Care Home: Gallaudet Unit

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What the care home does well Each service user who responded by survey said they are always treated well by staff and choose what they wish to do each day. Each relative who responded by survey said the home gave their relative the care and support they expected. The health professionals who responded by survey said the home works in partnership with them and meets the current and changing needs of service users. The staff team remain committed in providing support to each service user to enable them to lead fulfilling lives. Service users and staff continue to interact well. Staff use specialist communication skills to support this process. What has improved since the last inspection? The improvements in the care planning and review processes have now been completed for each service user. This helps to ensure consistent approaches in supporting each person, which are regularly reviewed. Staff training in relation to the Protection of Vulnerable Adults, Challenging Behaviour and other relevant courses have now been completed by a majority of the staff team. This promotes the safety and welfare of service users and ensuring appropriate and consistent levels of support. The improvement of the Risk Assessment processes have now been completed. This helps to ensure safe working practices are present within the home to promote the welfare of service users and staff. Fire safety has now been improved. This helps to ensure the welfare and safety of services users and staff. What the care home could do better: The carpeting within the home should be professionally cleaned, or replaced, to ensure a clean and homely environment is maintained for each person who lives in the home. The staff members who still require either mandatory or specialist training must complete this. This will ensure all members of staff have the knowledge and skills to support each service user. The progress in providing service users with information in a format which is accessible to them should continue to be reviewed. The home should improve the environment further, in line with the plans described in their AQAA, for the benefit of service users and staff. The home should consider conducting a quality assurance review. This will ensure the quality of the service provided is accurately measured. CARE HOME ADULTS 18-65 Gallaudet Unit RNID Poolemead Centre Watery Lane Twerton Bath Bath & N E Somerset BA2 1RN Lead Inspector David Smith Key Unannounced Key Inspection 22nd May 2008 09:30a Gallaudet Unit DS0000040658.V363903.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 Gallaudet Unit DS0000040658.V363903.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. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gallaudet Unit Address 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) RNID Poolemead Centre Watery Lane Twerton Bath Bath & N E Somerset BA2 1RN 01225 356487 01225 480825 ruth.young@rnid.org.uk RNID Mrs Ruth J Young Care Home 8 Category(ies) of Sensory impairment (8) registration, with number of places Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 8 persons aged 18 to 64, requiring personal care. 11th April 2007 Date of last inspection Brief Description of the Service: Gallaudet offers single rooms to accommodate deaf people with special needs, including those with moderate physical disability. The environment is a single storey building, which is part of a large complex incorporating other units, surrounded by attractive gardens and grounds. The home, one of the services operating as part of the Royal National Institute for Deaf People (RNID), has its own clearly defined philosophy of care, which aims to embrace varying levels of independence and autonomy where each person is encouraged to achieve their full potential as adult members of the wider community. The current fees range from £1100.00 to £2200.00 per week, depending on the particular support needs of service users. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced visit to the home as part of a Key Inspection of this service. The review of evidence and pre-inspection planning involved reviewing the report of the last Key Inspection carried out in April 2007 and the service history, which details all contact with the home including notifications of significant events which they have reported to us. We (the CSCI) provided the home with their Annual Quality Assurance Assessment (known as an AQAA, pronounced as ‘aqua’) and a range of survey forms for service users, their relatives, carers, advocates and health professionals, prior to our visit. The AQAA was completed and returned, together with ten surveys. We gathered additional information during our visit through informal discussions with service users, the Registered Manager, Deputy Manager and other staff members. Interaction and communication between staff and service users was also observed. Care plans and associated records were examined together with Risk Assessments, complaints procedures, medication administration, menu plans, staff personnel and training records and health and safety records. We also viewed all communal areas of the home and some of the service user’s own rooms. What the service does well: Each service user who responded by survey said they are always treated well by staff and choose what they wish to do each day. Each relative who responded by survey said the home gave their relative the care and support they expected. The health professionals who responded by survey said the home works in partnership with them and meets the current and changing needs of service users. The staff team remain committed in providing support to each service user to enable them to lead fulfilling lives. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 6 Service users and staff continue to interact well. Staff use specialist communication skills to support this process. 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. Gallaudet Unit DS0000040658.V363903.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 Gallaudet Unit DS0000040658.V363903.