Care Home: Kingscourt

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What the care home does well People are given clear information about the home so that they can decide if this is the right place for them to live. People are given a full assessment so that the home will know that their needs can be met. Staff are given up to date information so that people are supported consistently. People are supported in their chosen lifestyle; they are offered meaningful activities and helped to be more independent. They are encouraged and supported to live as a part of the local community. Staff have good working relationships with both families and healthcare professionals. This helps ensure that people are working in the same way to meet peoples needs. What has improved since the last inspection? Staff training records showed staff have attended required mandatory training and other relevant training. Repairs and redecoration have been made to peoples rooms. Good practice recommendations met: House rules have been reviewed with the involvement of people. Staffing levels have been reviewed in relation to the mix of people and their gender preferences. Receipts are numbered corresponding with balance sheet. What the care home could do better: Complete risk assessment for an individual where a restriction in place helps to keep them safe. Keep a clear record of the date when medication is administered to an individual. Keep a record of action taken in response to investigation of an individual`s complaint. CARE HOME ADULTS 18-65 Kingscourt 100/102 Kings Drive Bishopston Bristol BS7 8JH Lead Inspector Sarah Webb Unannounced Inspection 23 & 24th April 2008 09:00 rd Kingscourt DS0000040011.V360317.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 Kingscourt DS0000040011.V360317.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. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingscourt Address 100/102 Kings Drive Bishopston Bristol BS7 8JH 0117 9232132 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) kingscourt@supportedindependence.co.uk Supported Independence Ms Nicola Jane Stanworth Ms Catherine Twine Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Kingscourt DS0000040011.V360317.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 providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 12. Date of last inspection Brief Description of the Service: Kings Court is registered with the Commission for Social Care Inspection as a care home for up to twelve people with a learning disability. The home is able to accommodate people aged 18 to 64. The home is based in two adjoining semi detached houses in a residential area in North Bristol. It is approximately a quarter of a mile to local shops and a variety of community facilities. Public transport links (buses) are available in Kings Drive close to the home. Bedrooms are on three floors, including three ground floor bedrooms; stairs are the only means of access to each floor. Kings Court is presently the only service registered with the Commission for Social Care Inspection as personal care is offered to one or more people. The philosophy of care for Supported Independence is that a continuum of care is available to provide people with an opportunity to progress towards greater levels of independence from within a consistent and planned environment. Kings Court is part of a three step approach that help to support people to be independent. The two other areas that offer opportunities for people to further develop an independent lifestyle are through a supported living and outreach service. The cost of placements at the home is £875-1200 per week, and additional charges are made for hairdressing, toiletries, some activities and holiday spending money. Kingscourt DS0000040011.V360317.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 was an unannounced inspection conducted over the course of one and a half days. The purpose of the visit was to review the progress to meet the requirements from the inspection in April 2007 and monitor the care provided to the people living at Kings Court. As part of the inspection process records were looked at including care and support plans, risk management, the administration of medication, and staff training. We looked around the premises and also spoke with people using the service, staff, the Director and the manager. A completed Annual Quality Assurance Assessment (AQAA) was received before this visit providing further information. Surveys were received from 9 people using the service, 8 relatives, 4 health professional, and 5 staff. Both relatives and health professionals made positive comments about the level of care and support offered. Comments from surveys have been included in this report. We issued three requirements and four recommendations The requirements and recommendations from the last inspection have been met. What the service does well: People are given clear information about the home so that they can decide if this is the right place for them to live. People are given a full assessment so that the home will know that their needs can be met. Staff are given up to date information so that people are supported consistently. People are supported in their chosen lifestyle; they are offered meaningful activities and helped to be more independent. They are encouraged and supported to live as a part of the local community. Staff have good working relationships with both families and healthcare professionals. This helps ensure that people are working in the same way to meet peoples needs. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 7 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 Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 8 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, & 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home so that they can make an informed decision about whether the service is right for them. Peoples needs are identified through assessment so that the home can plan to meet them EVIDENCE: The home provides information to people wishing to use the service through a Statement of Purpose, Service Users Guide (‘Guide to Living at Kings Court’) and new web site. The ‘Guide to Living at Kings Court’ is detailed and informative and includes how a referral is made and visiting the home. ‘Guidelines’ include how people are expected to join in and interact with each other. A recommendation has been met for these to be reviewed; the manager has involved the views of people using the service. This was confirmed by people and that they were happy with the guidelines. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 9 There have been 4 new people admitted to the home. The assessment process showed people had visited the home before moving in; some had stayed over night, meeting staff and other people using the service. People also confirmed that this happened. Placing authorities and the home carry out a full and comprehensive assessment of peoples needs. These were seen in the care files of all 4 new people. 7 of the 9 surveys received from people stated that they had been asked if they wanted to move to the home; that they had enough information before they moved in so they could decide if it was the right place. A family member said the choice of home had been good and that their relative’s needs were met. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 10 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, 8, & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide good information in how to support people individually. Some people would benefit from a more accessible, easy read style of care plan. Care plans are reviewed regularly. People are consulted with and helped to make decisions about their lifestyle. Risk assessments support people to take risks as part of their lifestyle. EVIDENCE: We looked at three care plans, spoke with 3 staff members and three people. Care plans are based around the holistic assessment of needs completed by staff when people first come to the home. Care plans provided comprehensive information on the areas of support each person required. They were set out under separate headings, including risk factors, physical health, self-care, daily living skills, relationships and leisure. ‘Short term’ goals are set to help people to focus on developing skills and to include them with their care planning. Staff also confirmed that they are given up to date information about peoples needs. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 11 We discussed with the manager accessibility of information for people; that the use of picture symbols and photographs can benefit those people who cannot read. The home has started looking at this area of communication and is aware that this is an area that needs to be developed There is an effective review process. Annual review meetings are held with people, their relevant funding authority, family members and staff. Care plans are also reviewed by the home every six months, or sooner should their needs change. Peoples’ care and general welfare is also monitored by keyworkers every week through a 1:1 ‘supervision’meeting. People are asked key questions about how they are feeling about living at Kings Court, and goals they may have achieved. The results of surveys received from people using the service were varied in whether they felt they made decisions each day. Three people said they ‘always’ make decisions with comments stating that they decide where they want to go on trips. One person said they ‘usually’ make decisions and another 3 said ‘sometimes’. There were two people who said they ‘hardly ever’ make decisions. However there was evidence to show that people are consulted with. House meetings are held weekly to involve people in making decisions about the running of the home and what they would like to do. This was confirmed by people and written minutes of meetings showing suggestions people had made for outings, summer holidays and the menu. Written 1:1 supervision records also showed people are asked if there is anything else they want to do. Where a risk had been identified, an assessment had been made to minimise risk to people. These assessments had been regularly reviewed in light of changing needs of the person concerned and had been signed by both the manager and the individual. A restriction in place for one person found this limitation was based on their protection. However a risk assessment must be developed to include regular review of this practice with their funding authority. A healthcare specialist said staff support vulnerable people ‘to lead a safer life’; that they help facilitate people in making choices about their life style. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 12 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. People are supported in making choices about their lifestyle and in developing their independence skills. They are helped to take responsibility in their daily lives. People benefit from taking part in social, and recreational activities in the local community, and in keeping in contact with family and friends. The menu is varied, and they are able to choose the food they prefer and like. EVIDENCE: Care files showed that people are supported through a structured day that meets their individual needs. There are opportunities to be involved in a wide range of meaningful activities. These include college, day services, and work placements. The home also provides several in house projects people can choose to go to. These include music and gardening projects, a mechanics course and art shop. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 13 People are supported to go into the local community including shopping trips, visits to pubs, the cinema, cafes and swimming. Individual diaries are kept showing the activities people are involved with. The manager said the home has started using a ‘floating’ member of staff every day to work with people individually. This allows flexibility in helping to meet their needs. However staff said that this does not always happen if other shifts need to be covered. This is discussed un detail in Standard 33. The returned AQAA stated that people have been given more choices about where they want to go on holiday. People have the opportunity to have two holidays a year; one of these being a free holiday paid for by the organisation. Last year people went to Tunisia with day trips to London and Longleat. People have been to Blackpool this year and said they were in the process of deciding their second holiday. The home provides transport and people are not charged for its use. Bus passes are also used to access the community and encourage people in being independent. Family members are always welcome to visit the home whenever they choose. This was confirmed by a relative who said they often turn up unannounced and are made welcome. They said a friendly and active service is provided to give people different opportunities. People are helped to develop independent living skills and have a day at the home to carry out ‘room care’, and do their laundry. They are also involved with the routines of the home. People said they had their own household chores to do. Staff said they felt the home provided a friendly and supportive environment for people to develop skills towards independence. Staff interaction was observed with people that showed good working relationships. There are two kitchens available for people to prepare and have support with cooking meals; one is considered a ‘training’ kitchen and is used more for those people who want to increase their independence skills. Each person has an individual training programme when they are involved in choosing and preparing a main meal. Menus were seen and these showed that a choice of food is offered that is varied, well-balanced with healthy eating options. The manager is currently involved in a project funded by Skills for Care to help develop food awareness. A workshop has been organised on healthy eating and healthy lifestyles. The majority of people said they could do what they wanted to during the evening. A few said this was not the case. Almost everyone said they could do what they wanted to at weekends. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 14 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. People are supported to lead healthy lifestyles through healthcare being well monitored. Appropriate action and intervention is taken when peoples’ needs change. People are treated in a respectful manner by staff. People are supported safely with taking medication; however one area of recording needs to be clearer. EVIDENCE: The majority of people require minimal assistance with their personal care needs; care files showed that people are supported through prompts in some areas. Since the last inspection, a good practice recommendation has been met to review staffing levels in relation to gender preferences. This has helped to address an imbalance of male staff. Most of the people using the service said they felt staff ‘always’ treated them well and were respectful. A few people felt this was the case ‘sometimes.’ Surveys received from families stated that the home “always” gives the support or care to their relative that has been agreed. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 15 Peoples’ health care records showed that staff look after individuals physical and emotional health needs well, with peoples’ medication kept under regular review. Records showed that there is good communication with the General Practitioner (GP) surgery, and other healthcare professionals. During the visit we met a healthcare specialist who had a meeting with the manager to review the specialist support some people were getting. It was evident that the manager supports a multi disciplinary approach in meeting peoples needs. The AQAA has shown that the home plans to develop and implement health action plans. These will be followed up at the next inspection. The procedures for the administration of medication were looked at. All medicines seen were stored securely. Individual medication files showed the description of medication to be taken. Regular medicines are supplied using a monthly blister pack system. The medications held were consistent with the recorded balances. The record for an individual’s ‘as required’ medication was unclear as to when it was given. A clear record must be kept of when medication is given to ensure people are kept safe. The home has informed us when a medication error was made with appropriate action taken. A record is kept of the disposal of unused medicines. A visit was made by the local pharmacy in January 2008 to assess the homes procedures. There were no changes to be made. Staff complete an external college based course in ‘Safe Handling of Medication’ to help ensure people are supported safely. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 16 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. People are supported to make complaints and express concerns about the service. There are some areas of the recording of outcomes of complaints that must be improved. The home follows clear procedures in order to protect people from abuse with staff having received appropriate training. People benefit from robust procedures in place to help protect them from financial abuse. EVIDENCE: The organisation has policies and procedures for equal opportunities, bullying, and responding to complaints. There have been 5 complaints logged since the last inspection. A complaints/comments box is available for people to use. Staff give people a pictorial slip with a choice of faces on it to help show how they are feeling and to record their concern or complaint. The pictures ranged from happy to angry, upset and sad. Completed slips are posted in the box and followed up by the manager who said she looks in the box regularly. Some of these were kept in the complaints log to show how people had complained. People also make verbal complaints. The complaints log showed records of all but one complaint that had been investigated and with the outcome recorded. A requirement is made to log the outcome of this complaint to show that people are listened to and appropriate action is taken. Everyone said they knew who to speak to if they were unhappy; all but one person said they knew how to make a complaint. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 17 There were varied views from people about whether they thought staff listened and acted on what they said. Five people said they felt this was ‘always’ the case, while three people said ‘sometimes’ and another ‘usually’. A comment made through a survey said that ‘Sometimes I am happy, and sometimes I’m not, sometimes there is a misunderstanding’. The home has safeguarding policies and procedures to help keep people safe. New staff have appropriate checks as part of the recruitment process to help ensure peoples protection. The manager is a qualified trainer in the Protection of Vulnerable Adults and records showed that all staff are up to date with training in this area. The home informs us of any incidents relating to the safety of people with action taken. The home has a missing persons policy and individual procedures in place if people are missing from the home. Training records showed that staff are trained through Control and Restraint General Services (CRGS) and that this is updated 12 monthly. These strategies are used for people who have behavioural issues that may result in physical intervention from staff. The AQAA stated that there are improved finance records in place. Signed service user agreements showed that people are involved with making decisions about managing their finances. Since the last inspection, staff carry out a financial risk assessment for each person that shows the level of support they need with managing their finances. Financial records and three peoples monies kept for safekeeping were checked. Monies held were consistent with recorded balances. However there were a few discrepancies in one person’s records; a receipt was missing and a transaction had not been recorded on their financial record. The manager was not available on the day the finances were looked at but informed us the next day of the whereabouts of the receipt. Two recommendations regarding financial practice have been met and overall the home has made improvements in ensuring peoples finances are protected. Although there are now controls in place, some areas of monitoring could be improved. For example, there was no evidence that people’s bank statements had been checked against transactions. Kingscourt DS0000040011.V360317.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, 27, &30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a clean and homely environment where improvements to the environment have been made. EVIDENCE: Kings Court is two semi-detached houses that have been converted into one property. The home is located near to local amenities, bus routes and relevant support services such as day resource centres and leisure centres. Since the last inspection, we have agreed for the home to increase the occupancy from 11 to 12 people. Accommodation is arranged over three floors with shared space on the ground floor and bedrooms on all floors. Bedrooms seen were individually decorated, personalised and presented individual characteristics. Three bedrooms have been recently redecorated as has the landing, passages and training kitchen. Two other bedrooms are also to be decorated. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 19 A requirement has been met to repair a damaged ceiling in en suite area of an individual’s room and peeling wallpaper in another persons en suite. One persons bathing facilities have been refurbished, and this is an area that is being looked at generally to improve. Shared spaces are sufficiently furnished and the dining room is an area where people are expected to eat together. Staff said that people are still discouraged from leaving the dining table till everyone else has eaten as set out in the homes ‘Guidelines’. There have been no recorded complaints, or concerns and there was no evidence from people spoken with that they were unhappy with this. Although a recommendation has been met for the home’s ‘guidelines’ to be reviewed, it is recommended that the home continue to consult with people on a regular basis to show any changing views are listened to. The home has a rotating maintenance programme; this was seen incorporated into the business plan. The AQAA showed that the home is aware of the need to improve maintenance work on time. We were told a bedroom door could not be locked and this was passed on to the manager and was dealt with immediately. There is a large garden area around the home; the Director said funding has been agreed for a project to improve the gardens. The home operates a no smoking policy; however, there is a designated area in the garden for those who smoke. A cleaner is employed at the home on a daily basis to help keep communal areas clean. These areas were clean on the day of the inspection. Laundry facilities are separate from the main house, but nearby in a building opposite the back entrance. Peoples’ views were varied about the cleanliness of the home. Four people said the home is ‘always’ ‘fresh and clean’, while 5 people had shared views of ‘usually’ and ‘sometimes’. We were told about some specific concerns such that there was no dishwasher and that sometimes mugs were not being washed up properly. The manager responded that part of the homes independence programme was for people to learn domestic skills so that they could cope if they moved on to living more independently. We were also told that some people had not been asked if a member of staff ‘s dog could go into the lounge. This was also passed on to the manager who said that some people enjoyed the dog being in the house, and although she understood people had been asked, she would bring this to a house meeting again to get everyone’s views. Kingscourt DS0000040011.V360317.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): 31, 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. People benefit from a staff team who have a good understanding of their role and responsibilities who are experienced and trained to meet the individual needs of people. However further specialist training that is targeted and focused would help improve outcomes for people. People do not always benefit from an effective staff team. A robust recruitment procedure helps to ensure people are protected. People benefit from staff being supervised regularly. EVIDENCE: Staff are given job descriptions that set out their duties and responsibilities. Staff spoken with described their role and responsibilities and gave examples of how they supported people. It was evident that staff are experienced and have knowledge to meet peoples needs. Care staff complete Skills for Care Induction during their first three months. Feedback from staff surveys stated that their induction ‘mostly’ covered everything they needed to know, but that a lot was also learnt from actually doing the job. The manager is a qualified trainer in autism and asperger’s syndrome. Staff training records confirmed that staff had been trained in these areas. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 21 Staff said they were given relevant training to do their job; they said they also needed some more specific training in specialist areas to help meet peoples needs better such as supporting people with their relationships. Specific training for senior staff included stress management, communication, staff supervision, and time management. Since the last inspection, the staff team has been restructured. Returned staff surveys showed there are ‘usually’ and ‘sometimes’ enough staff on duty to meet peoples’ needs. Although a new rota included flexibility for one staff member to work on an individual basis with people every day, staff said this did not always happen if shifts were not covered. Staff also said that sometimes weekend shifts were not covered and this stopped them from taking people out. Comments made by relatives also suggested that there were times when staff were short. However, there are occasions when several people go home for weekends, half term holidays and family holidays and the rota is adjusted to reflect numbers of people needing support. When trips and outings are organised staffing is increased to take in to account their support needs. Comments made by staff suggested that the manager should not always be included in the care hours as sometimes staff were left short. This was not made as a detrimental remark as it was felt she is a ‘hands on’ person but that she had a large workload that sometimes impinged on her care duties. A recommendation is made for the managers care hours to be reviewed to show there is a capacity to carry out both duties of care and managing. Comments from relatives stated that there had been several recent staff changes and that the home would benefit from more consistency. However, most of the staff changes were in meeting a good practice recommendation to review staffing levels in relation to gender preferences. Three staffing files seen showed staff had undergone a thorough recruitment process. Records showed application forms, two written references, and police checks through the Criminal Records Bureau. Staff confirmed that they meet with their manager regularly for formal supervision and that targets are set. Kingscourt DS0000040011.V360317.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, &42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service and staff benefit from a well run home with good outcomes for people. Peoples are protected through health and safety monitoring. EVIDENCE: Catherine Twine is the director of the organisation Supported Independence; The registered managers position is that of a shared role with Catherine Twine and Nicola Stanworth. Nicola carries out the daily management duties of running the home. She has completed the Registered Managers Award and National Vocational Qualification at Level 4. She has 25 years experience of working in care including mental health, autism and aspergers syndrome. Kingscourt DS0000040011.V360317.R01.S.doc Version 5.2 Page 23 She has continued to broaden her training by recently completing a course in equality and diversity in the workplace and continues to be a Skills for Care ambassador. Since the last inspection, a quality assurance manager for the organisation has been recruited. The Director said their expected role is to get the views of people using the service and monitor their goals. A quality audit framework checklist was seen covering all areas of running the home The home has systems in place for people to speak up and be consulted with. People are asked what they think is good about the service and what can be improved. These views and results of questionnaires help to inform the business plan and are presented at an annual meeting. Minutes from regular house meetings, weekly ‘supervision’ sessions and six monthly reviews of peoples’ care also showed that people are consulted with. The home is visited on a monthly basis by an external service reporting on all aspects of the homes management. Staff training records showed staff have either been trained or are booked for updates in health and safety, first aid, manual handling, and food safety awareness. A fire risk assessment had been completed. The fire logbook record showed that the range of required fire safety checks were being carried out and were up to date helping to ensure the safety of people inside the building is maintained. All staff attend both fire training and regular fire drills. Staff felt that communication systems ‘usually’ and ‘sometimes’ work well but that this was an area that could be improved. They said this has already been identified and has been discussed at staff meetings. Kingscourt DS0000040011.V360317.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 3 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 3 27 3 28 x 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 4 15 4 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 Kingscourt DS0000040011.V360317.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. 1. 2. 3. Standard YA9 YA20 YA22 Regulation 13(4)(c) Sched 3 Sched.4 Requirement Timescale for action 09/06/08 30/04/08 30/04/08 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. Refer to Standard YA6 YA24 YA33 Good Practice Recommendations Investigate accessible communication formats to help involve people in understanding the care planning process. Continue to consult with people regarding the expectations of the home as set out in the homes ‘guidelines’. Review managers care hours to show whether she is able to meet both her role of manager and carry out her care duties. Kingscourt DS0000040011.V360317.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 Kingscourt DS0000040011.V360317.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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