Care Home: Gombards

Similar services:

• Coopers Mill Ltd
• Bramley Avenue (73)
• Paradise Lodge
• Grangewood
• Upaya Ananda
• Newton Court (1-2)
• Kings Lane (32)
• Pemdale

What the care home does well The Annual Quality Assurance Assessment (AQAA) states, "We are able to provide a service and home for the people we support that encourages their own personal and social development. The service provides flexible support which is organised around the needs of the tenants." There is good relationship between the staff and residents, and the staff who we spoke to feel well supported in their work and said that there is a good training programme available for them. People are involved in a wide variety of activities, both in the home and in the community, and the staff do everything they can to enable these to take place. One staff survey included the comment, "What the home does well is to provide active support and outings for all service users, and a basis for 1:1 support as best we can when we are staffed to give this to our service users, ensuring that in turn they all benefit from a good relationship with the staff, and that any extra needs are met in full." The residents who we spoke to and observed appeared to be relaxed and happy.The care plans have a person centred format, which emphasises and encourages each person`s independence. They provide good details of each resident`s needs, and procedures for any actions that are needed. One staff survey included the comment, "The service supports service users with all every day`s needs very well. Management is supportive and efficient." What has improved since the last inspection? The manager sent an action plan to CSCI that showed what actions were taken to meet all the requirements from the last inspection report. During our visit we saw that the care plans are now up to date, and they provide clear information and guidelines for the staff. The staff support everyone to take part in their chosen activities, and people go out more with the staff or with their families and friends. United Response continues to provide a good programme of training for the staff, and four more people are working towards the NVQ qualification. This is a great improvement, and indicates that almost 80% of the staff are achieving qualifications for their work. All the health and safety concerns have been met, and we saw good records to monitor health and safety in the home during our visit. In the last year the lounges have been decorated and new flooring has been laid, which looks modern and attractive. The sensory room has been completed, and it provides a calm environment with soft seating, and lighting and sound effects. In one Whole Life Review it is recorded that the person`s father complimented the manager and the staff on achieving so many positive changes at Gombards over the last twelve months. CARE HOME ADULTS 18-65 Gombards 6 London Road Welwyn Herts AL6 9EL Lead Inspector Claire Farrier Unannounced Inspection 8th September 2008 1:20 Gombards DS0000063291.V370857.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 Gombards DS0000063291.V370857.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. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gombards Address 6 London Road Welwyn Herts AL6 9EL 01438 712892 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) www.unitedresponse.org.uk United Response Mr Raymond Jay Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2007 Brief Description of the Service: Gombards is a purpose built home first registered in 2005. It was designed with full wheelchair accessibility and was built as two self contained units each catering for four service users with learning and physical disabilities. The home is jointly owned by Health, Social Services and by Aldwyck Housing Association, and it is managed and run by United Response (a voluntary organisation). The home is situated in Old Welwyn. Local shops and entertainments are only a short distance away from the home. The home has suitable bathrooms and shower rooms to meet the needs of the people who live there. There are additional aids and adaptations that include overhead tracking systems. The home is spacious and provides a homely environment for the people who live there. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective residents. The current charges are from £1,500 - 1,800 per week. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We (The Commission for Social Care Inspection) spent one afternoon at Gombards, and the people who live there and work there did not know that we were coming. The focus of the inspection was to assess all the key standards. Some additional standards were also assessed. We looked around the home and the garden. We met most of the people who live in the home, and we spoke to the staff. We looked at some of the records kept in the home. We also looked at a sample of care plans so that we could see how people are involved in planning their own care and support. We talked to the manager about what we had seen during our visit. The manager sent some information (the Annual Quality Assurance Assessment, or AQAA) about the home to CSCI before the inspection, and his assessment of what the service does in each area. Evidence from the AQAA has been included in this report. The AQAA is a self-assessment document that focuses on outcomes for service users. It also provides us with some statistical information. What the service does well: The Annual Quality Assurance Assessment (AQAA) states, “We are able to provide a service and home for the people we support that encourages their own personal and social development. The service provides flexible support which is organised around the needs of the tenants.” There is good relationship between the staff and residents, and the staff who we spoke to feel well supported in their work and said that there is a good training programme available for them. People are involved in a wide variety of activities, both in the home and in the community, and the staff do everything they can to enable these to take place. One staff survey included the comment, “What the home does well is to provide active support and outings for all service users, and a basis for 1:1 support as best we can when we are staffed to give this to our service users, ensuring that in turn they all benefit from a good relationship with the staff, and that any extra needs are met in full.” The residents who we spoke to and observed appeared to be relaxed and happy. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 6 The care plans have a person centred format, which emphasises and encourages each person’s independence. They provide good details of each resident’s needs, and procedures for any actions that are needed. One staff survey included the comment, “The service supports service users with all every day’s needs very well. Management is supportive and efficient.” What has improved since the last inspection? What they could do better: We are confident that the manager has recognised how the service can improve. In the AQAA he has recognised the need to have more accessible information for new residents, and to have more structured risk assessments in place for the people in the home. There are plans to improve the garden so that it is more accessible for everyone in the home. In the staff surveys two people said that what the home could do better is to employ more full time staff. One person said, “Unfortunately high volume of agency staffing can cause inconsistency for the people we support, but usually the same agency staff are requested so this adds some stability to our service users needs.” Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 7 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. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient information on residents’ needs and access to appropriate services to enable their needs to be met. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) states, “All referrals are assessed on an individual basis acknowledging the needs and requirements of the potential new service user and the people that already live at Gombards. All new referrals have a thorough needs assessment undertaken carried out by the staff that would be supporting them to enable relationships to develop prior to admission. We also obtain copies of current assessments and plans via Social worker/ family/ current residence. The needs assessment we carry out is done via meetings with the individual concerned/ families/ social worker/ care staff and any other professionals involved. We would then compile a comprehensive person centred plan so this was in place prior to admission to the service to enable a smooth transition. The assessment would cover suitability of placement, staffing and any specialist needs of a new service user, and whether we are able to meet their needs and wishes.” No one has Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 10 moved during the past year. Before the last person moved in the referring social worker provided a detailed assessment that was updated before admission. The home also carried out their own comprehensive assessment, which included good information on all the person’s needs, and the process of pre-admission visits to the home. Most of the staff who completed surveys for this inspection said that they have the right support, experience and knowledge to the different needs of the people who use services. The assessments and care plans that we saw on this occasion address the residents’ cultural and spiritual needs, and how the service will meet those needs. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans are person centred and provide the staff with appropriate information to enable them to meet people’s individual needs. EVIDENCE: We looked at four care plans, and used them to track the care and support that is provided for the people who live in Gombards. In the last year all the care plans have been reviewed and revised where needed. The care plans are clearly written, with good details of all the residents’ needs and procedures and guidelines for meeting those needs. The care plans have a person centred format, which emphasises and encourages each person’s independence. The care plans for personal care are written in the first person and include how to communicate with the resident, and praise for their participation. Each person’s assessed needs are detailed in Active Support Plans, with goals such Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 12 as socialising and communication. The Active Support Plans are clearly written, with good details and procedures for any actions that are needed. For example, one resident has a plan for helping to prepare a meal. The procedure includes encouraging them to wash and feel the texture of the vegetables, and stirring food. There are photographs of the resident carrying out each part of the activity. The behaviour guidelines for another person are written from the person’s point of view, and there is an explanation of what each behaviour may mean, that the person is in pain, frustrated etc. Everyone has a yearly Whole Life Review. The staff who we spoke to said that the care plans provide them with good information on each person’s needs, so that they are able to provide a good quality of care in the way that each person wishes. The risk assessments are also clearly written, with good details of the risks involved and the measures needed to support people to manage their risks safely. The purpose of risk assessments is to ensure that the people who live in the home can take part in the activities that they wish to. The risk assessments that we saw covered all aspects of each person’s life in the home and in the community. For example, using transport, using a wheelchair, refusing medication. In the Annual Quality Assurance assessment (AQAA) the manager said, “In the next 12 months we plan to review the risk assessment process and streamline those that are relevant and where there is actually a risk in place.” All the residents of Gombards have limited communication, and most have no verbal communication. POWhER provides an advocacy service. None of the residents are able to take any responsibility for their own finances. The home has satisfactory procedures for managing each person’s spending money. Gombards DS0000063291.V370857.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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are encouraged to make choices for their activities, and to be involved according to their abilities in developing their skills for independence. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) states, “The people we support are an active part of the local community with staff being fully aware of the facilities and services available locally.” Most people attend day services three or four days a week. Outings into the local community are arranged with the residents, and the home has its own vehicle for longer trips. Records of outings are maintained in each person’s daily notes. Planning for trips occurs on the shift planner, which enables each member of staff to arrange and support the service user in making choices to attend. The activities that are Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 14 currently listed include lunch out, going to the library, aromatherapy, touch and taste, cookery, board games, and writing to family and friends. One person went swimming with a member of staff during this inspection. One room has been converted into a sensory room, with soft seating and light and sound effects. Everyone has a scheduled time to use the sensory room, but this is flexible and two people enjoyed some time there during our visit. The home also has a portable sensory machine that encourages the residents to interact. Residents are encouraged and enabled to take part in daily living activities in the home, and the shift plans show different activities for them for each day of the week. The staff said that there has been an improvement in the active support that they provide for people, and they enjoy supporting