Care Home: Girling Street and St Faith`s Villa

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What the care home does well Both St Faith`s Villa and Girling Street were clean, well maintained and homely environments for people to live in. Care plans were detailed and clearly explained the support that people needed and preferred to meet their needs. Staff had a clear understanding of their roles and responsibilities and had a good knowledge about the individual support that people were provided with. Interaction between staff and people that lived at the home was observed to be friendly and professional. Staff were observed to be attentive to people`s needs and people`s choices were listened to. Staff received a good training programme, which provided the information that they needed to ensure that people were safeguarded and that their needs were met. People were offered with the opportunity to participate in activities that were of interest to them. One service user survey commented `this house is nice`. Comments made in the relative surveys included `in our case (the person) is kept occupied with various activities` and `they care for (the person) in a most professional and thoughtful way. Her needs are always met and this allows her to live in an environment which is always stimulating, safe and happy`. The staff survey asked what the service did well and the comments made included `the service supports the service users to try to be independent and encourage them to try to fulfil any choices that they make`, `meet individual requirements`, `support, independence, choice` and `it meets the service users needs very well, they feel safe and secure with a very caring manager and staff`. The health professional survey stated `I have worked with Sue Snelling and her team for some years. I have always found the staff team extremely receptive to recommendations which have been followed accordingly. The care staff work well with members of the multi disciplinary team`. What has improved since the last inspection? During the last key inspection we did not have access to the staff recruitment records. They were available for inspection during this key inspection and it was noted that recruitment checks were made to ensure that people were safeguarded. The care plans had improved and were more person centred and the people that lived at the home had participated in the development of their care plans. CARE HOME ADULTS 18-65 Girling Street and St Faith`s Villa 34 Girling Street and 90 Queens Road Sudbury Suffolk CO10 1PG Lead Inspector Julie Small Unannounced Inspection 6th August 2008 13:50 Girling Street and St Faith`s Villa DS0000044272.V369864.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 Girling Street and St Faith`s Villa DS0000044272.V369864.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. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Girling Street and St Faith`s Villa Address 34 Girling Street and 90 Queens Road Sudbury Suffolk CO10 1PG 01787 882082 01787 882082 sudbury@regard.co.uk 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) The Regard Partnership Ltd Mrs S Snelling Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd August 2006 Brief Description of the Service: 34, Girling Street and St Faiths Villa, Sudbury are two residential care homes for women with learning disabilities, each home accommodates five service users. 34 Girling Street was first registered in 1997 and St Faiths Villa in 1999; the two homes are registered as on ‘core and cluster’ residential care home. The homes are within a short walking distance of each other and of Sudbury town centre. Both services are managed by one full time manager, Mrs Sue Snelling, who divides her time across the two sites. Mrs Snelling is supported by two small teams of staff who are allocated to each home, with some interchangeable shift arrangements. There are additional relief staff employed to cover for any staff vacancies, annual leave or sick leave. The primary role of staff within this service is to encourage and support service users to maximise their skills, abilities and interests. Service users are also provided with opportunities to pursue active lives in the community and to access a range of services and facilities available to them in the community. 34 Girling Street and St Faiths Villa are part of The Regard Partnership, which is responsible for other residential services for people with learning disabilities in other parts of the country. At the time of the last key inspection information for fees was obtained from service users contracts and range from £471.40 to £838.46 per week, dependent on support required by each individual. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The unannounced inspection took place Wednesday 6th August 2008 from 13.50 to 18.40. The inspection was a key inspection which focused on the core standards relating to adults and was undertaken by regulatory inspector Julie Small. The report has been written using accumulated evidence gained prior to and during the inspection. Staff members that were present during the inspection provided the requested information promptly and in an open manner. During the inspection three staff members were spoken with and three people that lived at the home were spoken with. Records viewed included four care plans of people that lived at the home, health and safety records and three staff recruitment records. Further records that were viewed are identified in the main body of this report. Prior to the inspection an Annual Quality Assurance Assessment (AQAA) and surveys were sent to the agency to enable people to tell us about their experiences of the service that they were provided with. The AQAA and six service user surveys, five relative surveys, one health professional survey and five staff surveys were returned to us. What the service does well: Both St Faith’s Villa and Girling Street were clean, well maintained and homely environments for people to live in. Care plans were detailed and clearly explained the support that people needed and