Care Home: Inglenook House

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What the care home does well Inglenook is a friendly and comfortable home. The residents have lived there for a long time, and are used to each other and the staff who support them. This means that the staff understand residents even if they do not say what they need, and know how to help them look after themselves very well. Residents have nice bedrooms that are arranged to suit them. They have interesting things to do each day, and go on holiday each year. What has improved since the last inspection? Now residents go to shops with staff to buy their own clothes. Residents` money is better organised, to make sure it is spent in their best interest. More activities have been provided for residents, at home and around the local community. The patio area has been made to look much better, and people have enjoyed spending time out there. They have grown flowers in pots, and enjoyed barbequesStaff have started a scrap book to keep photos to remind residents of nice days out they have had, and interesting things they have done. There has been more staff training to make sure they know what to do to support residents in the best way. A representative of the company running Inglenook had visited monthly to check that it has been properly managed. More frequent waste collections had been arranged, to improve hygienic conditions. What the care home could do better: The Home owner needs to make better arrangements to cover for when staff are off sick, so that residents can still get the support they need. A new medicine cupboard had been provided, but it had not been attached to a solid wall. The house does not have enough storage room, particularly now that some residents need mobility aids. Staff need to think carefully and not store things in resident` rooms which do not belong to them, as this is intrusive. CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Inglenook House 46 Lipson Road Lipson Plymouth Devon PL4 8RG Lead Inspector Stella Lindsay Key Inspection (unannounced) 1st September 2008 2:30 Inglenook House DS0000003533.V368002.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 Inglenook House DS0000003533.V368002.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 Older People and 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. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Inglenook House Address 46 Lipson Road Lipson Plymouth Devon PL4 8RG 01752 229448 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) clearviewpl4@btopenworld.com Jan Limited Mrs Dawn Florence Bartlett Care Home 10 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (10), Physical disability (10) of places Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Learning disabled adults some of whom may have a physical disability Age 18yrs Date of last inspection 4th September 2007 Brief Description of the Service: Inglenook House is a care home registered to accommodate up to ten adults with a learning disability, some of whom may also have a physical disability. The range of needs catered for includes men and women with medium to high levels of dependency. The house is a large, terraced property in the Lipson area of Plymouth and is close to the city centre and local shops and parks. Service users are accommodated in six single rooms, and two that are large enough to accommodate two people. There is a lounge, a separate dining area, kitchen, laundry, and garden/patio area. There is level access to the patio, and a ramp that can be fitted to the front entrance to enable residents who require the use of a wheelchair to get in and out. The fees charged are between £600 and £960. Additional charges are made for hairdressing, chiropody, toiletries, transport, and holiday spending money. The Statement of Purpose and Service User Guide are available from the office at Inglenook, and each person at the home has their own copy. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection took place over the 1st and 2nd September and was unannounced. It involved a tour of the premises and meeting with or observing all the residents. Some showed us their private room. We shared lunch and spent some time in the lounge. This approach is to help us see what life is like for the people who live at the home. We met with the Registered Manager, the home owner, and four staff on duty. The Registered Manager gave us their annual quality assurance assessment (AQAA). It was clear and gave us all the information we asked for. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some statistical and technical information about the service. Prior to the unannounced inspection we sent questionnaires to people who live at the home, and to people who work there. Four residents and six staff completed and returned these. What the service does well: What has improved since the last inspection? Now residents go to shops with staff to buy their own clothes. Residents’ money is better organised, to make sure it is spent in their best interest. More activities have been provided for residents, at home and around the local community. The patio area has been made to look much better, and people have enjoyed spending time out there. They have grown flowers in pots, and enjoyed barbeques. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 6 Staff have started a scrap book to keep photos to remind residents of nice days out they have had, and interesting things they have done. There has been more staff training to make sure they know what to do to support residents in the best way. A representative of the company running Inglenook had visited monthly to check that it has been properly managed. More frequent waste collections had been arranged, to improve hygienic conditions. 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. