Care Home: Jasmine House

What the care home does well The home is clean and well decorated so it is a nice place to live. Each person has a care plan so that staff know how to support them to meet their needs. The staff were seen to have excellent relationships with the people living there and spoke to them naturally, with empathy and supporting them as they wish. This gives people a sense of wellbeing. The health needs of the people living there are met and people get the care from other professionals they need. People living there said: " I`m enjoying my life now." "I`m happy here- I`m only going to leave here in a coffin or if I win the lottery!" " The food is very good, I can`t complain." " I love the food here". " It is a nice place to live". " I like it here, I`m looked after well." Staff are recruited and selected in ways that ensure safe skilled individuals are employed. Staff have the training they need so they know how to support the people living there. Professionals said, " I know how to make a complaint. It always seems a pleasant organised well run home. The person I work with looks better now than they have done for a long time." The home has in place a quality monitoring system based on seeking the views of the people living there so they decide how improvements are made. What has improved since the last inspection? The home has been proactive in addressing the previous recommendations. A medication trolley had been provided so that people are not at risk of taking medication they are not prescribed which may make them ill. Plans were in place for as `required medicines,` so staff know when the person needs them to ensure their wellbeing. Staff monitor the hot water more closely to make sure people are not at risk of being scalded. Regulator valves had been fitted to radiators so that they do not get too hot which could increase the risk of people being scalded. What the care home could do better: Information about the home should be updated so that people have all the information they need. Mental health relapse plans should include all the information about the individual so that staff can monitor and support people to ensure their safety and well being. People should be offered an opportunity to go on holiday each year so they can see different places and experience new things.Staff should have updated training in diabetic testing to ensure the person`s well being as some practices change over time and staff need to keep updated. The protocol for people taking their own medicines should be updated in more detail. This will mean people can be more independent but they can safely take their medicines. There should be regular staff meetings and staff should have regular supervision so that they are supported and know how to meet the needs of the people living there. Staff should have updated training in fire safety and the fire risk assessment should be reviewed so that the risks of there being a fire are reduced. CARE HOME ADULTS 18-65 Jasmine House 48 Radnor Road Heathfield Park, Handsworth Birmingham West Midlands B20 3SR Lead Inspector Sarah Bennett Unannounced Inspection 11th November 2008 08:55 DS0000068337.V373194.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 DS0000068337.V373194.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. DS0000068337.V373194.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jasmine House Address 48 Radnor Road Heathfield Park, Handsworth Birmingham West Midlands B20 3SR 0121 551 4326 F/P 0121 551 4326 jas.house@yahoo.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Maudlyn Smiley Provider in day to day control Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places DS0000068337.V373194.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Mental disorder, excluding learning disability or dementia (MD) 8 The maximum number of service users who can be accommodated is: 8 28th February 2008 Date of last inspection Brief Description of the Service: Jasmine House offers a residential service to eight adults who are users of mental health services. Some of the people also have additional needs relating to medical conditions that restrict their mobility and the home is currently able to meet these. The home is situated in a popular, residential area and is not distinguishable from other houses in the road. The home benefits from being close to a range of services including a GP, shops, chemist and public transport. The property has three storeys. On the ground floor there are two en-suite bedrooms and a single bedroom, a formal lounge, lounge/diner, kitchen, combined toilet/shower, and conservatory. The laundry is housed externally in an outhouse/garage. The first floor has 4 bedrooms; 1 single, 2 en-suite singles and 1 en-suite double. There is also a communal bathroom and a small manager’s office. The second floor is used for staff accommodation. At the rear of the property is a well-maintained garden. To the front of the building is off road parking. Access to the home is via a ramp with handrails so that people with mobility difficulties can get in and out easily. DS0000068337.V373194.R01.S.doc Version 5.2 Page 5 The service users guide did not state the range of fees charged to live there. This should be included so that people have all the information they need. DS0000068337.V373194.R01.S.doc Version 5.2 Page 6 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 inspection was carried out over one day; the home did not know we were going to visit. This was the homes key inspection for the inspection year 2008 to 2009. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and the Annual Quality Assurance Assessment (AQAA) completed by the manager. This provides information about the home and how they think it meets the needs of the people living there. Two of the people living in the home were case tracked. