Care Home: Glebe Road, 69

What has improved since the last inspection? :Staff are finding out more about people before they move into the home by visiting them wherever they are living.Support plans are reviewed regularly to make sure that they tell staff how to meet people`s need for support.People are supported to be independent.Most staff have obtained aqualification that helps them to provide care that meets people`s needs.The staff team have learned more about how to keep people safe.Improvements have been made to the home`s outdoor facilities.The new manager was given plenty of time to learn how to run the home before the previous manager left. What the care home could do better: :The home needs to make sure that people`s care plans cover all of the recommended good practice areas. People`s care plans need to be available in a format which can be more easily understood by people using the service.The home should obtain a copy of each person`s Health Action Plan.The new manager must make sure that all staff working at the home receive the support, guidance and supervision they need to do their job well.Put a system in place which will help to ensure that the home is run in the best interests of the people living there.Ensure that staff receive extra training to help them meet the needs of people with dementia and mental health needs. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glebe Road, 69 69 Glebe Road Bedlington Northumberland NE22 6HQ two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a key inspection. Lead inspector: Elizabeth Gaffney Date: 0 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Glebe Road, 69 69 Glebe Road Bedlington Northumberland NE22 6HQ 01670823831 01670821108 ASpratt@northumberland.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Northumberland County Council SSD Name of registered manager (if applicable) Anne Spratt (Unregistered Manager) Type of registration: Number of places registered: Conditions of registration: Category (ies): Number of places (if applicable): Under 65 Over 65 15 0 care home 15 Learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places: 15 The maximum number of service users who can be accommodated is: 15 Date of last inspection 2 0 0 2 2 0 0 7 A bit about the care home The home provides care for 15 younger adults with learning disabilities. Most people live in the main building. Two people live in the bungalow and two more live in a bed-sit. One person lives in a separate flat. The home is in Bedlington, which is in Northumberland. There is a good bus route near the home. There are shops close by. Each person has their bedroom with their own things in. Some people have their own bed-sit. There are bathrooms which people with physical disabilities will find easier to use. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: Two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home: The Inspector talked to three staff to check that they know how to care for people living at the home. We talked to three people using the service to see if they are happy with the care they receive. The inspector looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We looked at some of the records that are kept by staff. We checked the building to make sure that it is a safe place to live. This is a sample of some of the things that the care home does well: People are supported to keep in contact with their relatives, and they can see visitors whenever they want. People receive the health care they need to stay healthy. People receive their medication and staff keep good records. The homes medication policy has been reviewed and the manager has made improvements to how medication is looked after in the home. People receive support to visit shops, go out for meals and attend educational classes. Staff help people to make choices and decisions. What has got better from the last inspection: Staff are finding out more about people before they move into the home by visiting them wherever they are living. Support plans are reviewed regularly to make sure that they tell staff how to meet peoples need for support. People are supported to be independent. Most staff have obtained a qualification that helps them to provide care that meets peoples needs. The staff team have learned more about how to keep people safe. Improvements have been made to the homes outdoor facilities. The new manager was given plenty of time to learn how to run the home before the previous manager left. What the care home could do better: The home needs to make sure that peoples care plans cover all of the recommended good practice areas. Peoples care plans need to be available in a format which can be more easily understood by people using the service. The home should obtain a copy of each persons Health Action Plan. The new manager must make sure that all staff working at the home receive the support, guidance and supervision they need to do their job well. Put a system in place which will help to ensure that the home is run in the best interests of the people living there. Ensure that staff receive extra training to help them meet the needs of people with dementia and mental health needs. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Elizabeth Gaffney CSCI St Nicholas Buildings St Nicholas Street Newcastle upon Tyne NE1 1NB If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are suitable arrangements for making sure that peoples needs are assessed before they are admitted into the service. This helps to ensure that staff will be able to meet peoples needs after their admission into Glebe Road. Evidence: Admissions into the home do not take place until after a full needs assessment has been done and a multi-disciplinary team has considered whether Glebe Road will be able to meet the persons assessed needs. Where social services have carried out the assessment, the home obtains a summary of the assessment. People only move into the home if the manager is confident that staff have the skills and training necessary to meet their assessed needs. The home also carries out its own pre-admission assessment to ensure that it can give people the care they need. Where relevant, assessment information is also obtained from other professionals such as Speech and Language Therapy staff and the Behavioural Support Team. The new manager has already identified plans to improve the homes performance against the Choice of Home standards. Of the seven people using the service who completed surveys, all said that they received enough information about the home before they moved in. A member of staff who returned a survey said that staff are given enough information about how to meet peoples needs. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Peoples needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are good arrangements for helping people to make day-to-day decisions and take responsible risks. However, some care plans do not fully cover peoples assessed need for support with personal, health and social care tasks. This could lead to staff being unclear about how to meet peoples needs. Evidence: Staff have spent a lot of time and effort trying to ensure that good care plans are in place. Staff spoke about how they are committed to doing an even better job. A sample of care records was looked at. They include such information as:    A brief summary of peoples life history. However, a completed life history was not available in one of the records checked. Where possible, assessment and personal profile information is completed in consultation with the service user. The benefit of having life history and assessment information is that it helps staff to understand what life was like for the person before they moved into Glebe Road; A more in-depth assessment of peoples needs in areas such as accessing the community and personal care. Staff have also completed a strength/needs list and a self-care checklist for each person. This helps staff to understand what people can manage for themselves and where they might need help from staff; Care plans setting out how the home intends to meet peoples needs. This helps staff to be clear about the actions they must take to meet peoples needs. However, peoples care plans do not always cover all of the areas recommended by the National Minimum Standards. For example, in one persons care records, care plans have not been devised in the following areas: maintaining family Evidence: contact; management of finances; culture and faith; physical health and communication. Some of the people living at the home have developed behaviours which staff can find difficult to manage. In such situations, the home works closely with the local Behavioural Support Team and where necessary, complex behavioural support plans are drawn up to provide staff with clear guidance about how to work with people and deliver consistent care. The home operates a key worker system. This enables staff to spend more one to one time with people and to develop positive relationships with them. Key workers complete monthly updates that describe what events have taken place in a persons life during the previous month. This helps staff to gain a better insight into how people are progressing or whether there are problems that need to be addressed. People using the service know who their key workers are and they were able to describe some of the things that they did for and with them. People said that they enjoy spending time with their key workers. Six monthly placement reviews take place. However, some peoples care plans have not been updated following their reviews. People are invited to attend their own reviews and comment on the care they receive at Glebe Road. Two of the most recent reviews held had been attended by the people concerned. One of these people was supported by an advocate from SENSE to help them understand what was being said. Wherever possible, peoples care managers and their family are invited to attend their reviews. A range of risk assessments have been completed for each person. For one individual these cover such areas as road safety, money management, using the stairs and the management of their challenging behaviours. Risk assessments are reviewed every six months. People are supported and encouraged to take control of their own lives and make their own decisions and choices. For example, people said that they chose: who comes into their bed-sits; who they are friends with; how to spend their time and what to eat. Of the seven people using the service that completed surveys: Six people said that they make decisions about what they do each day. One person said that this was only sometimes the case;  All said that they could do what they want during the day, evenings and weekends.  Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are provided with opportunities to develop and maintain social, emotional, communication and independent living skills. They are supported to make choices and take decisions. This helps people to live a fulfilling lifestyle that takes account of their needs, wishes and personal preferences. Evidence: People are supported to develop and maintain important personal and family relationships. Although care plans covering this area have not been devised, the home recently supported a couple to address their relationship difficulties in a positive and constructive manner whilst also helping to keep them safe. People are encouraged to take up recreational and educational opportunities in their local community. For example, an activity timetable has been devised for one person. This shows that they attend a work placement at a local resource centre. The person is also supported to go to a gym session and a flower arranging class every fortnight as well as participating in various trips out organised by a local physical activity centre. Another person visits a local day care centre twice a week. Arrangements have also been made for this person to take regular swimming lessons and go on a holiday. People using the service said:  I have enough to do each day. I cannot think of anything else I would like to Evidence: do;  Staff support me to go out when I ask them to. They arrange things for me to do if I ask them to;  Staff dont make me to do anything I dont want to. I enjoy doing things in my bedroom and spending time in the dining area each day. If I want to do something I can. None of the people whose care records were examined required assistance to eat and drink. People are supported and encouraged to take a healthy diet. Peoples care records contain information about their food likes and dislikes. Staff said that people are consulted on a monthly basis about the meals that they want to see on the menu. Pictorial menu aids are used to help people make more informed choices about what they want to eat. The menus are varied with a number of choices including a healthy option. The meals served are nutritionally balanced and cater for peoples dietary needs. People said that they are happy with the food served at the home. During the inspection, people were observed taking their lunchtime meal. The mealtime was relaxed and unhurried. Staff were on hand to offer support. The dining room is a pleasant area that has been nicely decorated. A water cooler is available which people can help themselves to. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Generally, the arrangements for meeting peoples health and personal care needs are good. This means that people using the service can be confident that staff will know how to meet their needs. Evidence: The homes statement of purpose includes information about how Glebe Road will meet peoples health care needs. Staff spoke knowledgeably about how they support people to keep healthy. Information about peoples health needs has been recorded in their care records. People whose care records were looked at had accessed an optician and a dentist during the previous 12 months. People had also seen their GP and hospital consultant in line with their healthcare needs. However, none of the records checked contained copies of peoples Health Action Plans. Access to Health Action Plans would provide staff with historical health information and enable them to better monitor and plan for peoples health and well being. Peoples weight is not always being checked every month. Staffs approach to meeting peoples personal care needs is person centred. Staff were observed supporting one person to use the toilet. This was done in a quiet and dignified manner. Another person was supported to sit more comfortably in their armchair. The carer consulted the person about how they could make them feel more comfortable and also inquired as to whether they needed anything before they left them. One person told the inspector that staff helped them with their personal care needs in a nice way and gave them all the help they needed. Staff are provided with training in how to meet peoples health care needs. For example, some staff have completed training in oral healthcare. All staff have completed a National Vocational Qualification in Care, which covers how peoples Evidence: health and personal care needs should be met. The home has a medication policy which staff are expected to follow. The policy has been updated since the last inspection. Peoples medication is kept secure at all times. The room used to store medication is clean and hygienic. Photographs identifying each person have been placed with their medication records. Records covering the receipt, administration and disposal of medicines are in place. Records examined were up to date and well maintained. However, it was identified that Tippex had been used to eradicate an error in recording. This practice prevents anyone from checking what the original mistake was. Also, one persons medication administration record contained a number of items of medication, which the service user no longer takes. Removing these items will help to reduce the possibility of confusion occurring. Staff administering medication have completed accredited training. However, not all staff have completed Level 1 medication training as recommended by the Commission. Staffs competency to administer medication has not been recently assessed. None of the people currently using the service administer their own medication. One person told the inspector that they would like to do this as they had done it before they moved into Glebe Road. Mrs Spratt said that she would look into this following the inspection. Hand wash facilities are not available in the area in which medicines are stored. However, staff carry anti-bacterial wipes at all times. Checks of the air temperature of the area in which medications are stored are carried out. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The arrangements for keeping people safe and listening to any concerns that people might have are good. This means that people can feel confident that they will be protected from harm or abuse and their opinions and views will be listened to and acted upon. Evidence: The provider has a detailed complaints procedure that also includes a process for handling unresolved complaints. A staff guide to reporting and responding to complaints is also available. The complaints procedure is available in a variety of formats on request. The home has devised a pictorial complaints file that can be used where the complainant has complex communication needs. Each person has been provided with their own copy of the procedure. People are clear about what they would do if they needed to make a complaint. Neither the home nor the Commission have received any complaints since the last inspection. Staff spoke clearly about what action they would take in response to a complaint. Of the seven people who returned surveys, all said that they would know whom to make a complaint to if needed. A safeguarding policy is in place. Staff spoken with were clear about what action they would take to protect people from potential harm. In the three staff files examined, there was only documentary evidence that one person had received safeguarding training. However, arrangements have been made for these staff to complete the necessary training. The home has notified the Commission of three safeguarding alerts, all of which have been related to the same issues. The home took robust action to protect the well being of the people concerned and worked in partnership with other professionals to achieve this goal. People using the service are satisfied with the care they receive. They feel safe and well supported by staff. The manager is very clear that any concern about the Evidence: well being of anyone living at Glebe Road would be addressed immediately. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is well-maintained, safe and has been satisfactorily adapted to meet the needs of the people living there. This means that people can be confident that they live in a safe building where staff have access to the equipment necessary to care for them. Evidence: The home has been adapted to meet the needs of the people living there. The environment is well-maintained and provides specialist aids and equipment to meet peoples needs. The provider has completed a Disability Discrimination Act assessment and is in the process of implementing the subsequent recommendations. The home has an in-house budget for small repairs, day-to-day decoration and for the replacement of furnishings and fittings. Where an improvement requires a larger sum of money, Mrs Spratt liaises with her line manager. Mrs Spratt said that this process works well. The manager reported that repairs are always rectified quickly. The home is nicely decorated and its furnishings and fittings are of a good standard. At the time of the inspection, the home was safe and free from potential hazards. There were no unpleasant odours. Bathrooms and toilets were clean and hygienic. Of the seven people who returned surveys, all said that the home is always fresh and clean. People have access to good-sized bedrooms providing them with both a bedroom and a lounge area. People have personalised their bed-sits according to their personal preferences. The bed-sits visited are different and individual. The lay out and design of the home allows for smaller groups of people to live together in more domestic settings. People have access to a range of communal spaces from a large lounge in the main building to the smaller lounge areas in the flat, bungalow and two-person bed-sit. Evidence: The provider has devised an infection control policy which staff are expected to follow. The kitchen and laundry were hygienic, clean and tidy. Staff have received training in the control of infection. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. Peoples needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using the service are supported by qualified staff that have been properly vetted. This means that staff are safe to work with the vulnerable people they care for. However, arrangements for supervising staff are not fully satisfactory. This means that people are not able to benefit from being cared for by staff that are properly supported and supervised. Evidence: There are rotas in place which show what staff are on duty and at what times. People using the service said that there are always enough staff on duty to give them help when they need it. The rotas show that extra staff are available during busier times of the day. Of the seven people using the service who returned surveys, all said that staff treat them well and listen to and act on what they say. When planning for the admission of a new person, careful consideration is given to whether Glebe Road has the required staffing levels as well as staff who have the right balance of skills and knowledge. Mrs Spratt said that a new admission would not go ahead unless this was the case. The home employs 36 full time and five part time care staff. In the last 12 months, five staff have left their employment at the home. This level of turnover is considered low. Maintaining a stable staff team helps to ensure that people using the service receive consistent care provided by an experienced and stable staff group. A comprehensive training programme is available to Glebe Road staff. The programme covers mandatory training courses as well as training aimed at developing staffs knowledge in specialist areas such as working with people whose behaviour is challenging. For example, where the home agrees to provide a placement to a person with complex support needs, specialised training input is arranged. With one exception, a training and development plan has been completed for each member of staff. It was Evidence: also identified that some staff have not completed training in person centred planning, dementia and mental health awareness. This is considered important as some people living at the home have needs in this area. New staff complete a specialist induction for people with learning disabilities. However, there was no evidence in one staff members file that they had been signed off as having completed the specialist learning disability induction. Staff complete statutory training in areas such as moving and handling, first aid and food hygiene. Mrs Spratt said that apart from those staff whose statutory training updates have already been arranged, all other staffs training is up to date. However, certificates confirming that staff have completed their statutory training are not always in place. Mrs Spratt confirmed that she intends to discuss this matter with the training provider as soon as possible. Thirty-six of the forty-one staff employed at the home have completed a National Vocational Qualification in Care at Levels 2 or 3. Equality and diversity issues are covered as part of this qualification. Some staff have also received extra equal opportunities training. The provider has devised a robust recruitment procedure, which takes account of equality and diversity issues. For staff appointed after the introduction of the National Minimum Standards, there is evidence that the required preemployment checks have been carried out. For example, two written references and a Criminal Records Bureau disclosure certificate have been obtained. The provider has also obtained a declaration from each member of staff confirming whether they have any convictions. The provider has also established that staff are medically fit to do the job for which they have been employed. Some staff have not received supervision at the frequency referred to in the National Minimum Standards. For example, two staff only received four sessions during the previous 12 months instead of six. The provider has recently revised its approach to staff supervision policy and documentation. The new manager intends to improve the way in which supervision is delivered within the home. One member of staff returned a survey. They said that: their employer had carried out pre-employment checks and given them a good induction; they have received the training they need to have to do their job; they meet with their manager on a regular basis; there are usually enough staff on duty to meet peoples needs; they felt they had the right support, experience and knowledge to meet the different needs of the people using the service. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. Peoples opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The arrangements for keeping people safe at Glebe Road are good and staff follow safe working practices. This means that people living at Glebe Road can be confident that they will be kept safe and protected from harm. Evidence: Although the home does not have a registered manager, a new manager has been appointed since the last inspection. The manager is a qualified nurse with a teaching qualification and is in the process of completing a foundation degree in social care management. Mrs Spratt has extensive experience of working with adults with a learning disability in a residential setting. Mrs Spratt has also worked in Care Management. Throughout the inspection she displayed the professional competence required to manage Glebe Road. Since the last inspection, the provider has reviewed many of its policies and procedures and made them available for use at the home. The Council is in the process of reviewing its data protection arrangements to ensure that the information it holds about people using the service and staff is properly protected. Arrangements are in place to monitor the quality of care offered at the home. For example:  The provider carries out unannounced monthly visits to monitor the standard of care provided at Glebe Road. A copy of the report is forwarded to the home so that required improvements can be addressed. As part of these visits, the provider interviews a small sample of people living at the home. However, one of Evidence: the reports examined contained very little evidence of what had actually taken place during the visit; Elected members also carry out monthly visits. Reports from their visits are forwarded to the home and senior Council members; The manager submitted an Annual Quality Assurance Assessment (AQAA) when we asked for it. The AQAA identified some of the areas that the home aims to improve in the year ahead.   However, it was also identified that:   The home does not have an annual development plan. Devising such a plan will demonstrate how the home intends to further improve the services and facilities offered at the home; A quality assurance report as required by Regulation 24 of the Care Homes Regulations 2001 has not been prepared. Mrs Spratt agreed to address this matter with her line manager following the inspection. A tour of the premises identified no health and safety concerns. A range of health and safety records is maintained to ensure that the building is kept safe for the people living there. For example: a detailed fire risk assessment has been carried out; staff whose files were checked have participated in two fire drills during the last 12 months; the emergency lighting and fire extinguishers receive visual checks each month and the fire alarms are tested weekly. An independent contractor carries out routine inspections of fire safety equipment. An environmental health inspection carried out in 2008 reported that kitchen standards were good. The home has a current gas safety record. Mrs Spratt also has managerial responsibility for an Independent Supported Living Scheme located in the Newbiggin-on-Sea area. Following a recent inspection carried out by the local fire service, concerns were expressed about fire safety arrangements within the scheme. To address these concerns, the provider has made a decision to transfer the two people living there to more appropriate accommodation in January 2009. A fire risk assessment has been carried out and Mrs Spratt is in the process of checking that the fire service is satisfied that interim arrangements put in place to keep people safe are satisfactory. Are there any outstanding requirements from the last inspection? Yes No   Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1. 6 15 Ensure that peoples care plans cover the areas referred to in the National Minimum Standards. This will help staff to be clear about what help and support people require and how this is to be done. 01/06/2009 2. 7 Schedule 3, Paragraph 3. 01/06/2009 Ensure that each persons care record contains all of the information referred to in Paragraph 3 of Schedule 3. This will help to ensure that staff have access to all of the information they might need to care for the person and keep them safe. 3. 23 13 Ensure that there is documentary evidence that all staff have completed safeguarding training. This will help people using 01/06/2009 the service to feel confident that staff will know how to keep them safe. 4. 36 18 Ensure that staff receive 01/02/2009 supervision at least six times a year. This will help to ensure that people are able to benefit from being cared for by staff who are properly supported and supervised. 5. 39 24 Ensure that a system for 01/08/2009 reviewing and improving the quality of care provided at the home against the National Minimum Standards and Care Homes Regulations is established and maintained. A copy of that report should be made available to the Commission and people using the service. This will help people using the service to see what action is being taken to improve the home they are living in. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1. 7 Complete a life history profile for each person using the service. Ensure that peoples care plans are updated following six monthly placement reviews. 2. 18 Obtain a copy of each persons Health Action Plan. In consultation with the service user, make arrangements to weigh the person monthly. A written record should be kept. 3. 20 Ensure that staffs competency to administer medication is assessed and a written record kept. Avoid using Tippex to eradicate errors on medication records. Ensure that medications listed on peoples medication administration records are promptly removed when they are no longer being taken. 4. 20 Ensure that all care staff complete level 1 training in medication as recommended by the Commission. A written record of the training provided should be kept. Ensure that all relevant staff complete training in malnutrition care and providing people using the service with assistance to eat and drink. Make sure that a training and development plan has been completed for each person and placed in their training record. Ensure that all staff complete training in person centred planning, dementia and mental health awareness. Ensure that a record is kept confirming that staff have been signed off as having satisfactorily completed the Skills for Care (TOPPS) specialist induction. 5. 32 6. 35 7. 8. 35 35 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!