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Clear information is available for prospective residents, and their needs will be fully assessed before accommodation is offered. EVIDENCE: We were given a copy of the Service Users’ Guide for Inglenook, which had been up-dated in July, with added photos of the house, the people who live and who work there, and photos of local places including the park and the Post Office. Each resident had one complied for themselves, with a picture of themselves on the front, and another of their keyworker. A statement of purpose is also available, letting people know what can be offered at Inglenook. The Manager said they had produced a brochure for new residents, Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 9 to tell them what is available at Inglenook, and what they can access in the local community. There had been no admissions since the last inspection. The records of the most recently admitted resident included a record of consultation with their family, and a copy of a letter sent to say how Inglenook was suitable for meeting their needs. All the residents who filled in questionnaires said that they had been asked whether they wanted to move into this home, and all but one said they had been given enough information about it. Each resident had been given a statement of terms, and those we saw had been signed on behalf of the resident by a family member or representative. They included an agreement that the resident’s Disability Living Allowance would be used as a contribution towards their travel costs. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Staff are able to understand the residents’ care needs and provide support in the way they prefer, encouraging people to do what they can for themselves in a safe way. EVIDENCE: All residents had care plans with detailed information about their general health and medical conditions, and we looked at three in detail. Their preferred daily routine was written out with precise instructions to staff on how to meet their personal needs and encourage and enable them to do things Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 11 themselves. Some of the people at Inglenook would not be able to explain this themselves, so it is important that staff know what has been agreed as the best way. A new form had been introduced for each staff member to sign to say they read and understood each resident’s care plan. Their weekly routine of activities was charted, including activities inside and out of the home and visits with family and friends. Aims and objectives were recorded. Guidance was included from the Challenging Behaviour Service, and reports and assessments from Speech and Language Therapists and Occupational Therapists had informed the plans. Care plans had been reviewed during staff meetings to make sure that team members had a chance to give their observations and hear advice on any changes. Although residents were in general unable to give evidence of collaborating in these plans, the detail in the observations showed that staff were fully involved with the resident while drawing them up. The registered provider was appointee for the residents. Records were kept in the home of fees paid, and statements from residents’ bank accounts were available for inspection. Money from their Disability Living Allowance is paid towards their transport costs. This varied according to the amount of assistance they need, rather than the amount they travel. The Manager told us that most residents use the home’s vehicle every day. Some had been supported to obtain bus passes, and the Manager was in the process of drawing up risk assessments in order to safely promote their use of public transport. Risk assessments had been considered in order to protect residents, and enable them to join in their preferred activities with their particular needs carefully provided for. This included medical emergencies as well as selfinjurious behaviour and other challenging behaviour. Reports on file showed that health and social service staff appreciated the work achieved at Inglenook, for example, ‘Relevant care plan aims have been achieved’, and ‘the interaction I have observed with the staff has been good, with them naturally adopting an intensive interaction style.’ The four residents who returned surveys all said that the staff treat them well and listen to what they say. All except one said they could make decisions about what they do every day. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. Service users find the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) 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 are is good. This judgement has been made using available evidence including a visit to this service. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 13 Residents have opportunities to be involved in meaningful activities within and outside the home. EVIDENCE: We saw that residents were engaged on activities with staff throughout our visit. All the service users who returned surveys said they could do what they want at various times of day. People had enjoyed baking, and though staff cooked the main meals, some residents had helped with clearing and washing the dishes. One staff member was trying to engage a resident in tidying and cleaning their room, but had found they were not all accustomed to doing this, and needed encouragement. Staff and residents were still adapting to life without the day services that had been withdrawn. When we arrived at the start of this inspection, one resident was out with a Support Worker, returning with new clothes from the shops. A group of residents and staff were looking forward to a disco that evening. The Manager told us that two residents attended a weekly gym session, and one had become involved with a local drop-in centre. Some residents enjoyed swimming, and some liked going out for walks. All had a weekly chart showing planned activities, and we could see that the plans were adhered to. A camera had been obtained, and staff were planning to keep a photographic record of activities, to help people remember and choose. One resident said they would like to go out to work again. The Manager agreed to investigate possibilities. One resident regularly visited a family member and enjoyed weekend visits home. Plans were being made for a holiday in Ilfracombe. All the residents were going. They would be staying in small groups in five chalets, so that staff would be able to respond to different choices for activities, meals and daily routines. The Manager said that residents had been involved in menu planning, looking through menu books for the week’s meals. Menu choices for two residents who needed directing in their dietary intake, were easily accessible in the kitchen. Three residents chose to take their meals in the lounge, as they preferred each other’s company. It also made it easier to serve the meals, allowing more room around the dining table. Staff did not eat with the residents. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and healthcare support is provided in a person centred way, with competence, care and attention to detail. EVIDENCE: Staff were aware of residents’ preferred way of having their personal care needs met, and enabled them to choose the worker to support them when possible. Staff said they were proud of the level of personal care and emotional support they were able to provide – ‘very professional, and providing the residents with dignity and respect.’ Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 15 We saw that care plans for particular medical conditions had been written, to ensure that staff knew what support was needed. A Specialist Nurse had helped the team to draw up Health Action plans for the residents. It was clear that professional assessment had been obtained to help residents as their mobility declined. One was being assessed for a wheelchair. Staff had received training with respect to diabetes. Specific staff had been trained to carry out an invasive procedure with the express consent of the individual. A member of the Challenging Behaviour Team had been invited to discuss with the team the best practice in addressing one resident’s problems. A staff member said, ‘if changes are needed, they are talked about by the staff as a team, then the right agencies are called for help or suggestions.’ The home had a policy and procedure for the safe administration of medication, which staff followed to promote and maintain the residents’ good health. No residents were assessed as being capable of administering their own medication. No residents were prescribed Controlled Drugs at the time of this inspection. A new medicine cupboard had been provided, but it had been fixed to a partition wall. There was a solid wall adjacent, and the Service Provider agreed to move it, to improve security. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Good practice in this area was underpinned by sound policies and staff training, to ensure protection of residents. EVIDENCE: The Commission for Social Care Inspection had not received any complaints about this service. The Manager said that she had received a complaint from another service about the actions of a staff member when out with a resident. She had looked into this and found that the staff member had acted properly in the circumstances, and had made arrangements to prevent these circumstances recurring. We saw that staff had good understanding of the residents and their needs. The Manager was confident that they or their relatives would make it known if they had any worries, and no complaints had been received. They had been given an opportunity each year to give feedback and any comments on the service provided. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 17 The home had a sound policy and procedure in place to advise staff on what to do in the event of any allegation being made. The Manager had called appropriately for the care manager and the safeguarding team when there had been an incident of concern to the wellbeing of certain residents. Staff had received training in the Protection of Vulnerable Adults, and were aware of the Alerters’ Guidance and their duty to report any concerns. Some of the residents did not have close family, and may need an advocate to help them when life decisions are needed. At times of change, the Manager should request professional assessment for individuals’ capacity to make decisions. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Inglenook provides a safe and comfortable home for the residents. EVIDENCE: We looked round the home, and found that it was in good decorative order. The house remains not easy for wheelchair users to get around; however, with improved bathing facilities and one fewer occupant, problems are eased. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 19 Staff were helping residents to organise their rooms to suit them. A curtain pole was being provided to suit a resident who could not manage their curtains how they were. One resident had just got a room to themselves after sharing for a long time, and were now able to display more of their own belongings. Two others were still sharing after many years. One needed a monitoring device because of their health problems, and to have objects put away for protection, and this affected the liberty of the other. The home owner was considering plans that might ameliorate this situation. The bedroom doors had suitable locks to provide privacy without any danger of a resident being locked in. Some residents had developed mobility problems, and had mobility aids. The home has limited storage space, and some equipment, including the carpet cleaner, was seen to be stored in the rooms of residents that it did not belong to. This should be avoided where possible, as it is an intrusion into their privacy and space. In the previous inspection it was noted that there is insufficient space for wheelchairs in the lounge, and they are “parked” in front of armchairs or sofas. This means then means that there the person in the wheelchair would have difficulty communicating with the people sitting with them, as sometimes people had to sit behind the person in the wheelchair. We saw that two of the three wheelchair users often transferred into easy chairs in the lounge, but there was still one person who was likely to be in their wheelchair without a space to ‘park’ it. Two new showers had been provided. The downstairs bathroom had been converted into a ‘wet room’, which had made bathing safer and more enjoyable for the residents. A shower had also been installed in the upstairs bathroom. There was a removable ramp to enable people in wheelchairs to use the front door. There is access to the patio from the dining room, and this area had been improved with planters and people said they had enjoyed being out there this summer, including a barbeque. The laundry is at a lower level from the patio, and not accessible to residents. Its floor had been resurfaced, and was washable though not entirely smooth, and the walls were not easily washable. Improvements had been made in the collection of waste, and the way the laundry was used for storage, to improve hygiene. There was no report from the Environmental Health Officer, so it was not evident that their advice had been sought with respect to storage and bins in the laundry. Although the home was generally clean there were two areas where there were unpleasant odours. One instance was a household task that had been missed by a Support Worker; however, staff said it was difficult to keep the house free from odours without the domestic, and she was employed elsewhere by the company at the time of this inspection. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Staff are caring, competent and well trained, and usually employed in sufficient numbers to meet the residents’ personal and social needs. EVIDENCE: There is a written rota, which shows that there were always a minimum of three staff on duty, except at night when there is one awake carer and one asleep. There were up to five staff on duty at times to ensure that residents could attend appointments and enjoy activities. During this inspection there were sufficient staff to enable residents to take part in their planned activities, Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 21 and staff who spoke to us or wrote in surveys said that the staff levels were sufficient except that sometimes it had not been possible to cover for absence – if staff were sick when other were on holiday, for instance. This could lead to difficulty in meeting residents’ needs. The homeowner should consider ways of supplying this need satisfactorily. At the time of this inspection the cleaner was needed elsewhere in the company to cover for absence, which was leading to a shortfall in standards at Inglenook. The team had ordered their daily planning better, marking with colours on the rota to show who would be supporting specific residents to get ready for breakfast, and who would be attending activities with them. We could see that staff knew the residents well and had developed effective communication with them. A thorough induction programme had been implemented within the home for new staff members, and existing staff were also working through it to recap on their knowledge. 50 of the care staff had achieved at least the equivalent of NVQ2. We looked at the files of two recently recruited staff, and all checks needed to ensure protection from potential harm had been made. The Manager said that applicants are invited to Inglenook to complete the application forms in the dining room, where residents may meet with them, and staff may observe their interactions. This is to ensure that staff who can relate well to the residents are appointed. The new staff had already received training in fire safety. They were expected to sign a declaration saying that they had read and understood all the residents’ care plans, but not all of them had done this. The Manager kept a matrix to show staff achievement in training, and which updates were necessary. This helped with planning the training. This showed that almost all staff were up to date with Moving and Handling training, and basic food hygiene. They had achieved a variety of other courses including Total Communication, and Person Centred Planning, and training in epilepsy and dementia care were pending. Staff were very positive about the training provided to help them meet the residents’ particular needs, and about the support and supervision given by the Manager. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. Service users live in a home which is run and managed by a person who is fit to be in charge of good character and able to discharge his or her responsibilities fully. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a safe and well-managed home. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 23 EVIDENCE: The Manager, Dawn Bartlett, has worked at Inglenook for many years and has significant experience of working with people with a learning disability. She has achieved the Registered Managers’ Award and NVQ level 4. Mandy Nicholson is the Responsible Individual for the company and is a regular visitor to the home. She completes monthly reports about the running of the home in accordance with regulation 26. She told us of her plans for the service, which were in line with currently recognised good practice. Staff said they felt well supported in their work. Some said that communication at handover could be better, as sometimes there was confusion, but in general people felt that teamwork was good. The Manager said she felt more staff meetings would be helpful. One had been held the previous week, which had included necessary up-dates about residents’ health and welfare as well as the forthcoming residents’ holiday, and a request for help for all residents to complete their Quality Assurance forms. The Manager said that following the previous gathering of feedback for quality assurance, suggestions had been received and put into practice. These had included activities, and arrangements and decoration for residents’ rooms. We looked at some health and safety records including the records of fire safety in the home. The fire precaution system had been serviced professionally on 25/04/08, risk assessments had been reviewed on 31/08/08, and staff training in fire safety had been provided to 12 staff on 20/05/08. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 24 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. Where there is no score against a standard it has not been looked at during this inspection. 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 1 2 3 4 5 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 3 43 X 3 3 X X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Inglenook House Score 3 3 3 X DS0000003533.V368002.R01.S.doc Version 5.2 Page 25 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. 1. 2. 3. 4. Refer to Standard YA20 YA24 YA33 YA30 Good Practice Recommendations The medicine cupboard should be fixed to a solid wall. Best use of space should be reviewed, to make sure people have room to live comfortably, and do not have objects that are not their own stored in their private room. The home owner should make effective arrangements for covering for staff absence. The advice of the Environmental Health Officer should be sought about the use of the laundry as bin and food storage area. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Inglenook House DS0000003533.V368002.R01.S.doc Version 5.2 Page 27 - 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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