Care Home: James Phoenix House

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What the care home does well James Phoenix House is an established respite care service, which is valued by the people who use the service and their representatives including relatives and health care professionals. The home`s care planning systems are person centred and outward looking so people are helped to life fulfilling lives. Because the people who use the service are not always able to state their preferences, family members are usually asked for information about the person`s needs, lifestyle, likes, dislikes and morning, afternoon and evening routines. In this way each person`s diverse needs are recognised and recorded so care staff have the guidance they need to provide care in the way the individual prefers. Staff were seen to work as an effective team. They carried out their work with sensitivity and skill, communicating effectively with the people who use theservice, so people`s needs were met in the way they preferred. When we asked one person what they liked best about the home they said the staff. Many of the staff had long experience at the home and others were new but had brought complementary skills to the staff team. Staff told us they enjoy good working relationships and support one another by sharing skills and knowledge so they can meet the needs of the people who use the service in the most effective way. Staff benefit from training that is targeted and focused on improving outcomes for the people who use the service. More than 70% of the staff have or are working towards National Vocational Qualifications at level 2 or 3 in care and four staff members are working towards the Learning Disability Award. This shows us that staff are experienced, well trained and skilled so the people who use the service are in safe hands. The manager is experienced and qualified to run the home. Staff receive the support, leadership and guidance they need and operate as an effective team so people receive a consistent and reliable service. What has improved since the last inspection? Managers and staff have worked consistently with the people who use the service and their representatives, including relatives and other health and social care professionals, to improve communication and the home`s care planning arrangements. This has had positive outcomes for the people who use the service. Each person has a care plan that confirms their needs, likes, dislikes and personal preferences so they receive care and support in the way they prefer. Some care plans have been illustrated with pictures, photographs and symbols and the complaints procedure has been produced in an easy read format so people who do not read are helped to understand the information. Some risk assessments have been improved so people are safe and are involved in important decisions about their lives. Parts of the home have been redecorated and maintenance tasks have been carried out so people live in pleasant surroundings and are comfortable and safe. What the care home could do better: Managers and senior staff should make sure that the assessment process is completed in sufficient time to confirm, in writing, that the home is suitable to meet the individual`s needs before they use the service. This is an important part of the assessment and care planning process, which should be donebefore the individual makes an overnight stay so they and the staff know that their needs can be met at the home. Risk needs to be assessed and any risk management plans recorded and agreed before the individual uses the service so the individual is safe and their wellbeing assured. Any limitations on a person`s freedom of movement or power to make decisions that are put in place for their safety need to be recorded on the risk assessment and care plan and agreed with the individual or someone acting on their behalf. This will ensure that the individuals` rights are promoted. People should be invited to sign and agree their care plans so they can confirm that they are happy with the way their care is to be provided. Locks should be provided on all bedroom doors to promote privacy and provide at least one comfortable chair should be provided in each bedroom so people can sit in comfort in their rooms if they choose. CARE HOME ADULTS 18-65 James Phoenix House Hilden Road Padgate Warrington Cheshire WA2 0JP Lead Inspector David Jones Key Unannounced Inspection 5 and 9 September 2008 09:50 James Phoenix House DS0000036270.V365007.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 James Phoenix House DS0000036270.V365007.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. James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service James Phoenix House Address Hilden Road Padgate Warrington Cheshire WA2 0JP 01925 815586 01925 826387 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) Warrington Borough Council Ms Samantha Jane Duncan Care Home 10 Category(ies) of Learning disability (10) registration, with number of places James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of ten (10) service users in the category of LD (Learning disability) 24 August 2007 Date of last inspection Brief Description of the Service: James Phoenix House is owned and managed by Warrington Borough Council and is part of the Social Services Special Needs and Disability Division. The premises, a two-storey building with garden and parking areas, are situated in the Padgate area of Warrington. The service provides short-term care for adults who have a learning disability and live within the Borough of Warrington. Although the home is registered for ten service users, only eight people are accommodated for short-term care at any one time. A ninth bed is kept for emergency admissions. Information about James Phoenix House including copies of the most recent inspection report is made available to each person who use the service and can be acquired by contacting the home on the telephone number given above. For people paying the full cost of their care the fees for the home are £430.84 per week. James Phoenix House DS0000036270.V365007.