people to take part in a wide range of activities. In one Whole Life Review it is recorded that the person’s father complimented the manager and the staff on achieving so many positive changes at Gombards over the last twelve months. One staff survey included the comment, “What the home does well is to provide active support and outings for all service users, and a basis for 1:1 support as best we can when we are staffed to give this to our service users, ensuring that in turn they all benefit from a good relationship with the staff, and that any extra needs are met in full.” Everyone is supported and encouraged to meet with their families, and families are welcomed into the home. One person states in their care plan, “I speak to my mum on the phone at the weekend. I like to sit with (another resident) and we hold hands.” Some people have befrienders who take them out to enjoy activities in the community. We did not observe a meal on this occasion, but we saw that the menus offer a balanced and nutritious diet. There is a two weekly alternating menu, which is the same on both floors. The meals are cooked separately in the kitchen on each floor, and the daily shift planner details what should be cooked each day. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced team of staff, who have the training and skills to provide a good quality of care for the people who live in the home, and to ensure that individual needs, choices and preferences are met at all times. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) states, “We provide support according to the person we are supporting and their individual needs and preferences, enabling them to have as much control over this as possible, ensuring we maintain the dignity and privacy of the people we are supporting whist doing this. The person centred plans detail exactly how, when, and where etc a person wishes their care to take place and how.” The care plans that we saw provide good details of the residents’ personal care and health care needs (see Individual Needs and Choices), and we observed a good relationship between the staff and the residents. The care plans have clear guidelines for how each person likes to be supported with their personal care Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 16 needs. For example, “I like to be involved in choosing my clothes.” “I can lift my arms up to shoulder high and lift my legs to assist with dressing.” The home has a good relationship and professional support from medical professionals, including appropriate referrals for Speech and Language and Occupational Therapy assessments. The care plans contain clear guidelines for management of challenging behaviour and for epilepsy where needed. The district nurse provides support for any concerns about skin care, and the staff are aware of good skin care practices to prevent pressure sores. Food and fluid charts are maintained for every resident, and they are weighed regularly. One person has a PEG feed. The district nurse provides support for the staff in managing this, and there is good information in the home on the procedures and safeguards. The staff who we spoke to feel confident that they have good information and support to meet each person’s health needs. Medication is stored separately for the residents on the ground floor and the first floor. There are appropriate procedures for administering medication, and is a weekly audit of the MAR (medication administration record) charts and of the stocks of medication. However the audit only checks that there are sufficient stocks of each medication in place, and there is no tally of the stocks with the MAR (medication administration record) chart to check that medicines have been administered correctly. The audit also does not check if there is too large a stock of medicines. We saw large supplies of paracetamol for two people, and more had been ordered when it was not needed. It was not possible to carry out an accurate audit of the PRN (when required) paracetamol for these two people, because the current MAR chart did not show what stock was in place. Another person has a prescription for paracetamol when it is needed, but there is no paracetamol for them in the home. It was reported that this person rarely needs paracetamol, and if they were in pain they would be referred to the GP. However there is a risk that another person’s medicine may be used if there is none for the person who needs it. All prescribed medicines must be kept in the home so that they are available when needed. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are encouraged and enabled to make their views and concerns known, and appropriate procedures are in place to ensure that they are protected from abuse and neglect. EVIDENCE: The complaints policy contains clear definitions to differentiate concerns and complaints, and appropriate procedures for investigating any complaints. The action plan following the last inspection stated, “The manager has put in place an operational complaints file in line with United Response policy which shows the process of investigation, the outcome and any action taken.” There has been only one complaint to the home since the last inspection, and the complainant also contacted CSCI. This was concerning activities for one of the people in the home. Changes have been made as a result, and the complainant is now happy with the outcome. All the staff have received training in prevention of abuse as part of the company’s comprehensive induction programme. The support workers are aware of their responsibilities and the procedures for reporting any concerns. The Annual Quality Assurance Assessment (AQAA) states, “Staff are encouraged to report any concerns they have even if just a feeling that something is wrong.” Everyone who completed a survey for this inspection said Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 18 that they know what to do if a resident or relative has concerns about the home. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and well-maintained environment for the people who live there, and the staff maintain a good standard of cleanliness. EVIDENCE: The building is detached house. It was designed and newly built for the service and it is situated on an access road behind Old Welwyn High Street. It was built as two self contained units each catering for four service users with learning and physical disabilities. It is furnished and decorated in domestic styles that produce a homely, comfortable environment, which allows the residents to relax and feel at home. The residents all have their own rooms, arranged and decorated to reflect their particular interests and tastes. The lounge, dining room and kitchen are domestic in style and are comfortably furnished and well equipped. In the last year the lounges have been decorated Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 20 and new flooring has been laid, which looks modern and attractive. The sensory room has been completed, and it provides a calm environment with soft seating, and lighting