still cook. A large section of work surface, with a separate hob and sink, can be lowered electronically to a convenient level for wheelchair users. There is also an alarm on the kitchen door to alert staff that the kitchen is in use. The home has a separate utility room containing appropriate laundry facilities, the water heating controls and oil tanks for the central heating system. All boilers and controls are cool touch and changes can only be made with the appropriate key system. The CoSHH cupboard (Control of Substances Hazardous to Health) for storing cleaning products is in a secure storage area under the stairs. There is no lift in this home so wheelchair users will only be housed on the ground floor, however all exits to the grounds are level with the doors, to avoid any lifting in and out of the home. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 22 The property has been assessed by the local fire officer and contains all the equipment required by current legislation. Doors throughout the home can be left propped open as required, as they are fitted with ‘catches’ that release on activation of the fire alarms. Admittance to the home is by a electronic fob entry system only, there are no external key locks, to ensure safety of the people living there. There is CCTV (Closed Circuit television system) covering the front and back entrances of the building, which is monitored in the managers’ office, but this does not encroach on the privacy of people living in the home. At the time of registration all necessary maintenance and servicing records were examined and were found to be satisfactory, as were the sample of records examined on the day of the inspection. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Futures are cared for by a competent, well trained staff team who can meet their needs and have been employed following thorough recruitment checks to ensure people living at the home are protected. EVIDENCE: The manager explained that because of the complex needs of the people living in the home, staffing levels are currently one-to-one. From discussions with the manager and from observations during the course of the inspection it was evident that care staff have a good understanding of their responsibilities and they follow good practices. The manager demonstrates a commitment to supporting staff to complete National Vocational Qualifications (NVQ). Out of the eight care staff working in the home, four have achieved NVQ at level 2 or above and one is working towards level 3. The numbers of staff already holding the award meet the minimum of 50 of carers with NVQ as recommended in the National Minimum Standards. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 24 A sample of personnel records were examined and were well organised. Records contained all the documentation required by regulations, including two written references, relevant proofs of identity with photographs, Criminal Record Bureau (CRB) enhanced disclosures and a completed application form with no unexplained gaps in employment. Personnel records contain evidence of induction training and a range of other training which has either taken place or was due to take place in the few weeks following the inspection. The manager has a Workforce Development Plan in place that documents the essential skills for the job as well as additional desirable skills and has used this to identify and plan courses to meet any gaps in people’s training. Staff training includes Health and Safety, First Aid, Fire Procedures, Infection Control and Manual Handling. Other training that is planned includes epilepsy training, medication and IT skills (Information Technology). Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 25 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately managed in the best interests of people living there. EVIDENCE: The registered manager, Sally-Anne Edwards, has a number of years experience both in healthcare and as a registered manager. She is a registered nurse for people with a learning disabilities and is currently registered with the Nursing & Midwifery Council; she completed a management diploma in 1998 and her Registered Managers Award in 2005. As part of the registration process for the service she supplied the Commission with evidence of ongoing training. During discussions the manager was able to demonstrate a thorough knowledge of issues relating to people with learning disabilities as well as a Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 26 good understanding of managerial responsibilities, the Care Standards Act and other legislation required to run a care service. The home has a Quality Assurance system in place, which the manager is in the process of developing. On the day of the inspection we discussed the home’s Quality Assurance system with the manager, who was able to demonstrate a good awareness of the importance of seeking the views of people living in the home or their representatives. The manager has devised questionnaires for people living in the home or their representatives and will seek the views of staff through the supervision and appraisal process. As the people living in the home have only been there for a short time, the Quality Assurance system there is not yet fully developed to include a development plan for the home. However, sufficient evidence was presented to confirm that the management team actively seek the views of people living in the home and their representatives and act on the information that they receive. Futures has a comprehensive range of policies in place relating to health and safety. Records relating to safe working practices were examined and all were found to be in order. There is a comprehensive Fire Risk Assessment and premises plan detailing escape routes and other preventative and protective measures. The fire alarm system ‘maintenance and log book’ was examined and confirmed that the system is well maintained. There are additional risk assessments in place relating to cleaning chemicals, the boiler room and risk of burns and scalds, Legionella, cooking, hot water, falls or trips and VDU (computer screen) equipment. Water outlets have thermostatic valves fitted and water temperatures are checked daily. The windows have appropriate restrictors fitted to reduce the risks to people living in the home. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13 (4) (a) (c) Requirement An appropriate facility for the storage of controlled drugs must be available in the event someone in the home may be prescribed medication that requires this type of secure storage. Timescale for action 31/12/08 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 YA39 Good Practice Recommendations The management team should continue to develop the Quality Assurance system so that when they seek the views of people living in the home and other interested parties, the information is used to form a development plan, which demonstrates that people’s views are being acted upon. Futures DS0000071766.V370749.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. 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