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. A partial tour of the premises took place. A sample of care, staff and health and safety records were looked at. The people living there were spoken to and asked their views on living in the home. The manager and staff on duty at the time were spoken with. What the service does well: The home is clean and well decorated so it is a nice place to live. Each person has a care plan so that staff know how to support them to meet their needs. The staff were seen to have excellent relationships with the people living there and spoke to them naturally, with empathy and supporting them as they wish. This gives people a sense of wellbeing. The health needs of the people living there are met and people get the care from other professionals they need. DS0000068337.V373194.R01.S.doc Version 5.2 Page 7 People living there said: Im enjoying my life now. Im happy here- Im only going to leave here in a coffin or if I win the lottery! The food is very good, I cant complain. I love the food here. It is a nice place to live. I like it here, Im looked after well. Staff are recruited and selected in ways that ensure safe skilled individuals are employed. Staff have the training they need so they know how to support the people living there. Professionals said, I know how to make a complaint. It always seems a pleasant organised well run home. The person I work with looks better now than they have done for a long time. The home has in place a quality monitoring system based on seeking the views of the people living there so they decide how improvements are made. What has improved since the last inspection? What they could do better: Information about the home should be updated so that people have all the information they need. Mental health relapse plans should include all the information about the individual so that staff can monitor and support people to ensure their safety and well being. People should be offered an opportunity to go on holiday each year so they can see different places and experience new things. DS0000068337.V373194.R01.S.doc Version 5.2 Page 8 Staff should have updated training in diabetic testing to ensure the persons well being as some practices change over time and staff need to keep updated. The protocol for people taking their own medicines should be updated in more detail. This will mean people can be more independent but they can safely take their medicines. There should be regular staff meetings and staff should have regular supervision so that they are supported and know how to meet the needs of the people living there. Staff should have updated training in fire safety and the fire risk assessment should be reviewed so that the risks of there being a fire are reduced. 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. DS0000068337.V373194.R01.S.doc Version 5.2 Page 9 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 DS0000068337.V373194.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People do not have all the information they need so they can make a choice as to whether or not they want to live there. EVIDENCE: The service users guide stated that it was given to the people living there in 2006. The manager said that it had not been updated since then. It did not state the range of fees charged to live there. This should be stated so that people have all the information they need about the home so they can make a decision as to whether or not they want to live there. None of the people living there had been admitted since the last inspection. Therefore standard 2 relating to assessment before admission was not assessed. There were seven people living there. One person has the shared room and the other part of this room is vacant. However, the person has a pet that has lived with them for several years. The manager said that because of this she has no plans to admit another person. DS0000068337.V373194.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, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have most of the information they need so they can support people in the way that the individual chooses so ensuring their safety and well being. EVIDENCE: The records of two of the people living there were looked at. These included an individual care plan that stated how staff are to support the person to meet their needs and help them achieve their goals. Records showed that people had been involved in their care plan. Staff had signed peoples care plan to say that they had read them and know how to support the individual. One person had recently been diagnosed with a medical condition but they did yet have a care plan as to how staff are to support them with this. The manager said that this would be put in place. DS0000068337.V373194.R01.S.doc Version 5.2 Page 12 The people living there said and it was observed that they could make choices about what they do during the day, how they spend their time and what they eat and drink. Sometimes formal meetings are held with all the people living there. The minutes of these showed that people talked about menus, the key worker system, respecting others privacy, the outcomes of our inspections, complaints, day trips and how they want to celebrate their birthdays. Records included individual risk assessments that stated how staff are to support individuals to take risks in their day -to-day lives whilst ensuring that they can be as safe as possible. Risk assessments were in place that showed staff how to monitor individuals to ensure that if they have a relapse in their mental health staff would be able to recognise this and ensure they had the support needed. A risk of this for one person had been identified in their care plan as self - neglect but this was not stated on this risk assessment. These should include all the risks of the persons mental health relapsing so that appropriate support is given. DS0000068337.V373194.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements ensure that people living there experience a meaningful lifestyle that ensures their self-esteem and well being. People are offered a healthy diet and enjoy their meals. EVIDENCE: Care plans sampled stated the leisure and social activities that people enjoyed and how much staff support they need to be able to do these. Some people go to day centres during the week and some do college courses. How many days a week and which day centres they go is dependent on the individuals choice. One person said that they attend day centres six days a week as they like to keep busy and they are responsible for certain jobs at the centre. People travel to day centres using public transport or the Ring and Ride transport service. DS0000068337.V373194.R01.S.doc Version 5.2 Page 14 Records showed and people said that if they are not at the day centre they could choose what they do. On the day of the visit one person went to visit their relative for lunch, one person went out for a drink and another person spent the day relaxing at home. People said that if they want to they could go shopping with staff. Two people went to a Sunday market the weekend before with staff. In the lounge there was a TV, a selection of CD’s, magazines and games that people can use when they want to. A fortnightly exercise class is held in the home that people can take part in if they want to. Some people go to church if they want to and staff support them in this as much as the individual needs. Most