and sound effects. The home has a small garden that is accessed from the ground floor lounge, and there are plans to improve this area and to make it more accessible for everyone in the home. The home has appropriate equipment for the residents, including track hoisting in the bathrooms and lounges, and in the bedrooms of the residents who need it. One resident has a specially designed toilet seat, and several residents have their own specially designed seating systems and wheelchairs. The home is generally well maintained, and the hoists and lifts are serviced regularly. The Annual Quality Assurance Assessment (AQAA) states, “Monthly environmental checks take place to identify any health and safety or maintenance issues - we have a maintenance agreement with Aldwyck and this includes 24 hour call out for emergencies.” The home appeared to be clean, and the staff follow appropriate procedures to maintain hygiene and prevent the risk of infection. The staff store food for their own lunches in the fridges in the kitchens. There is minimal risk that the people in the home would have access to this. However it would be good practice to label all staff food clearly, so that there is no risk of it being given to the residents. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are supported by a stable staff team who have the experience and training to understand and meet their needs. EVIDENCE: The staff who completed surveys for this inspection said that they feel well supported in their work, and that they have the training and information that they need to provide a good quality of care for the people who live in the home. Staff rotas show that there are five or six support workers in the home during the day and evening, and two waking night staff during the night. These levels are adequate to meet the complex needs of the residents. However there are only thirteen permanent staff in the home, and agency staff are employed on every shift. Several members of staff commented on this in the surveys. Two people said that what the home could do better is to employ more full time staff. One person said, “Unfortunately high volume of agency staffing can cause inconsistency for the people we support, but usually the Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 22 same agency staff are requested so this adds some stability to our service users needs.” There is an ongoing programme of recruitment, and a pilot scheme is taking place with an agency to recruit more permanent staff. The daily schedules are very detailed, and specify which support worker will provide care or support for each resident for all periods throughout the day. This ensures that the residents’ assessed needs are fully met as described in their care plans. Everyone said that the management and the other staff are supportive to the new staff, and they have good information from the shift plans and care plans on what to do each day, and what each person needs. United Response provides comprehensive training for staff that covers all mandatory training in first aid, moving and handling, fire safety, food hygiene, etc, and training to meet special needs the residents have such as epilepsy and behavioural problems. The staff who completed surveys confirmed that the have appropriate training. One person said, “The company always ensure up to date training is provided, any new information is fed back immediately, any problems between staff are dealt with in a constructive way involving staff and service managers.” There is a comprehensive induction programme that includes 5½ days of mandatory training. The company is aiming to ensure that all the staff have completed their mandatory induction training, and they should then register for NVQ training. The action plan following the last inspection stated that four staff were identified for NVQ training from January 2008. The Annual Quality Assurance Assessment (AQAA) provided information that 7 people have a qualification at NVQ2 or above, and four are working towards it. This is a great improvement, and indicates that almost 80 of the staff are achieving qualifications for their work. The manager said that the recruitment procedures followed by the company are robust and that he sees all the information on each applicant during the recruitment process. All staff information is now kept in the home. We saw the files of two members of staff who have been employed in the last year. They contained all the required information to show that they are fit to work with vulnerable people, including CRB (Criminal Record Bureau) disclosures and appropriate references. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed for the benefit of the people who live there, and their views are actively sought and acted on. EVIDENCE: The manager was appointed in October 2006. He has completed NVQ level 4 in Health and Social Care, and he has registered for the Registered Managers Award. He is qualified as a NVQ assessor and as a moving and handling trainer. There are two deputy managers, who each oversee the care provided in one of the units. The staff who we spoke to said that the managers support them in their work. One staff survey said, “Management is supportive and Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 24 efficient.” Another said that there is nothing that the home could do to improve. “All service users needs are met and all staff have good working methods, and work together, management team are always available to discuss any concerns as they may arise.” United Response has established a robust system for quality assurance, which includes quarterly service audits of the home, with recommendations for any actions needed. The action plan following the last inspection stated, “Yearly questionnaires are sent out to families/ professionals etc to get feedback on what has happened, what they would like to happen.” The manager said that he follows up on suggestions and comments from these questionnaires. The home maintains appropriate records for the health and safety of the residents and staff in the home, including monitoring hot water temperatures, checks of fire equipment and regular fire drills. All the staff have regular training in moving and handling, fire safety, and food hygiene. Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 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 3 30 3 STAFFING Standard No Score 31 3 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 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Timescale for action Measures must be put in place to 30/11/08 ensure that medication is audited effectively, and that any errors in medication are noted and rectified without delay. A Previous timescale of 29/02/08 met in part, but further improvements are needed. Requirement 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 Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 27 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 Gombards DS0000063291.V370857.R01.S.doc Version 5.2 Page 28 - 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!