preferred to meet their needs. Staff had a clear understanding of their roles and responsibilities and had a good knowledge about the individual support that people were provided with. Interaction between staff and people that lived at the home was observed to be friendly and professional. Staff were observed to be attentive to people’s needs and people’s choices were listened to. Staff received a good training programme, which provided the information that they needed to ensure that people were safeguarded and that their needs were met. People were offered with the opportunity to participate in activities that were of interest to them. One service user survey commented ‘this house is nice’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 6 Comments made in the relative surveys included ‘in our case (the person) is kept occupied with various activities’ and ‘they care for (the person) in a most professional and thoughtful way. Her needs are always met and this allows her to live in an environment which is always stimulating, safe and happy’. The staff survey asked what the service did well and the comments made included ‘the service supports the service users to try to be independent and encourage them to try to fulfil any choices that they make’, ‘meet individual requirements’, ‘support, independence, choice’ and ‘it meets the service users needs very well, they feel safe and secure with a very caring manager and staff’. The health professional survey stated ‘I have worked with Sue Snelling and her team for some years. I have always found the staff team extremely receptive to recommendations which have been followed accordingly. The care staff work well with members of the multi disciplinary team’. 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. Girling Street and St Faith`s Villa DS0000044272.V369864.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 Girling Street and St Faith`s Villa DS0000044272.V369864.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, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect that that their needs will be assessed before they move into the home and that their needs will be met. EVIDENCE: The records of four people that lived at the home were viewed and each included a needs assessment that had been completed prior to them moving into the home, which had been updated with changing needs and people’s preferences. There had been no people admitted to the home since the last key inspection. The previous key inspection reports identified that the needs assessments met the required standards. The AQAA stated ‘we have a referrel team with the company who would involve me should we have a vacancy. The prospective client would be assessed and if felt suitable for the service arrangements would then be made for them to visit the home before they move in’ and ‘we would complete a full needs assessment, care plans would be put into place, and a three month settling period, a review would be held after this to decide on the next steps’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 9 People’s records included detailed care plans, which showed how the assessed needs of the people that lived at the home were to be met. Five relative surveys stated that they and their relative were always provided with enough information about the home to help them to make decisions. Girling Street and St Faith`s Villa DS0000044272.V369864.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, 8, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People can expect that their individual care plan reflects their needs and goals, that they are supported to make decisions about their lives, that they are consulted with regarding the support that they are provided with and that they are supported to take risks as part of an independent life style. EVIDENCE: The records of four people that lived in the home were viewed and each contained a detailed care plan that clearly explained the support that people required and preferred to meet their needs. Since the last key inspection the care plans had been improved and were ‘person centred’. They included the wishes, future goals, likes and dislikes of each person in picture and text format which ensured that they were accessible to the people who used the service. The care plans included areas such as ‘my life now’, ‘things that make me cross’, ‘my support – how I like it’, things that I am good at’ and ‘the Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 11 important people in my life’. Care plans were reviewed regularly with people’s changing needs and preferences. The AQAA stated ‘Care needs assessment and care plans take into account the service users wishes and input from other professionals and family are encouraged. Care plans include health, personal hygiene, activities, finances etc giving a full care needs plan’. A person that lived at the home was spoken with and confirmed that they had participated in completing their care plan. They said that the staff had listened to their choices and they were happy with the contents of their care plan. The care plans were signed by each person, which showed that they were consulted with about the contents of the plan and the support that they were provided with to meet their needs. The care plans clearly detailed how people’s diverse needs were to be met, for example their chosen religious worship, if they chose to worship in the community and their methods of communication. Care plans detailed how people’s independence should be respected and areas of their care that they could manage independently, such as with personal hygiene. The records included risk assessments for their day to day living and for their chosen activities. The risk assessments included details of the possible risks and methods of minimising the risks. Staff had signed and dated documents in people’s care plans that stated that they had read and understood people’s care plans and risk assessments. Staff spoken with reported that the care plans detailed the information that they needed to meet people’s needs. They had