of the people living there had visited the Walsall Illuminations earlier in the month and said that they enjoyed this. Staff said and records showed that they celebrate the cultural festivals relevant to the people living there such as Easter, Christmas, St Georges Day and Halloween with parties and that people enjoy these. Staff said that an entertainer had been booked for the Christmas party. The people living there go out for meals to celebrate their birthdays. Records showed and people said that individuals choose where they go. They have been to Carvery, Chinese or some people prefer to have a take away at home with the other people living there. The manager said that people had not been on holiday this year but have been on day trips and they also go on lot of day trips with their various centres. The manager said that in the past people have been on holiday to Jamaica, Spain, Scotland and Devon and other holidays would be arranged in the future. One person said they had not been on holiday for a few years but remember a good holiday in Ibiza with the staff. Records sampled showed and people said they can keep in touch with their family and friends if they want to. This ensures that people can maintain relationships that are important to them. People were observed spending time talking to each other and to staff. Some people said that their friends are the other people living there and staff and living there is like being part of a family. One person has a pet that has lived with them at the home for several years. It was evident that they enjoyed looking after their pet and staff respected this and supported them where needed. Records sampled showed that people are encouraged to be as independent as possible and participate in household tasks. People said that they do jobs around the home and they were observed doing so. One person said that they plant the pots in the garden as they like gardening. People said that times for going to bed and getting up are flexible. One person said they go up to their DS0000068337.V373194.R01.S.doc Version 5.2 Page 15 room about 9.30pm but do not go to bed until about midnight as they watch TV and do things in their room so they can have some privacy. The service users guide stated that people need to agree to smoke only in the conservatory. Throughout the day people were observed to be doing so and arrangements had been made so it was safe for people to do so such as providing fire retardant furnishings and a metal bin to dispose of cigarettes. People said that they like the food that is provided. Some people have their main meal at their day centre and a snack in the evening but a main meal is provided for those who want it. People said and records sampled showed that people choose what they have for their breakfast. Staff said and records sampled showed that there is a choice of snacks in the evening and people choose what they want. Staff demonstrated an awareness of what food and drink each person likes and if people have any dietary needs. One person said they had been helped to lose weight and feel healthy for it. The menus were generally British food, which is reflective of the cultural background of most of the people living there but there were also alternatives of Caribbean dishes so all wishes are catered for. Staff said menus are only a guide but sometimes people want something else and this is provided. Staff said it is difficult when people need to have a healthy diet to be well but do not want this. They said and records showed that they offer advice about quantities and what are the healthy foods and inform people of what the risks are if they do not follow a healthy diet. Fresh fruit and vegetables were available. DS0000068337.V373194.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of the people living there are met so ensuring their well being. EVIDENCE: Care plans stated how staff are to support individuals with their personal and healthcare needs. The people living there were well dressed in appropriate styles to their age, gender, cultural background and the activities they were doing. Attention had been paid to individuals personal care indicating that people had the support they needed so ensuring they felt good about themselves. Several of the people living there smoke and this is only permitted in the conservatory. Staff had provided information about stopping smoking and NHS smoking cessation workers had offered support but records showed that people said and had signed to say they did not want this. Some people drink DS0000068337.V373194.R01.S.doc Version 5.2 Page 17 alcohol, records sampled showed that staff had advised people about the risks of this to their health and how it may have a greater affect on them because of the medication they take. Care plans stated how people are to be supported to keep their mental health well. One persons daily records stated that they had been hearing voices. Staff were told to monitor for the next few days and report and record any changes. The record had been highlighted so to draw attention to it for staff. Staff had recorded any changes and monitored this so that health professionals could be contacted to prevent the person having a relapse in their mental well being. One persons care plan stated they need prompting to attend health appointments. Their records showed that staff had supported them to attend health appointments and have investigations into their health concerns. From sampling this persons records it is to be commended that staff have supported this person to do this as in the past they refused any interventions into their healthcare. One person who has diabetes is prescribed insulin for this. This means that staff need to test the persons blood sugar every day so to determine how much insulin the person needs. Records showed that staff did this and were competent in doing so. However, records showed that staff had not had updated training in this since 2006. It is recommended that they have this to ensure the persons well being as some practices change over time and staff need to keep updated. Records sampled showed that other health professionals are involved in peoples care where needed. Records showed and staff said that they work with other professionals to ensure individuals well being. People attend health check ups with the dentist, optician and chiropodist to ensure their health needs are met. Since the last inspection a trolley for peoples medication had been provided that is secured to the wall so that people are not at risk of taking medication that is not prescribed for them. Boots supply most of the medication and a