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): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their relatives have access to the information they need in order to make an informed choice about where to live. Each service user knows their needs and aspirations will be assessed and met by the home. EVIDENCE: The home has a Statement of Purpose, which is detailed and updated every six months. It is still anticipated that this document will be made available in accessible formats; however, this may be a longer-term goal. Each service user who responded by survey said that they were asked if they wanted to move into the home and had enough information to help them decide if Gallaudet was the right home for them. One service user has moved into the home since we last visited and we therefore took this opportunity to review their care records. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 9 These show that this individual was already known to the organisation as they use a local RNID day service. The home also carried out a thorough assessment of the areas of support this person requires to ensure they are able to meet them. An initial care plan has been put in place which covers key areas of support, such as daily routines, healthcare, mobility and how to communicate effectively. Gallaudet Unit DS0000040658.V363903.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that the service provided to each individual takes into account their changing needs and personal goals, supported by both written information in care plans and risk assessments which are subject to regular review. EVIDENCE: Each service user has an “Evidence Folder” and “Daily Records” file. The improvements to each Evidence Folder, where the main care planning records are stored, have been completed for each individual since our last visit to the home. Each file contains both a full needs assessment plus a Care Plan which describes how each person’s support needs are to be met. This covers relevant areas of support such as daily living skills, home skills, communication, family Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 11 contact, education and money. The ‘Daily Records’ continue to provide a summary of each service user’s day. There have been a number of annual review meetings. These have been attended by the service user, staff members, family members and a representative of the relevant Funding Authority. Each meeting has been recorded and these records clearly explain the discussions which took place and the agreed outcomes. The home operates a keyworking system whereby each service user has a named member of staff who plays a key role in co-ordinating the services they receive. Regular ‘Care Team Meetings’, involving the service users and their Keyworkers, are being held for each person who lives in the home. This provides an effective system to ensure all care plans are regularly reviewed and updated with the involvement of the service user wherever possible. Clear records of each meeting are kept as part of each individual’s care plan. During the course of our visit we observed interaction, communication and support between the staff team and service users. These demonstrate staff members continue to have a good knowledge of service users support needs and how to communicate effectively with them. Various forms of communication continue to be used to enable service users to make choices. We observed British Sign Language, clear speech and some written or drawn communication being used. There are also pictures or picture symbols in use and some information has been adapted into the ‘Writing with Symbols’ format (which is generally known as ‘Widget’). There are now a number of person centred Risk Assessments in place for individuals, which support them to take risks as part of their lifestyle. Each of the assessments viewed is well-written and subject to regular review. Gallaudet Unit DS0000040658.V363903.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): 11, 12, 13, 14, 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. Each individual has opportunities and appropriate support to access leisure and educational facilities both locally and in the wider community including holidays, day trips and visits to family and friends. Each person’s rights and responsibilities are recognised in their daily lives. A healthy and balanced diet for each individual is promoted. EVIDENCE: Service users have the opportunity to attend daily Educational Development Studies (known as ‘EDS’). Each service user’s care plan we examined contained a rota of planned activities, which included music, aromatherapy, art, craft and woodwork. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 13 Individuals are supported by staff to use facilities in the wider community, including going to the cinema, the theatre, swimming, shopping, going for walks, ten-pin bowling, trips to local pubs and going out for meals. The home’s AQAA confirms that by introducing pictorial notice boards and information, they have been able to offer individuals a wider choice of activities. Each person is supported to choose, organise and attend a holiday. Staff accompany service users on trips, such as the recent holiday to Butlins. The service users we spoke with appeared to be happy living in the home and those who responded by survey said they were able to choose how to spend their day and generally were able to do the things they wished to do. Service users are supported to maintain regular contact with their family and friends and visitors to the home are welcomed. A record of all contact with family and friends is kept as part of each person’s care plan. These records show that service users are supported to visit their friends and family and also write to them, use mobile phone texting and contact them by telephone using a ‘minicom’ machine, which allows people who are deaf to type their message. Four relatives who responded by survey said the home provides the care and support they expect, helps their relative keep in touch with them and they are kept up to date with important issues. One relative said “it is a very good home” and another that their relative “is having and has had wonderful care”. One family who responded by survey said they felt the home does “extremely well regarding communication. (Our relative) has improved and become much more calm due entirely to the excellent communication (they) have had with the staff”. Observation during our visit and discussion with both service users and staff shows that each person who lives in the home is treated with respect and dignity. Each person is seen as an individual and treated as such. Service users are offered a key to their own rooms, should they wish to have one. The home’s AQAA explains that a ‘Rights and Responsibilities’ document has now been introduced. These are being completed at review meetings, where family members are also involved, then kept as part of each person’s care records. The health professionals who responded by survey said the home does support people to live the life they choose, respects individual’s privacy and dignity and is good at meeting individual’s differing needs. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 14 The menus show that each individual is offered a choice of healthy and nutritious food. Service users continue to be encouraged to choose the food they would like to be included on the menu. Their general likes, dislikes or dietary needs are known by the staff. Individuals generally eat their meals in the dining room, which overlooks the patio area and communal gardens. Gallaudet Unit DS0000040658.V363903.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. Service users are supported in their preferred manner and their personal and healthcare support needs are well met. The policy and procedures relating to administration of medication ensures service users’ welfare and safety. EVIDENCE: Each service user is registered with a local GP, Dentist, Optician and other relevant professionals. There are varying levels of support as necessary from other health care professionals. These are provided by Bridges Community Learning Disability Team. Contact with these professionals is recorded in each service users file and the outcomes acted upon. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 16 Each person’s care plan describes the support they require with personal care or their health care. These care plans are regularly updated, as described earlier in this report. Despite recent changes within the staff team, a core of experienced staff remain who have a good knowledge of service users’ healthcare needs. Any changes, which may cause staff concern, are noted and acted upon. It remains evident that the management and staff spoken with are sensitive to the personal, healthcare and emotional needs of those living in the home. The health professionals who responded by survey said the home meets each person’s health care needs, seeks their advice and acts upon this to manage and improve individual’s health care. The home uses the Boots Monitored Dosage System of medication administration. Medication storage has been improved by moving this to a spare office where staff can work without interruption. The staff spoken with felt this is a positive development. The medication records show profiles of each service user, details of their medication, times of administration and manufacturers notes on the prescribed medications administered within the home. Staff have signed the medication policy and provided a sample of their initials, which they use on records. Two staff members are required to sign records each time medication is dispensed. Each of the service user’s records we examined had been correctly recorded and signed by both staff. Staff members are provided with formal training in relation to medication administration. The home supports staff to complete ‘Protocol’ Training, which is accredited by the City of Bath College. This is in the style of an NVQ unit and contains four elements; introduction to medicines, care workers role, administration and medicines of differing client groups. The home’s GP, who responded by survey, said that service user’s medication is appropriately managed in the home. Gallaudet Unit DS0000040658.V363903.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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to communicate their views and they can be confident that they will be listened to and their views acted on if necessary. Clear policies and procedures are in place in order to protect service users from the likelihood of abuse, neglect and self-harm. EVIDENCE: The home has a formal Complaints Policy (which is also available in symbol format within the home), an Adult Protection Policy and a Whistle Blowing Policy, which staff can use in confidence to raise any issue or concern they have regarding the service. We examined the home’s complaints log. This contains a copy of the home’s policy and a record of complaints, which shows there has been one complaint since our last visit to the home. This is currently being addressed by the home’s Deputy Manager in accordance with the home’s policy. The service users who responded by survey said they know who to speak to if they are unhappy, know how to complain and confirmed that they felt safe living at the home. They felt that staff listen to them and act on what they say. Four relatives who responded by survey said they are aware of the home’s complaints procedure. They said the home responds appropriately to concerns Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 18 they raise and they feel they can also discuss issues informally with the Manager. The home has clear guidelines and Risk Assessments for supporting service users who are distressed or presenting behaviours which may be perceived as challenging the service provided. Each care plan has details of known trigger points and the appropriate defusing techniques. These are described as ‘Methods of Approach’. Both the RNID policy and the Department of Health Guidance on Restrictive Physical Interventions are also available in the home. The staff we spoke with said they felt that the staff team responded consistently to this type of behaviour and it is generally easy to help defuse. The home has developed an effective system of recording any incident where ‘challenging behaviour’ is displayed. The forms we examined clearly describe what happened and how staff responded. The checklist at the end of the form also helps to ensure staff complete all necessary records, such as the accident book, if this is necessary. Staff are provided with training in responding to challenging behaviour using the ‘MAPA’ system (Management of Actual or Potential Aggression), which is accredited by the British Institute of Learning Disabilities. Since the last inspection, most of the staff team have now completed this training, with the remaining staff undertaking training in June 2008. Staff spoken with welcomed this training and found it useful and informative. Staff are also provided with both Protection of Vulnerable Adults and Child Protection training. Most staff have now completed this, however newer members of the staff team will be offered training as soon as possible. The home maintains clear records of all other accidents and incidents and notifies us of any significant event which occurs. Gallaudet Unit DS0000040658.V363903.