a clear knowledge of people’s individual needs and the interaction between staff and people that lived at the home was observed to be friendly and professional. Five staff surveys stated that they were always provided with up to date information about the people that lived at the home and comments included ‘any information is passed on to staff through reading and signing updates also discussions at meetings’ and ‘if anything has change or been updated my manager always tell me and I will read up on it ASAP’. Staff were regularly updated regarding the well being and changing needs of people that lived at the home. Daily records and monthly reports of people that lived at the home were viewed and they identified people’s wellbeing and actions. Staff meeting minutes that were viewed showed that any changes in people’s circumstances or issues regarding people’s care were regularly discussed by the staff team to ensure that any changes in people’s support needs were addressed and that their needs were met. The relative survey asked if they felt that their relative’s needs were met and if they felt that people were supported to live the life that they chose to. Four answered always and one answered usually to each question. Comments Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 12 included ‘(the person’s) needs are met fully at St Faiths. All of her physical, mental and moral needs are considered and met fully in a most professional and caring way’. People were consulted with regarding the support that they were provided with in monthly key worker meetings. They met with their key worker to discuss their well being and their preferences about how their needs were met. Key worker meeting records were viewed and the areas discussed included ‘goals’, ‘health’, ‘finance’, ‘daily living’ how I am doing’ and ‘what I am going to do next’. The records were signed by the key worker and the person to show that they had agreed with what had been recorded. Records of review meetings were viewed, which showed that the support that people required and preferred was reviewed by the person that lived at the home, their representatives and by professionals that were involved in their care. The AQAA stated ‘all service users have regularly monthly one to one meetings, during which time they are encouraged to make their wishes and opinions known, all of which are minuted and any required actions are logged in the keyworker action book and signed off when the appropriate action has been taken’ and ‘each service user has a 6 monthly review which includes the service user and family and care managers are invited. The service user is encouraged to participate’. The service user survey asked if the staff listened and acted on what they said. Four answered always, one answered usually and one answered sometimes. Six service user surveys stated that they always made decisions about what they did each day. People who lived at the home that were spoken with confirmed that they could choose what they wanted to do and that the staff listened to their choices. During the inspection staff were observed to listen to people’s choices, for example what they wanted to do during the day and what they wanted to eat and drink. The minutes for house meetings were viewed and showed that people were consulted with and advised about the support that they were provided with and discussions included the activities that they wished to participate in, results of the recent satisfaction surveys, how the Regulation 26 reports had been changed to be more user friendly, CSCI surveys and explanations of the CSCI inspection process. The house meeting minutes were noted to be user friendly and were in picture and word format. The AQAA stated ‘regular service user meetings are held, where service users are encouraged to voice their opinions and minutes are kept in a format they prefer’. People that were spoken with reported that they were always told about what was happening at the home and that the staff asked them what they thought about any changes. Girling Street and St Faith`s Villa DS0000044272.V369864.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, 14, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People can expect to be supported to take part in appropriate activities, to maintain contacts and to be provided with a healthy and balanced diet. EVIDENCE: People were provided with the opportunity to participate in activities that were of interest to them both in the home and in the community. The records of people that lived in the home that were viewed identified the day services, activities and social clubs that they chose to attend on a regular basis. Each care plan included a weekly timetable that was in picture and text format. The timetables showed people’s regular activities and routines for each week. The activities that people participated in included an annual holiday, horse riding, attendance at a local social club, shopping in Sudbury and surrounding towns, visits to the coast and eating out. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 14 The AQAA stated ‘service users attend a range of adult educational and day services including Sudbury Resource Centre, Bradbury Courtyard and The Bridge Project, West Suffolk College in Sudbury and a range of Asdan courses, Sports sessions at the Centre for a variety of courses suited to their needs and wishes. The service users also attend a range of recreational activities including eco class, art class, swimming, bowling, spa sessions, gateway club, meals and trips out which enables them to take place in age, peer and culturally appropriate activities’. When we arrived at St Faith’s Villa the staff and three people that lived at the home were preparing to go out to the park. We agreed that we would visit Girling Street to enable the people to carry out their planned activity. A person that lived at the home was observed talking to the neighbours and was petting their cat. At Girling Street one person was in the home and they were observed to be washing up their lunch utensils. They were