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 stars. This means the people who use this service experience good quality outcomes This key inspection was unannounced. The visit to the home took place over two days and took 11 hours and 10 minutes in total. It started at 9:50 pm on the first day. This visit was just one part of the inspection. Before the visit took place we (the commission) asked the registered manager to complete a document called Annual Quality Assurance assessment or AQAA for short. We ask all services to complete this document once a year. It gives us information about how the home is meeting the needs of the people who use the service and includes future plans for further development. We made survey questionnaires available for the people who use the service and the staff. Their views about the home have been taken into account. We also looked at the information that we already had about the service and this with the information from the AQAA helped us to form our inspection plan. Records for two of the people who use the service were checked to see the care they receive. Some people were spoken with and their views taken into account. We also visited Warrington Borough Council’s Personal Department at their offices in Warrington Town Centre so we could check staff recruitment records. Some of the home’s policies and procedures were also checked. What the service does well: James Phoenix House is an established respite care service, which is valued by the people who use the service and their representatives including relatives and health care professionals. The home’s care planning systems are person centred and outward looking so people are helped to life fulfilling lives. Because the people who use the service are not always able to state their preferences, family members are usually asked for information about the person’s needs, lifestyle, likes, dislikes and morning, afternoon and evening routines. In this way each person’s diverse needs are recognised and recorded so care staff have the guidance they need to provide care in the way the individual prefers. Staff were seen to work as an effective team. They carried out their work with sensitivity and skill, communicating effectively with the people who use the James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 6 service, so people’s needs were met in the way they preferred. When we asked one person what they liked best about the home they said the staff. Many of the staff had long experience at the home and others were new but had brought complementary skills to the staff team. Staff told us they enjoy good working relationships and support one another by sharing skills and knowledge so they can meet the needs of the people who use the service in the most effective way. Staff benefit from training that is targeted and focused on improving outcomes for the people who use the service. More than 70 of the staff have or are working towards National Vocational Qualifications at level 2 or 3 in care and four staff members are working towards the Learning Disability Award. This shows us that staff are experienced, well trained and skilled so the people who use the service are in safe hands. The manager is experienced and qualified to run the home. Staff receive the support, leadership and guidance they need and operate as an effective team so people receive a consistent and reliable service. What has improved since the last inspection? What they could do better: Managers and senior staff should make sure that the assessment process is completed in sufficient time to confirm, in writing, that the home is suitable to meet the individual’s needs before they use the service. This is an important part of the assessment and care planning process, which should be done James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 7 before the individual makes an overnight stay so they and the staff know that their needs can be met at the home. Risk needs to be assessed and any risk management plans recorded and agreed before the individual uses the service so the individual is safe and their wellbeing assured. Any limitations on a person’s freedom of movement or power to make decisions that are put in place for their safety need to be recorded on the risk assessment and care plan and agreed with the individual or someone acting on their behalf. This will ensure that the individuals’ rights are promoted. People should be invited to sign and agree their care plans so they can confirm that they are happy with the way their care is to be provided. Locks should be provided on all bedroom doors to promote privacy and provide at least one comfortable chair should be provided in each bedroom so people can sit in comfort in their rooms if they choose. 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. James Phoenix House DS0000036270.V365007.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 James Phoenix House DS0000036270.V365007.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): 1, 2, 3, and 4 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People who are interested in using the services provided by James Phoenix House have their needs assessed so they know their needs can be met at the home. They are given useful information about the home and are encouraged to visit before they make an overnight stay so they can be confident that the service is suitable for them. EVIDENCE: Four people who use the service returned our survey questionnaires. All of them told us that they had received enough information about the home so they could decide it was the right place for them. The home has a statement of purpose, a welcome guide, and a service users guide. The statement of purpose needs to be revised so people have confirmation of the visiting arrangements for the home. The welcome guide, the service users guide and complaints procedure are illustrated with photographs and symbols so people are helped to understand the information. The manager and staff are aware of the importance of providing information in a way that is accessible to all people who use the service. They are working with the people who use the service and their James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 10 representatives including health and social care professionals to develop and improve methods of communication used in the home. Consideration should be given to producing the statement of purpose and service users guide in an audiovisual format. This may help people who do not use Makaton (a specialist sign language) or relate to symbols to understand the information. There are good procedures for introducing new people to the home. Records show that a care management assessment is received following referral from the social work team. Senior staff use this information to form the basis of their assessment as to whether the home is able to meet the individual’s needs. They visit the individual in their own home and carry out a more detailed care needs assessment. Because the people who use the service are not always able to state their preferences family members are usually asked for information about the person’s needs, lifestyle, likes, dislikes and morning, afternoon and evening routines. In this way each person’s diverse needs are recognised and recorded so care staff have the guidance they need to provide care in the way the individual prefers. The individual is encouraged to visit before they make an overnight stay so they can familiarise themselves with the home and make an informed choice about staying there. Care records for two of the people who use the service were read as part of the inspection. Both people had a thorough needs assessment in place before they were provided with the service. However, it was noted that the care management assessment for one person was received the day before they were due to make an overnight stay at the home. This meant that staff did not have sufficient time write to the individual and/or their representatives to confirm how their needs were to be met before they actually used the service. This is an important part of the assessment and care planning process, which should be done before the individual makes an overnight stay. It will give the person confidence in the home’s abilities to meet their needs in the way they would prefer and it provides them or their representatives with an opportunity to query and correct any misunderstandings. The home’s admissions procedures were not confirmed in writing for the guidance of staff. The manager took action to address this issue and produced a written admissions procedure before the end of the inspection. James Phoenix House DS0000036270.V365007.