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, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Gallaudet provides a homely and comfortable environment for service users. EVIDENCE: Although not purpose built to meet the needs of service users, Gallaudet provides a homely environment. It is a self-contained unit, on the ground floor of the main Poolemead Building. There are large communal grounds on the Poolemead site and the home also has its own patio area, which can be accessed directly from many rooms within the home. The home has two communal lounges, a large conservatory area, dining area and kitchen. Each area is tastefully decorated, with several pictures fixed to the walls. There are also several photographs of service users and examples of their artwork, which are prominently displayed. This helps to personalise the home. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 20 There have been a number of improvements and changes to the home since our last visit. There has been continued redecoration of each of the rooms in the home, the laundry room has been moved, as has the storage facilities for medication. A large unit has been removed from the communal corridor and this has allowed for an additional quiet sitting area for service users to be created. The office has been redecorated and furniture moved and this has improved the working environment and the storage facilities for the home’s records. The home’s AQAA confirms that further improvements to the home are planned. These include replacing the windows, improving access to one of the bathrooms for service users who have mobility difficulties and to install a kitchenette area within the conservatory to help service users to plan, prepare and cook individual meals. The home was generally clean and tidy during our visit. However, some areas of carpeting within the home are now stained, due to the amount of work carried out in the home, and other areas appear worn. The Manager told us that contractors would attend to these as soon as possible and either clean or replace the carpeting. Staff told me that they continue to ensure the home remains clean and tidy on a day-to day basis and they involve the service users in this as much as possible. The home also employs a domestic assistant who was working in the home during our visit. Each service user who responded by survey said the home is ‘always’ fresh and clean. Gallaudet Unit DS0000040658.V363903.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): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The clarity of staff roles and responsibilities along with staff training and supervision are designed to provide a consistent approach to the support of staff and service users. The home’s recruitment policy promotes both service users’ rights and their safety. EVIDENCE: There have been some changes within the staff team since our last visit, however there remains a core of well-established staff with varying abilities who are skilled and experienced to meet the needs of those living in the home. Some members of the staff team have their own areas of responsibility, such as providing Keyworker support to service users. Staff members spoken with said that the staff team is open, honest and supportive. They feel well supported by the management team and are able to discuss issues in an open and honest way. Staff were observed interacting well Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 22 with service users and those spoken with demonstrated a good understanding of the support needs of each person who lives in the home. The home has recently recruited Support Workers, to fill existing vacancies within the team. Some of these members of staff have previously worked in the home as agency workers and therefore have a good knowledge of the people who live here and how to support them. We spoke with two newer members of staff who both said they are enjoying working at Gallaudet, feel well supported in their role and spoke highly of their formal induction into the home. Each service user who responded by survey said staff members ‘always’ treat them well. The relatives who responded by survey said the home provides their relative with the care and support they would expect. The staff team continues to meet regularly. Staff spoken with said they find these meetings useful and are able to discuss any issues they wish as these can be added to the agenda. If staff are not able to attend, they read the minutes to ensure they remain up to date. The home operates a robust recruitment process. We examined the personnel records of four members of staff, including two who have been recently recruited. These files contain copies of each person’s application form, job description, at least two satisfactory references, documents confirming their proof of identity and eligibility to work in the UK, induction checklists and Enhanced Criminal Record Bureau Disclosures. Staff are provided with a variety of training opportunities and a considerable amount of training has been completed by staff since our last visit. Most members of the staff team have completed mandatory training such as First Aid, Adult Protection, Child Protection, Food Hygiene, Health and Safety, Fire Safety and MAPA. Staff are also provided with more specialist training to enable them to meet the current and changing needs of service users. This training includes British Sign Language, Deaf Awareness, Sexual Awareness, Intimate Care, Working with People Who Self-Harm and those who have Diabetes. The training schedule supplied by the Manager shows that training opportunities are