spoken with and said that they enjoyed washing up. They told a staff member that they wished to go out to the shops to buy some sweets and they were supported to do so. Two people had been on a day trip that was organised by their day services. On their return they told a staff member about their trip, which they said that they enjoyed. Two people returned from their day services and the staff asked them how their day had been. A person was spoken with and they stated that they regularly attended a day service, which they enjoyed and that they participated in lots of activities. They said that they could choose what they wanted to do and if they wanted to participate in a new activity then staff would help them to find out about it. They said that they chose their holiday and that they chose who they wanted to go on holiday with. They said that they had recently been out for a Chinese meal with the other people that lived at the home and that they had decided on the activity in their house meeting. The house meeting minutes that were viewed showed that people had discussed the possibility of going out for a Chinese meal together. On our return to St Faith’s Villa people had returned from their trip to the park and they had gone out in the home’s vehicle to collect a person from their day centre, then to the supermarket to purchase bread. A person nodded when they were asked if they enjoyed their time at the park. Six service user surveys stated that they could do what they wanted to during the day, evening and weekend. Comments included ‘I like going out’. A comment made in a relative survey was ‘(the person’s) interests are always paramount when activities, holidays etc. are considered and planned. She is free to choose but due to her ability she is guided in a very understanding way to enable her to be safe and happy as well as being stimulated’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 15 Two people that were spoken with explained how they maintained contact with their relatives and comments made in the service user surveys included ‘I go home’, ‘I like to go home at weekends’ and ‘see mum and granddad’. During the inspection two people were visiting their family. Four care plans that were viewed clearly identified the contacts that people maintained with family and friends. The AQAA stated ‘service user’s friends and family are welcomed into the home and the service user has a choice of communal rooms, bedroom or garden to entertain them. Service users are supported to write home, use email to contact family and telephone’. Five relative surveys stated that they were always kept informed of important information about their relative and that their relative was always supported to keep in touch with them. Comments included ‘we are able to contact (the person) by phone at all times. We are always made welcome when we visit (the person). They enable (the person) to remember all family occasions by involving her in the choosing, writing and sending of cards, gifts etc. We always receive postcards from (the person) when she goes on holiday’. Two people spoken with during the inspection confirmed that they had a key to their bedroom and one stated that they had a safe and secure place in their bedroom where they could keep their valuables. During the inspection staff were observed to knock on bedroom doors before entering to ensure that people’s privacy was respected. A person that was spoken with reported that staff always knocked on their bedroom door and waited to be invited in before they entered. A health professional survey stated that the people’s privacy and dignity was usually respected. It was noted that people were supported to take responsibilities for ensuring that their own home was kept clean and tidy. People spoken with said that they helped to keep the home and their bedrooms clean and tidy. The service user surveys included the comments ‘I like cleaning my room’, ‘I help clean’, ‘I like hoovering and hanging out washing’ and ‘I help hoover’. Interaction between staff and people that lived at the home was observed to be friendly, respectful and professional and the staff included people in their discussions. People were introduced to us and they were provided with information about why we were present in their home. A person became distressed during the inspection and a staff member was observed to be caring and calm and they spoke to the person about what they were distressed about and how they could help them. People spoken with said that the staff were nice to them. The service user survey asked if the staff treated them well and five answered always and one answered sometimes. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 16 The menu was viewed and showed what meals people had chosen to eat each day and it was noted that the menu was varied and nutritious. It was noted that there was fresh fruit available which people could help themselves to. At Girling Street people chose what they wanted to eat each week and made a list for the shopping. People then chose each evening what they wanted for their evening meal. During the inspection the staff and the people that lived at the home were observed discussing what they wanted to eat for their evening meal. People were observed to help themselves to drinks. A person that was spoken with said that they enjoyed their meals and sometimes there was too much. They said that they could leave the food if they did not want to eat all of their meal. At St Faith’s Villa people were observed preparing for their evening meal, on our arrival a person that lived at the home provided us a cold drink. The evening meal was spaghetti bolognaise. One person went to the cupboards and got something different out and staff were observed to support them in preparing their alternative meal, which showed that people’s choices were listened to. The person helped to dry up the washed crockery and put the items away. The AQAA stated ‘service users are involved in the planning of our weekly menu which includes opportunities for service users to choose food