pharmacist from there visits to ensure that the systems in place protect the people living there. They had made recommendations from their last visit that had been met including providing a new fridge thermometer so to ensure that medication is stored at the correct temperature. Insulin for one person is stored in the fridge. This is stored in a separate container that is labelled so that it does not contaminate and is not contaminated by the food. At the front of each persons Medication Administration Record (MAR) there is a photo of the person so that unfamiliar staff would know who to give the medication to. MARs sampled had been signed when medication had been given indicating that medication had been given as prescribed. DS0000068337.V373194.R01.S.doc Version 5.2 Page 18 The Mental Health Team supplies some peoples medication. Arrangements are in place to ensure that people get the medication they need at the right time. Some people have injections that are given by their Mental Health Nurse. The Nurse signs the persons MAR when they give it so the home has a record of all the persons medication so if they were unwell health professionals would have the information they need. A protocol for people taking their own medication was in place. The pharmacist said that this needed more detail. Staff said that none of the people living there were self medicating at present. This should be updated in more detail so that people can have this opportunity to be more independent if they are able to but safeguards are in place to ensure peoples well being. Since the pharmacist visited a record of what homely remedies each person can take with their prescribed medication is kept. This ensures that people can take cough and cold remedies for example whilst knowing that these will not have a detrimental effect to their health because of the prescribed medication they take. DS0000068337.V373194.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements ensure that the views of the people living there are listened to and acted on and they are protected from abuse so ensuring their well being. EVIDENCE: The complaints procedure stated how people could make a complaint if they are not happy with the service provided at the home. It stated that if they want to they can contact us but our previous contact details were stated. These should be updated so that people have the correct information. The AQAA stated that no complaints or safeguarding referrals have been made to the home in last 12 months. We have received no complaints about this home in the last 12 months. The finance records of two of the people living there were looked at to ensure that their money was being looked after appropriately and was safe. Individuals benefits are paid straight into their bank accounts. People received their personal allowance money regularly and signed to say they had received this. Receipts were kept of all purchases and were kept when money was withdrawn out of the persons bank account. These matched the amounts stated on the individuals finance records. One persons records sampled showed that their savings had increased significantly since they had lived at DS0000068337.V373194.R01.S.doc Version 5.2 Page 20 the home indicating that people are supported to manage and budget their money well. A record of the belongings that each person has is kept. These are updated and signed by the individual when they had bought new things or disposed of anything. Records showed and staff said that they have had training on safeguarding adults who are vulnerable so they know how to recognises signs of abuse and report this so that the people living there can be safe. The manager said that she had briefed staff on the Mental Capacity Act 2005 and the trainer had also discussed this with staff with a particular emphasis on how this legislation could affect the people living there. This legislation came into force in April 2007 and requires an assessment of a persons capacity to be done if there is any doubt that they may not have the capacity to make a decision. Where a person has been assessed as not having the capacity an Independent Mental Capacity Advocate (IMCA) can be appointed to act on their behalf. DS0000068337.V373194.R01.S.doc Version 5.2 Page 21 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a clean, well decorated and safe home that meets their individual needs. EVIDENCE: We looked around the communal areas of the home. These were clean, well maintained and decorated. Records showed that equipment had been regularly tested to make sure it was safe to use. On the ground floor there is a lounge, lounge/diner, kitchen and conservatory smoking room. This provides a range of spaces for people to spend time in. People also said that they spend time in their bedrooms if they want time on their own. There are some bedrooms on the ground floor. There is a toilet and shower on the ground floor that is accessible to people with mobility difficulties. There is DS0000068337.V373194.R01.S.doc Version 5.2 Page 22 ramped access at the front of the home so people can get in and out of the home easily. People said they had the things they needed in their bedroom. One person said that they had recently had their bedroom redecorated. They said they had chosen how this was done and liked it. Where people have mobility difficulties referrals are made to Occupational Therapists and Physiotherapists who can recommend aids and adaptations for the person. Records showed and it was observed that these were provided where people needed them. DS0000068337.V373194.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for staffing, their support and development generally ensure that the needs of the people living there are met. The recruitment practices help to ensure that the people living there are safeguarded from abuse. EVIDENCE: The AQAA stated that there are six permanent staff. It stated that all the staff have achieved National Vocational Qualification (NVQ) level 2 or above in Care so they should have the skills to meet the needs of the people living there. This exceeds the standard that at least 50 of staff have this qualification. Staff meeting minutes showed that these had not happened regularly. The standard states that there should be at least six in a year so that staff can keep updated with best practice and know about the changing needs of the people living there. Staff said that they have regular handovers and use the staff communication book so they know what is going on and if the needs of the people living there have changed. The manager said that handovers are now more detailed so often use that