planned for staff up to September 2008. This training includes both mandatory and specialist training courses, which must be completed by both newer and longer standing members of the staff team. The home has made good progress in supporting staff to work towards a National Vocational Qualification (known as an ‘NVQ’). One member of staff has recently qualified as an NVQ Assessor, with one other member of staff Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 23 currently working towards their assessor award. Both are supporting staff within the home with their NVQs. Relatives who responded by survey said they felt the staff did have the right skills and experience to look after people properly. Health professionals who responded by survey said the staff team do have the right skills and experience to support service users. Each staff member is provided with regular, formal supervision. Supervision of support workers is shared between the management team, with the Senior Support Workers and the Deputy being supervised by the Manager. A clear record of each supervision meeting is maintained and each record is signed by the supervisor and supervisee. Staff spoken with said they find supervision useful and supportive. Each member of staff told us these meetings remain well planned and they feel able to discuss issues openly. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 24 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, 38, 39, 40, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well-run and service users benefit from the ethos, leadership and management approach of the home. Service users views are sought in relation to the monitoring and review of the service provided by the home. Each person’s rights and best interests are promoted by the home’s record keeping and the organisations’ policies and procedures. The health, safety and welfare of people living in the home is promoted and protected. Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 25 EVIDENCE: The Registered Manager, Mrs.Young, was present throughout this visit and supported the inspection process fully. She has worked at Gallaudet for a number of years and has a good knowledge of the people who live in the home. The current management team consists of the Registered Manager, recently appointed Deputy Manager (who has worked for the RNID for some time) and two Senior Support Workers. The roles and responsibilities within the management team are clear and they remain supported by the RNID Residential Services Manager. It remains evident that the management team has continued to work extremely hard to ensure the significant improvements already made are maintained and built upon. It is clear that this team is providing strong leadership within the home and offering appropriate support to the rest of the staff team. There are now efficient management systems and structures in place to ensure the home runs effectively. The quality of record keeping in the home is generally good, with all records required during our visit easy to access and stored securely when not in use. The views of service users are sought as much as possible by the home. The home’s AQAA states these views are currently gained during annual reviews and other 1:1 meetings. The RNID has a number of policies and procedures, which are designed to ensure it complies with the law and remains aware of good practice guidelines. Full details of each policy were provided by the Manager as part of the AQAA she completed for us as part of this Key Inspection process. There are recording systems in place to support Health and Safety within the home, which are being used consistently. The safety of gas appliances was tested in October 2007 and the safety of portable electrical appliances was tested in February 2008. Fire safety in the home has now been improved. Staff are provided with fire safety training, fire drills and the home’s alarm system is tested weekly, with these tests now being shared between each home in the main Poolemead building on a rota basis. A number of general Risk Assessments are now in place, which are regularly reviewed. These support safe working practices within the home to ensure the welfare and safety of both service users and staff members. The improvement Gallaudet Unit DS0000040658.V363903.R01.S.doc Version 5.2 Page 26 in the risk assessment framework in the home has been supported by the RNID Risk Manager. The registered provider’s representative continues to make regular visits to the home, and produces a comprehensive report of his findings, which is sent to us on a monthly basis. Since the last inspection these visits have remained focused upon the improvements required within the service, as well as more general issues. Gallaudet Unit DS0000040658.V363903.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 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 2 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 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 3 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 3 3 3 3 3 3 Version 5.2 Page 28 Gallaudet Unit DS0000040658.V363903.R01.S.doc 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 YA24 Regulation 16(2) Requirement Timescale for action 2. YA35 18(1) The home’s carpets must be either cleaned or replaced to ensure a safe, clean and homely environment is maintained for service users. 22/08/08 To ensure staff have the knowledge and skills to provide a good quality service they must complete their training programme. 22/11/08 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. 2. 3. Refer to Standard YA6 YA24 YA39 Good Practice Recommendations The development of accessible formats for service users should continue to be reviewed by the home and a record kept as part of each person’s care plan. The home should improve the environment further, in line with the plans described in their AQAA, for the benefit of service users and staff. The home should consider conducting a quality assurance review. This will ensure the quality of the service provided is accurately measured. DS0000040658.V363903.R01.S.doc Version 5.2 Page 29 Gallaudet Unit Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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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