on a daily basis’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People can expect to be provided with support in the way that they prefer and require, to have their physical and emotional needs met and to be protected by the home’s medication procedures. EVIDENCE: The care plans of four people that were viewed included details of the support that they needed and preferred with regards to their personal care. The care plans identified what areas of personal care that people could carry out independently and how they preferred to be supported, For example the care plan of one person stated that they required help with rinsing their hair when they had washed it independently. A person who lived at the home that was spoken with reported that they had helped to write their care plan and that their choices were listened to. People spoken with confirmed that they chose their own clothing and how they wore their hair. Staff spoken with had a clear understanding of the personal care support that each person required and preferred. The AQAA stated ‘service users receive support in a way which they prefer and require. Physical and emotional needs are met’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 18 It was noted that all people that lived at the home that were met looked smart and clean. People’s records that were viewed included details of healthcare treatment that they had received, such as doctors, dentists and opticians. A person had recently had a minor medical procedure and a ‘short term’ health plan was in place to ensure that their needs were appropriately met. The health professional survey asked if the home sought advice and acted upon it to manager individual’s health care needs. The health professional survey that was received answered always and commented ‘I have always found the staff I work with will readily ask for advise/support and will follow this through to the best of their ability’. The health professional survey stated that people’s health care needs were usually met. People’s care plans clearly detailed the individual support that people required and preferred in areas such as their behaviour, when they were upset, what they liked to do and what they did not like. Staff spoken with had a clear understanding of how they supported people with their health care needs. The organisation had recently introduced a magazine for people who used the services of the organisation, which provided details to people about healthy eating and staying healthy. The home’s medication storage in Girling Street was viewed and medication was stored in a secure metal cabinet in the office and the controlled medication was stored inside the cabinet in a smaller secured metal cabinet, which was attached to the wall and provided adequate locking mechanisms. The home used MDS (monitored dosage system) blister packs. There were clear records of received and returned medication. The controlled medication book was viewed and clearly recorded stored and administered controlled medicines. The records of administered homely medication was viewed and showed when and why people had been provided with medication such as cold and pain relief. People’s care plans that were viewed and identified the types of medication that was prescribed and there was a medication file which provided further details and information regarding the medication that people were prescribed. The MAR charts were viewed and it was noted that there no gaps and codes were used is people had refused their medication or were absent from the home, such as if they were on home leave. The AQAA stated ‘improved medication file now in place which includes all information in relation to medication. We have pictorial formats for how sevice users like to take their medications, also pictorial formats for agreeing to take medication’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 19 The health professional surveys stated that people were usually supported to administer their own medication or manage it appropriately when this was not possible. Certificates of staff training and the training records were viewed and showed that staff had been provided with medication training and regular updates. The AQAA stated ‘all the care staff have received training in the safe dispensing and handling of medication where appropriate. To supplement this training the home carrys out its own quarterly medication update programme’ and ‘medication training now improved with exam at the end of the training, staff achieve a pass, credit or distinction’. Staff that were spoken with had a clear understanding about their roles and responsibilities regarding the safe handling of medication to ensure that people are safeguarded by the home’s medication procedures. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 20 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to have their views listened to and acted on and to be protected from abuse. EVIDENCE: The home’s complaints procedure clearly explained the procedures for making complaints and how they would be acted upon. The document was accessible to people that lived in the home and was in picture and text format. The complaints book was viewed and there had been no complaints made since the last inspection and the AQAA stated that there had been no complaints received in the last twelve months. CSCI had received no complaints about the home. A person that was spoken with stated that they knew what to do if they were not happy with something in the home, they said that they would speak to the staff. However, they pointed out that they were happy at the home. Five service user surveys stated that they knew who to speak to if they were not happy and four surveys stated that they knew how to make a complaint. Five relative surveys stated that they knew how to make a complaint. The relative survey asked if the home had acted appropriately if they had raised concerns. Two answered always, two answered usually and comments included ‘no complaints’ and ‘no issues’. The health professional survey asked if the home had acted