time as staff meeting. The manager said DS0000068337.V373194.R01.S.doc Version 5.2 Page 24 that sometimes during handovers they use training DVDs and then have a discussion. It is recommended that records be kept of these to show how staff are kept informed and updated with information that is important in meeting the needs of the people living there. The manager said that they do not use agency staff but that staff are very flexible at covering extra shifts if needed. There were no staff vacancies. The records of three of the staff who work there were looked at. These included the required recruitment records including evidence that a satisfactory Criminal Records Bureau (CRB) check had been completed to ensure that suitable people are employed. The manager said they have discussed with staff about disclosing and signing to say if had any convictions since they were employed and their CRB was completed. This helps to ensure that the people living there are protected. Training records showed that staff had received training in risk assessment, diabetes, health and safety, first aid, protecting vulnerable adults, food hygiene, mental health awareness, conflict management, moving & handling, medication, infection control and care of skin. This ensures that they know how to meet the needs of the people living there. Staff have not had training in fire safety for a year. This should now be updated so that staff have updated knowledge on how to reduce the risks of there being a fire and what to do if there is a fire. Records showed that staff had not received regular formal supervision sessions with their manager. The manager said that some supervisions had been booked as they were aware this has lapsed for all staff. Staff should have at least six formal supervision sessions each year so that they are supported and know how to meet the needs of the people living there. . DS0000068337.V373194.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management arrangements ensure that the home is safe and well run in the way that the people living there want. EVIDENCE: The registered manager has the qualifications required to be a registered manager and has several years experience of managing a care service. The manager co operated throughout the visit and demonstrated she knew the people living there and how to support them. There is a deputy manager in post who is working there on a voluntary basis while completing their Registered Managers Award so they can gain the experience needed to complete this. The manager and deputy were observed to work well together DS0000068337.V373194.R01.S.doc Version 5.2 Page 26 to ensure that the home was well run and for the benefit of the people living there. Surveys had been given to the people living there and their families or professionals that worked with them to complete with their views on the home. People were positive about the home and said the home friendly, the food was good food, Staff very helpful and treated people with respect, people are given choices, there were no signs of people being abused and there was nothing that needed to improve. Where people had asked for things to be provided for their bedrooms or in communal areas it was observed that this had been listened to and acted on. Risk assessments were in place for the building, people smoking and the equipment used in the home. This ensures that action can be taken to minimise the risks to peoples safety and well being. Radiators are not guarded but recently new thermostatic valves had been fitted on all radiators so that the temperature of them is regulated so that people are not at risk of being scalded. Records sampled showed that equipment in the home is regularly serviced and well maintained so it is safe to use. Fire records showed that staff test the fire equipment regularly to make sure it is working. There are regular fire drills so that staff and the people living there would know what to do if there was a fire so minimising the risks to their safety. The fire risk assessment was dated November 2007 and stated the actions to be taken to ensure the risks of there being a fire are minimised as much as possible. This should be reviewed yearly to ensure that appropriate action is still being taken to minimise these risks. Records showed and the AQAA stated that a qualified person had tested the gas and electrical appliances to ensure that they are safe to use. DS0000068337.V373194.R01.S.doc Version 5.2 Page 27 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 2 X 3 X 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 X 32 4 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 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 DS0000068337.V373194.R01.S.doc Version 5.2 Page 28 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. Refer to Standard YA1 Good Practice Recommendations The statement of purpose and service user guide should be reviewed to include the updated information. The service users guide should state the range of fees charged to live there. This will ensure that people have all the information they need about the home. Mental health relapse plans should include all the information about the individual so that staff can monitor and support people to ensure their safety and well being. People should be offered the opportunity to go on holiday once a year so they can experience different places and new things. Staff should have updated training in diabetic testing to ensure the persons well being as some practices change over time and staff need to keep updated. The protocol for people taking their own medication should be updated in more detail. This will give people the opportunity to be more independent if they are able to but safeguards are in place to ensure their well being. DS0000068337.V373194.R01.S.doc Version 5.2 Page 29 2. 3. 4. 5. YA9 YA14 YA19 YA20 6. 7. 8. 9. YA22 YA35 YA36 YA42 The complaints policy should be updated with the Commissions current contact details so that people know how to contact us if they want to. Staff should have updated training in fire safety so that they have updated knowledge on how to reduce the risks of there being a fire and what to do if there is a fire. There should be regular staff meetings and staff should have regular supervision so that they are supported and know how to meet the needs of the people living there. The fire risk assessment should be reviewed yearly to ensure that appropriate action is being taken to minimise the risks of there being a fire. DS0000068337.V373194.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. 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