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 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The people who use the services provided by James Phoenix House are supported to play an active role in the planning of their care and support so they receive the care and support they need in the way they prefer. EVIDENCE: The manager and staff believe it is essential to involve people in planning the care that affects their lifestyle and quality of life. All of the people who use the service have a care plan that is written in the first person so their needs are expressed as they would describe them. Both of the care plans seen were written in plain language and covered all areas of the individual’s life, including health and personal care needs, communication and personal preferences. Some care plans are illustrated with pictures, photographs and symbols so people who do not read are helped to understand the information. The manager told us that care plans were always written with the individual. However, the care plans seen were not signed by the individual or someone James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 12 acting on their behalf. We recommend that the people who use the service or their representatives are invited to sign and date their care plans so they can confirm that care is to be provided in the way they prefer. Records show that the people who use the service are helped to make choices about their daily lives, including when they get up and go to bed, what they wish to wear and eat and what they want to do in the evenings and at weekends for recreation and leisure. Limitations on choice and liberty to make their own decisions are only made in the person’s best interest. However the decision-making process was not always recorded in sufficient detail. For example, staff had identified through care planning and risk assessment that one person did not chew their food well and on occasion will eat so much they were prone to vomiting at nighttime in bed. Records showed that staff had intervened when the individual had eaten too much by restricting their access to food. The hazards of choking were documented in the person’s case records but the control measure of restricting access to food was not recorded in their care plan or risk assessment document. It is important that the decision making process is recorded and agreed with the individual and, where appropriate, their advocates and representatives including family members and health and social care professionals. This needs to be done to promote the individual’s rights and to comply with the Mental Capacity Act. The manager told us that she was systematically working through each person’s case file drafting risk assessments and updating existing ones so all people who used the service were safeguarded from avoidable risks to their health and safety. Risk assessments were clear and had been signed and agreed by the individual and key staff at the home. However, the case file for one person did not contain a risk assessment. The manager told us that risk assessments are normally drafted after the person has stayed at the home for the first time. We recommend that risk assessments are drafted before the individual stays at the home. Potential hazards and risks that may be presented to the individual should be identified during the initial assessment process. Where hazards and unnecessary risks to the individual’s safety are identified a risk management plan should be developed and agreed with the individual and their representatives where necessary. James Phoenix House DS0000036270.V365007.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 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People who use the service have a range of activities available to them and can take part in ordinary domestic routines in the home so they can live the life they choose and develop independent living skills. EVIDENCE: James Phoenix House has a welcoming, busy and sociable atmosphere. We observed good relationships between the staff and the people who use the service. Staff were seen to use communication aids to help people express themselves. People were enjoying friendly and good-humoured exchanges with staff and it was clear that they were happy to be at the home and were having fun. All of the people who responded to the survey told us that suitable activities were always or usually available. The staff to client ratio is relatively high. There were six staff members on duty with seven people staying at the home James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 14 on the evening of the inspection. This meant that care staff had enough time to sit and talk with people and support them in their chosen activity on a one to one basis, where necessary. The home shares a minibus with a local day centre and has unrestricted use of the vehicle at weekends and bank holidays. Staff told us that the home offers a range of activities in the community including the cinema, shopping, going to cafés and local pubs. One staff member supported one of the people who used the service to attend their usual Friday Night Social Club. They escorted them to the club and arranged to pick them up later in the evening. Some of the people who use the service have a communication book which travels with them between the home, the day centre and their own home. This helps to keep their families and day centre staff informed about the person’s stay. The manager told us that the TV had been moved out of the main lounge to encourage social interaction. Staff were seen to encourage people to enjoy each other’s company so they could develop relationships and friendships with one another. The TV had been put in room that had a settee and comfortable chairs so people could watch their favourite programmes undisturbed. People who use the service are able to maintain personal and family relationships. There are no restrictions on visiting. People can have visitors at any reasonable time and can entertain their guests in private if they wish. However this important information is not included in the current statement of purpose. All the people who returned survey questionnaires and all those spoken with told us that the food is always or usually good. Special dietary needs are catered for and records of meals served confirm that a varied and nutritious diet is on offer. Water was always available from the water cooler, which was in the corner of the dining room. Fresh fruit was available on request. However, staff told us that there was no reason why this could not be put out in a fruit bowl in the dining room and said they would do this so people can help themselves. James Phoenix House DS0000036270.V365007.