appropriately if they or the person that used the service had concerns and the survey stated ‘no concerns about care’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 21 The AQAA stated ‘complaints policy and procedure are kept in the homes policy folder, complaints procedure is incorporated in the service user guide and has been discussed with service users. Who to complain to notices are in easy to understand, picture supported formats which are displayed on service user notice board and in service user guide. All complaints would be responded to immediately and actioned as soon as possible’, ‘we have sent out complaints procedure to all parents as to refresh them of use’ and ‘at keyworker and service user meetings the complaints policy has been discussed so people are aware of how to complain’. Five staff surveys stated that they knew what to do if a person whished to make a complaint. Staff spoken with had a clear understanding of their roles and responsibilities regarding complaints. The safeguarding procedures clearly explained what staff should do if they had concerns about the safety of a person that lived at the home. Staff training records that were viewed showed that staff had been provided with safeguarding training. The AQAA stated ‘all staff received annual training in adult protection’. Staff spoken with had a clear understanding of the procedures for reporting concerns and the different types of abuse that may occur. The AQAA stated that there had been no safeguarding referrals made in the last twelve months. A previous safeguarding referral was made by the home, for which we were kept fully informed and we were assured that the home had acted appropriately with regards to safeguarding people. The AQAA stated as a result of the incident they had introduced a risk management plan to safeguard people, which was viewed. The records and storage of people’s finances were viewed, it was noted that records identified a running total for each person’s money kept in the home and clear records for their transactions. The balance of money was checked for two people and the records were noted to be correct. The home had a clear procedure regarding the safeguarding of people’s finances and property. People’s care plans clearly explained the support that each person required regarding their finances and risk assessments were in place. A person was spoken with and reported that they took care of their own finances and that they had a secure place in their bedroom where they could keep their money. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 22 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to be provided with a clean, homely and comfortable environment. EVIDENCE: Both Girling Street and St Faith’s Villa were within walking distance of Sudbury town centre, which provided shops, banks and a post office. There was a good public transport system if people chose to travel to neighbouring towns. The home was clean, well maintained and attractively furnished and decorated. There were no unpleasant odours in the home. There were communal areas that people could use in each house, such as a dining room and a lounge. The rear gardens had garden furniture, which enabled people to relax in the garden if they wished to. The AQAA stated ‘all communal areas of the homes are fully accessable to all service users. In addtion to their bedrooms a communal room is avaliable for Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 23 service users to take visitors in they so require.The environment is always clean and has a friendly and homely atmosphere.The home has well maintained and easily accessible gardens, service users are involved in watering the flowers and the small vegetable plot at Girling Street. The buildings are well maintained and the homes are close to local facilities’. The AQAA stated that they had improved the environment in the last twelve months by ‘all en suite bathrooms now have non slip flooring. The hall at Girling Street has now been decorated, new window fitted in dining room at St Faiths. Staircase enclosed at St Faiths, fire doors added to ensure compliance with new fire regulations. We have a new quiet area in a part of the dining room at St Faiths, for people to spend time quietly if they so desire’. People that were spoken with reported that they were happy with their home and that they were comfortable. A person said that they had contributed to choosing the décor of the home. Six service user surveys stated that the home was always fresh and clean. There was sufficient laundry washing and drying facilities in each home to ensure that people were provided with adequate facilities to clean their clothes. The communal toilets provided hand wash liquid and disposable towels to prevent cross infection. Staff spoken with had a good understanding of infection control procedures and they were observed washing their hands when working in the kitchen, which protected people from cross infection. There were disposable gloves and aprons that staff could use to prevent cross infection when supporting people with their personal care. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to be protected by the home’s recruitment procedures and that their needs are met by a qualified, trained and supported staff team. EVIDENCE: People that lived at the home were safeguarded by the home’s recruitment procedures. The recruitment records of three staff members were viewed and they contained the required information such as satisfactory CRB (Criminal Records Bureau) checks, two written references and an application form. Five staff surveys stated that appropriate checks had been made prior to them working at the home. A staff member that was spoken with reported that the organisation ensured that three yearly CRB checks were made to ensure that people that lived at the home were safeguarded. One staff member’s recruitment records that were viewed showed that their CRB check had been updated. The AQAA stated ‘no staff commence employment until a fully enhanced CRB check has been carried out. Two written