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 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs so they receive personal care in the way they prefer. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Personal health care needs, including specialist needs and dietary requirements, are recorded in each person’s care records so staff know what to do when a person is unwell including who to contact when further advice and guidance or is required. Two visiting health care professionals told us that they have good working relationships with the care staff at the home. They told us that the care staff are skilled and work in partnership with them so the needs of the people who use the service are met. All the people who responded to our survey told us that they always received the medical support needed. Records show that staff contact the person or their primary carer shortly before they are due to come to stay at the home. This is to obtain information about any changes in their needs so changes can be made to the person’s care James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 16 plan. This ensures that each person’s changing health and social care needs are met. However, one person’s medication records showed that staff had made arrangements to treat the person with homely remedies provided by their relatives before first checking out with the person’s health care professionals that the treatment was appropriate. This was raised with the senior member of staff on duty who immediately acknowledged the errors that had occurred. They consulted the district nurse who was visiting at the time and acted on their advice to refer the person to their GP for appropriate treatment. The home must make satisfactory arrangements to refer individuals to their health care professionals as and when treatment is required and should not administer homely remedies unless staff know the person’s health care advisors recommend them. A check of medication records showed that the people who live at the home received appropriate levels of support with their medication so their health care needs were met and their independence is promoted. Medication records were up to date and stocks of medication were found to be correct. James Phoenix House DS0000036270.V365007.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 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home has illustrated complaints and robust adult safeguarding procedures so the people who live at the home are able to express their concerns, are listened to and safeguarded from abuse and neglect. EVIDENCE: People who use the service are able to express their concerns and have access to an effective complaints procedure so they are listened to and their concerns are acted upon. The complaints procedure is illustrated so the people who live at the home are helped to understand the complaints process. The home had received one complaint since the last inspection. Records showed that this had been responded to appropriately. Staff training records show that staff had received training and periodic refresher training on safeguarding vulnerable people. They also have access to appropriate robust procedures for responding to suspicion or evidence of abuse so people are safeguarded from the potential for abuse. James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 18 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, 26 and 30 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home is well maintained so people who live there live in comfortable, clean surroundings that meet their needs. EVIDENCE: James Phoenix House is in Padgate, a residential are of Warrington. It has access to the local shops and public transport. A tour of the building was made, which included all of the bathrooms and toilet areas, a number of bedrooms and all communal areas. We found the home to be well maintained with good quality furnishings and fittings and clean and hygienic with no offensive odours. Staff working with the people who use the service have developed a wellequipped sensory room. This provides an interesting alternative environment in which people can relax and enjoy stimulating sights and sounds. James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 19 The bedrooms are spacious and generally well equipped but some do not have locks on the doors and some do not have chairs or appropriate bedside lights which can be operated without the person getting out of bed. We recommend that locks are fitted to bedroom doors so people can choose to lock them for security and privacy, if they wish. We also recommend that each room is equipped with at least one comfortable chair so people do not have to sit on their beds when they wish to stay in their rooms. All of the people who responded to the survey told us the home is always clean and one person told us they liked the home. Maintenance records show that electrical and gas installations, hoists and fire prevention equipment are serviced regularly so people are safe James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 People who use this service experience excellent outcomes in this area. We have made this judgement using available evidence including a visit to this service. Staff are trained, skilled and employed in sufficient numbers to meet the changing needs of people who use the service. Staff recruitment procedures are thorough to make sure that the people employed are suitable to work with vulnerable people. EVIDENCE: Staff were seen to work as an effective team. They carried out their work with sensitivity and skill, communicating effectively with the people who use the service. Many of the staff had long experience at the home and others were new but have brought complementary skills to the staff team. Staff spoken with told us that they enjoy good working relationships and support one another by sharing skills and knowledge so they can meet the needs of the people who use the service in the most effective way. The people who responded to our survey told us that staff are always or usually available and records of staff rotas worked showed us that there are always plenty of staff to meet the needs of the people who use