references are obtained. All posts are Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 25 subject to a 6 month probabtion period’ and ‘prospective staff are introduced to service users and their views are taken into account at interview’. The staff rota was viewed and the home was staffed twenty four hours a day, during the night there was a sleep in staff member and during the day there were between one and two care staff. During the inspection it was observed that there were two staff members in each house. People spoken with said that they liked the staff and that they helped them with what they needed. The AQAA stated ‘staffing levels are maintained at the required level, to meet the needs and requirements of the service users’. The staff survey asked if there was enough staff to meet the individual needs of people. Three answered always and two answered usually and comments included ‘staffing needs are met with no vacancies at present time’ and ‘we are fully staffed’. Five relative surveys stated that they felt that the staff had the right experience and skills to meet the needs of people and one commented ‘the care staff are fully dedicated and the ladies happiness and needs are always paramount in whatever they do. They are all guided very clearly and professionally by the senior staff and agency and training is an important part of the development of the professional care given by all members of staff’. There were training certificates included in the staff records and a training book which showed what staff had been provided with training that ensured that they were advised of appropriate methods of safeguarding people and meeting their needs. Training provided included a Skills for Care Common Induction Standards induction, safeguarding adults, medication, fire safety, food hygiene, manual handling, Mental Capacity Act and first aid. Five staff surveys stated that they had been provided training that was relevant to their role, helped them to understand and meet the needs of individual people and to keep them up to date with new ways of working. The surveys stated that their induction mostly covered what they needed to know when they started their job. The AQAA stated ‘all staff carry out a comprehensive induction which is the Skills for Care Common Induction Standards, Suffolk also provide training in the induction standards to compliment the Regard induction process’ and ‘the home has a good training budget and dedicated training team. The training offered is led by the service users needs’. Staff spoken with confirmed that they had been provided with the training that they required to help them to do their job and meet people’s needs. They had a good understanding of the responsibilities of their roles and the needs of the people that lived at the home. A staff member was spoken with and reported that newly recruited staff were provided with an in house induction, Skills for Care Common Induction Standards induction and then they were supported to achieve their NVQ (National Vocational Qualification) level 2. A staff member was spoken with that had worked at the home for one year, they stated that Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 26 they had been provided with a good induction course, training courses and that they had recently achieved their NVQ level 2. The home had met the target of 50 staff to have achieved a minimum of NVQ level 2 by 2005 that was identified in the National Minimum Standards relating to adults, which showed that they ensured that people’s needs were met by appropriately qualified staff. NVQ certificates were stored in the individual staff files. The AQAA stated that 80 staff had achieved their award and that the remaining staff were working on their award. The AQAA stated ‘two staff members who had NVQ2 have now completed NVQ3’. Staff were provided with the opportunity to discuss the expectations of their work role and how they met people’s needs. Staff records that were viewed showed that staff were provided with regular supervisions and staff appraisals. Staff spoken with reported that they had regular supervisions, appraisals and staff meetings. They stated that they could approach senior staff at any time to discuss any issues that they encountered in their work role or in meeting people’s needs. The staff survey asked if their manager met with them to provide support and discuss how they were working. Four answered regularly and one answered sometimes and comments included ‘supervisions are monthly with the manager but I am able to arrange a meeting with her if I have any issues I would like to discuss’ and ‘my senior staff member always does my supervisions but my manager always does my appraisals any concerns are passed on to the manager from supervision’. The AQAA stated ‘staff have monthly supervision, which will include some observational supervisions, 6 monthly appraisals. Regular staff meetings are held’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 27 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People can expect to live in a well run home, that their views underpin self monitoring, review and development of the home and that their health and safety is promoted and protected. EVIDENCE: The Statement of Purpose that was viewed and the AQAA stated that the registered manager had achieved their RMA (registered manager award) and NVQ level 4 in care. The registered manager had been successful in their CSCI registered manager application, which showed that they were fit to be in charge of the home. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 28 The AQAA stated ‘aims and objects as stated in statement of purpose achieved. Company policies and procedures adhered to. Budgets summary shows budgets are achieved and managed effectively. All appropriate registration certificates and insurance certs displayed’. Staff spoken with were complimentary about the management of the home and stated that the registered manager ensured that they were supported, trained, that the home was safe and that people’s needs were met. They stated that they felt that they could approach the manager regarding any issues that they had about the home. The registered manager returned the AQAA to us in the requested timescales and the contents of the AQAA provided us with the information that we needed to know about the home. The registered manager worked with us and kept us informed of any issues that occurred in the home and how the issues had been dealt with appropriately. We were routinely notified of any Regulation 37 notifications, which identified the nature of the issues and the actions that the registered manager had taken. People’s records that were viewed included records of review meetings and key worker meetings and house meeting minutes, which showed that people were provided with the opportunity to express their views about the service that they were provided with. People were further provided the opportunity to share their views of the service that they were provided with during the Regulation 26 visits. Records of monthly Regulation 26 reports were viewed, they included a visit to the home by the area manager where they spoke with staff and people that lived at the home and checked that the environment and records were being maintained appropriately. The Regulation 26 visit reports had been improved and were accessible to people that lived at the home and were produced in both picture and text format. The reports were displayed in the home, which enabled the people that lived at the home and their visitors to view if they chose to. The minutes from a recent house meeting were viewed and people were advised about the Regulation 26 visits, why they were carried out and that the reports would be accessible to them. At the same meeting people had been advised about our inspection process and how they would be provided with the opportunity to speak to us about the home or to tell us about their experiences in the service user surveys. The organisation carried out regular satisfaction surveys, in which people that used the service and their representatives could tell the organisation about their experiences service that they received. The results of the surveys and any actions taken as a result of the outcomes of the surveys were provided to people to ensure that they were made aware that their views were listened to. The organisation had recently developed a magazine ‘Best Regards’ and the Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 29 results of the surveys and quotes that had been made in the surveys were included in the magazine. People’s health and safety was promoted and protected. Environmental risk assessments were viewed and they included the identified risks in the environment, such as using the kitchen, using a bath board and infection control, and the methods of minimising the risks were clearly explained. Risk assessments had also been completed for activities and holidays that people had participated in, to ensure that staff were made aware of how they should safeguard people. Fire safety records were viewed, which included a fire risk assessment and there were regular fire safety checks, fire training and fire evacuations to ensure that people were safeguarded if there was a fire at the home. Records of health and safety checks were viewed which included fridge and freezer temperature checks, water temperature checks and tests of electrical appliances. The AQAA stated ‘all health and safety checks are carried out regularly’. Health and safety related procedures were viewed and included COSHH (control of substances hazardous to health), emergency policy, first aid, health and safety, infection control and food hygiene that clearly explained methods of safeguarding the people that lived at the home. There were procedures for how staff should ensure that people were safeguarded if there was a heat wave and in cold and icy weather. The minutes from a recent house meeting were viewed and people were advised of how they should take care of themselves in the hot weather to ensure that they did not get sunburnt or dehydrated. The home had a vehicle and the documents for the health and safety checks of the vehicle were viewed and included risk assessments and insurance to ensure that people were safeguarded when using the vehicle. People that lived at the home were provided with areas of responsibility in maintaining the health and safety in the home. They undertook weekly health and safety checks in the home with a staff member and any areas for repair were reported. The records of the health and safety checks were viewed and it was noted that the first aid boxes were checked to ensure that there were sufficient items, such as plasters, should anyone need them. The manager undertook a six monthly health and safety report, where they monitored the safety of the home. The accident records were viewed and showed that accidents and incidents were managed appropriately to ensure that people were safe. The staff training that were viewed showed that staff were provided with the information they required to ensure that they promoted and protected the health and safety for themselves and for people that lived at the home. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 30 Training provided included manual handling, first aid, fire safety and food hygiene. The AQAA stated ‘all staff are trained in mandatory training’. Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 31 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 3 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 3 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 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 4 X X 3 X Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 32 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 33 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. Extracts may not be used or reproduced without the express permission of CSCI Girling Street and St Faith`s Villa DS0000044272.V369864.R01.S.doc Version 5.2 Page 34 - 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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