the service. James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 21 We checked the staff recruitment files for two people who had been recruited since the last inspection and we discussed recruitment procedures with the manager and some staff. Records show that the home’s recruitment procedures are thorough so people who live at the home are safe and protected from harm and abuse. The manager told us that some people who use the service have been involved in the staff selection process so they can have a say in who provides their care and support. We talked to the manager and some staff about staff training opportunities and we looked at staff training records. All new recruits benefit from thorough induction procedures including Skills for Care common induction standards. These set down minimum expectations about learning needed so new care workers know how to work safely and effectively. More than 70 of the staff have or are working towards National Vocational Qualifications at level 2 or 3 in care and four staff members are working towards the Learning Disability Award. Staff have an annual appraisal which helps them and their managers to identify further training needs. The manager has comprehensive staff training records and was able to show us that arrangements were being made to make sure that all identified training needs are met. This showed us that the service ensures that all staff benefit from training that is targeted and focused on improving outcomes for the people who use the service. All care staff were cheerful, friendly and helpful. They told us they were well supported and appreciated the leadership and guidance provided by the manager and other senior staff. Records show that all care staff receive formal one to one supervision regularly. James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 22 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 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The service is well managed so that it is run in the best interests of the people who use it for respite care. EVIDENCE: The manager is a qualified and experienced in the care and support of people with a learning disability. She has the skills needed to manage the home effectively and ensure the well-being of the people who live there. She has an NVQ level 4 in care and is working toward the registered managers award. The home is well managed with positive outcomes for the people who use the service. Staff work together with the benefit of shared aims and objectives. They promote equality and respect diversity through person centred planning James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 23 and work effectively with health and social care professionals so people receive the care they need in the way they prefer. Managers and staff are committed to continuous improvement based on the views and changing needs of the people who live at the home. Quality assurance is approached in a number of ways. Senior managers visit the home at least once a month to satisfy themselves that the home is conducted in the best interests of the people who live there. Feedback from the people who use the service and their representatives is encouraged. The home’s medication records, financial records, and care planning records are audited regularly so people are safeguarded and their needs are met. The manager told us that the home will also survey the views of the people who stay at the home and their representatives by questionnaire. The results of the survey and information about how the home has responded to any quality issues will be published in an open report so people know their views are taken seriously and are acted upon. Warrington Borough Council promotes the health and safety of all employees and people who use James Phoenix House. The manager and other senior staff ensure that risk assessments are carried out for all working practices and significant findings are recorded and reviewed. Some risk assessments needed further development so all possible hazards are identified and managed. However, the manager responded to these findings during the inspection and took action to make sure that people were safe. Regular maintenance and safety checks are carried out at the home to ensure the safety of the staff and people who use the service. These included fire safety equipment, smoke alarms, emergency lighting, electrical wiring and portable electrical appliance checks. James Phoenix House DS0000036270.V365007.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. 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 2 3 4 5 CONCERNS AND COMPLAINTS Standard No Score 22 23 3 2 3 3 X 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X ENVIRONMENT Standard No Score 24 3 25 X 26 2 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000036270.V365007.R01.S.doc LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 James Phoenix House Score 3 2 3 X 3 X 3 X X 3 X Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard YA1 Good Practice Recommendations The statement of purpose for the home should be amended to include arrangements for visiting so people know that they can have visitors at any reasonable time if they so choose. The assessment process should be completed in sufficient time to confirm, in writing, that the home is suitable to meet the individual’s needs so they know how their needs are to be met before they stay at the home. People who use the service and/or their representatives should be asked to sign and agree their care plans so they can confirm that they are happy with the way their care is to be provided. Any decision made about any limitations on a person’s freedom of movement or power to make decisions should be recorded on the risk assessment and care plan and DS0000036270.V365007.R01.S.doc Version 5.2 Page 26 2 YA2 3 YA6 4 YA7 James Phoenix House agreed with the individual or someone acting on their behalf. This will ensure that the individuals’ rights are promoted. 5 YA9 Risk should be assessed and any risk management strategies should be recorded and agreed before the individual uses the service so the individual is safe and their wellbeing assured. Homely remedies should be used only after the individual’s health care professionals have been consulted and have confirmed that the treatment is suitable for the person so their health care needs are met. Suitable locks should be provided on all bedroom doors to promote privacy and at least one comfortable chair should be provided in each bedroom so people can sit in comfort in their rooms if they choose 6 YA19 7 YA26 James Phoenix House DS0000036270.V365007.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Region Unit 1, Level 3 Tustin Court Port Way Preston PR2 2YQ 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 James Phoenix House DS0000036270.V365007.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. 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