Care Home: Leopold Muller Unit

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What the care home does well Each resident spoken with, and those who responded by Survey, said they liked living in the home and `always` receive the care and support they need. Each relative who responded by survey said the home does provide the care and support they expect and supports people to live the life they choose. The health care professionals who responded by survey said the home meets individuals` health care needs and respects their privacy and dignity. The manager heads a professional team of workers who continue to be committed to delivering a high quality of care and support in line with each resident`s needs.Professional external advice is sought whenever necessary, and good contacts have been established through this process. This supports the specialist service provided to the residents. Staff are provided with specialist training to enable them to provide appropriate care and support to residents. What has improved since the last inspection? Care plans and risk assessments are now reviewed and updated following reports of falls or accidents. This promotes the welfare and safety of residents and staff. Strategies and risk assessments to support residents who present behaviours which challenge the service being provided have now been improved. This promotes the welfare and safety of residents and staff. Staffing levels during the night have now been increased to provide greater choice and promote the welfare and safety of residents. The home continues to review the progress in providing residents with information in a format which is accessible to them. This supports each person to be involved in their care planning in a meaningful way. Clear organisational guidance has now been sought to help assess suitability of staff members where a conviction is disclosed or is recorded on the Criminal Record Bureau Enhanced Disclosure. This helps to ensure the safety and welfare of residents. What the care home could do better: Fire safety checks within the home must be improved. This will promote the welfare and safety of people who live and work in the home. The home should continue to consider plans to develop communal space within the home and create a private garden area. This would provide an improved environment for residents. CARE HOMES FOR OLDER PEOPLE Leopold Muller Unit RNID Poolemead Centre Watery Lane Twerton Bath Bath & N E Somerset BA2 1RN Lead Inspector David Smith Unannounced Key Inspection 09:30 28th November 2007 X10015.doc Version 1.40 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 Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leopold Muller Unit Address RNID Poolemead Centre Watery Lane Twerton Bath Bath & N E Somerset BA2 1RN 01225 332818 01225 480825 gill.harris@rnid.org.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) RNID Mrs Gill Harris Care Home 22 Category(ies) of Sensory impairment (22), Sensory Impairment registration, with number over 65 years of age (22) of places Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 22 Patients aged 30 years and over with Sensory Deprivation, suffering from sickness, injury and infirmity Can include up to 5 Young Physically Disabled Persons Staffing Notice dated 03/04/2001 applies Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 1st February 2007 Brief Description of the Service: Leopold Muller, one of the services operating as part of the Royal National Institute for the Deaf (RNID), is registered to accommodate 22 residents with sensory loss, who have personal care or nursing care needs. There is a special provision, included within this number, for 5 residents who require nursing care to be aged 50 or under. The home is located on the main Poolemead site, together with other units, which provide support for a wide range of adults with sensory loss and other disabilities. Day services are provided for residents, which focus on occupational, educational, leisure and therapeutic activities. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home as part of a Key Inspection of this service. The review of evidence and pre-inspection planning involved reviewing the report of the last Key Inspection carried out in February 2007 and the service history, which details all contact with the home including notifications of significant events which they have reported to us. Other sources of evidence have been used as part of the Key Inspection process. These include the home’s action plan in response to our (the CSCI) last inspection report and the provider’s own monthly auditing of the service. We also provided the home with a range of Survey Forms for residents, their families and friends and health professionals who support the home. Four resident’s surveys were completed and returned, together with ten from other people involved with the home. I gathered information during my visit through discussions with Residents, the Registered Manager, Activity Co-ordinator, Nurses and Support Workers. Interaction and communication between staff and individuals who live in the home was also observed. Care plans and associated records were examined together with accident and incident reports, medication administration, staffing records, Risk Assessments and health and safety records. I was provided with a tour of the home and invited to view some of the residents’ own rooms. What the service does well: Each resident spoken with, and those who responded by Survey, said they liked living in the home and ‘always’ receive the care and support they need. Each relative who responded by survey said the home does provide the care and support they expect and supports people to live the life they choose. The health care professionals who responded by survey said the home meets individuals’ health care needs and respects their privacy and dignity. The manager heads a professional team of workers who continue to be committed to delivering a high quality of care and support in line with each resident’s needs. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 6 Professional external advice is sought whenever necessary, and good contacts have been established through this process. This supports the specialist service provided to the residents. Staff are provided with specialist training to enable them to provide appropriate care and support to residents. 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. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with the information they need to enable them to decide if they wish to live in the home. Each resident has their needs assessed prior to moving to the home, to enable them to feel assured their needs will be met. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home has a Statement of Purpose and Resident’s Guide which sets out its aims and objectives, including the range of available facilities. This enables prospective residents, their relatives and funding authorities to make fully informed choices about whether or not the unit is suitable to meet each persons’ specific needs. These documents have also been adapted into an accessible format using ‘Writing With Symbols’, which is usually known as ‘Widget’. This uses picture symbols to support the text, which helps people to understand the content of documents. The care records for one resident who has recently moved into the home were examined. These show that there were comprehensive assessments carried out to determine whether the home could meet their needs. These included medical details, preferred communication methods, their hobbies and interests and family involvement. Any potential risks to this person were also identified. Other information was also present such as the Funding Authority’s’ care plan and other historical information which helped the home to ensure they have assessed all aspects of the care and support this individual requires. Each resident who responded by survey said they did have enough information before they moved in to decide if it was the right place for them to live. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each individual’s health care need are fully met and details of these needs are set out in an individual plan of care. Residents are protected by the home’s medication policies and procedures. Each resident is treated with respect and their to privacy promoted. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 11 EVIDENCE: I examined four care plans during my visit. The care planning within the home has been developed and improved since the last inspection. Care plans contain clear guidance for staff in relation to the care and support each person needs in relation to their health and personal care. Files contain health care risk assessments such as assessments for the likelihood of a pressure sore developing, for the prevention of falls, how to move and transfer safely, nutritional assessments and methods of approach staff should use. Each of these assessments is updated each month and takes into account the daily records for each person, for example if an individual has a fall this information is used in the review process. Each section of the care plan now has an ‘Evaluation and Review’ sheet. This enables staff members to write about the effectiveness of the care plans and to note any changes which may require a particular section of the plan to be updated. This is good practice. Care plans are developed with the residents’ involvement where possible, but this very much depends on the level of the person’s skills, ability and awareness. Each care plan is written in plain English and staff have now begun adapting two care plans into a more accessible format using the ‘Widget’ system. Discussions with the Activity Co-ordinator showed that the development of appropriate accessible formats for residents continues to be reviewed, however due to the amount of work which will be required to complete this process, this will remain a longer term goal. I did note that our surveys were re-written using the ‘Widget’ system, to support residents’ understanding and we thank the home for doing this. Each resident who responded by survey said they ‘always’ received the medical support they needed. Each relative who responded by survey said the home meets residents’ needs and provides the care they expect. One person said the home “provides a caring and supportive environment with consideration for quality of life” and another said that their relative is “very happy in the home and has been very well treated”. There is clear evidence of review meetings being held and the outcomes reflected in the reviewing of care plans. Each time a meeting is held the minutes are forwarded to the relevant Funding Authority. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 12 The manager ensures a structured approach for the care planning and review process. Each Nurse has responsibility for a number of residents, care plans, review meetings and will also supervise the relevant Keyworkers. This system ensures consistency and accountability. Each care pan is supplemented by the daily records for each resident. These are divided between the care and support provided by the home’s staff and a separate record of other health care professionals, such as GPs, District Nurses and Chiropody. The health professionals who responded by survey said that the home meets residents’ care needs, seeks their advice and acts upon this to manage and improve individual’s health care and supports residents to live the life they choose. One professional said “the home provides a good standard of care” and another said “I am most impressed by the excellent application of person centred care”. The health professionals who responded by survey said the home responds appropriately to any concerns regarding residents’ care. The home’s policy in relation to medication administration was viewed and found to be comprehensive. The home’s GP said medication is appropriately managed in the home. I observed staff supporting residents by explaining information to them either by using British Sign Language, Deaf Blind Manual Alphabet and Hands On Signing. The staff observed appeared confident in the use of these communication methods. Their interactions also demonstrated a clear understanding of the needs and abilities of the residents. Through these observations it was apparent that each resident is treated with respect. Staff members were seen to address each person individually and knock on bedroom, bathroom and toilet doors or use doorbells (which make the light in each room flash), prior to entering rooms. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s lifestyles match their expectations, and satisfy their social, cultural and recreational interests. Residents are supported to exercise choice and control over their lives, use community facilities, enjoy holidays and visit family and friends. A healthy and well balanced diet is promoted within the home and is served in pleasant surroundings. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 14 EVIDENCE: Residents continue to have access to a wide range of activities and recreational pursuits, organised by staff and the activity co-ordinator. I spoke with the activity co-ordinator who discussed her role within the home and how she continues to link with the Manager, Nurses and keyworkers to ensure a varied programme of activities for each resident both within the home, accessing facilities on the Poolemead site and in the wider community. Residents regularly attend theatre trips, church services, lunches out of the home and days out. There are a number of planned events which are displayed on the home’s notice board and in a separate folder, which can be used to communicate with residents on a 1:1 basis, if this helps them to decide if they would like to attend. There are a number of trips planned for the next few weeks, including attending the ballet and the pantomime at the local theatre, to have a Christmas lunch outside of the home, various Christmas shopping trips, a visit to an open farm and visiting ‘Horse World’. The plans for each trip are displayed on the notice board and these include leaflets and brochures, the date of the trip, photographs of the Residents and staff who are attending and each includes ‘widget’ symbols to help individuals understand them. A number of residents have been supported to plan and attend a holiday. There have been trips to Blackpool, Hayling Island and other destinations. Each resident who responded by survey said there are ‘always’ activities planned which they can take part in. One individual said “there are lots of things to do, I look at posters on notice board and decide which ones I want to do”. The health professionals who responded by survey said the home supported each resident to live the life they choose. One professional said the home “encourage clients to retain independence and exercise choice over daily living wherever possible” and another said “they work hard to maximise independence in individuals”. Each resident is supported to maintain contact with their families and friends. Relatives who responded by survey said the home helped them to keep in touch and ‘always’ kept them up to date about important issues. One person said their relative was supported to “live life to the full, is taken out, on holidays and to shows which they love”. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 15 I observed interactions between staff and residents who communicated using British Sign Language, Deaf Blind Manual Alphabet or Hands on Signing. The staff informed the residents but allowed them to make decisions, with appropriate levels of support. Each member of staff allowed sufficient time to effectively communicate with each of the residents to support this process. The meals for the home are prepared in the main kitchen on the Poolemead site and served in the large adjacent dining area. This is a very pleasant and clean environment, which looks out over the communal garden. I joined staff and a number of residents for lunch during my visit. This mealtime was very relaxed and informal. Staff were on hand to provide appropriate support and guidance to residents. The food was of good quality and was well presented. The menu displayed showed a variety of healthy and nutritious meals. Each resident spoken with and those who responded by survey said they liked the food provided by the home. The home continues to meet regularly with the chef to ensure the menu remains to the resident’s liking and that each person’s dietary requirements are supported. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents, their relatives and friends can be confident that all complaints will be listened to, taken seriously and acted upon. Each individual is protected from abuse. EVIDENCE: The home has a formal Complaints Policy, an Adult Protection Policy and a Whistle Blowing Policy, which staff can use in confidence to raise any issue or concern they have regarding the service. The home’s complaints policy and procedure has also been produced in a symbol format, using ‘Widget’, to help each resident understand it’s content. There has been one complaint made within the last twelve months. I therefore examined this complaint and the records show that it has been investigated in accordance with the home’s policy, within the specified time scale and a clear record kept. The outcome of the investigation had been discussed with the complainant. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 17 Each resident who responded by survey said they knew who to speak to if they are unhappy and how to make a complaint. Staff ‘always’ listened to them and acted on what they said. Relatives who responded by survey said they are aware of how to make a complaint if they are unhappy with the service provided by the home and they felt the home ‘always’ responds appropriately to any concerns. Staff said they are aware of the RNID complaints policy, which they are asked to read and sign by the manager. They also confirmed that they would approach the manager if they had any concerns regarding a particular resident or an issue within the home. Each member of staff spoken with described clearly their responsibility in providing a safe home for residents to live in. They have been provided with training in the Protection of Vulnerable Adults and described what action they would take if they felt a resident were being abused, they suspected abuse or felt they were not safe. All staff are subject to an enhanced Criminal Record Bureau disclosure, prior to commencing their employment. All residents who can present behaviour, which challenges the service being provided, have strategies within their care plan for staff to follow. These are described as ‘Methods of Approach’. Each ‘Method of Approach’ I examined did provide clear information for staff to follow and clearly explained what may cause an individual to act or express themselves in this way. All staff either receive Non Abusive Psychological and Physical Intervention (known as ‘NAAPI’) or more recently ‘MAPA’ (Management of Actual or Potential Aggression) training to enable them to respond effectively to these behaviours in a planned and safe manner. The British Institute of Learning Disabilities accredits both of these approaches. Clear records are maintained of any accidents or incidents which occur in the home and the home has now introduced an improved system to link these records to the review of residents’ care plans and risk assessments. We continue to be kept informed of significant events which occur. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable, well-maintained and clean environment. There are sufficient lavatories and washing facilities and the residents benefit from the provision of specialist equipment to maximise their independence. EVIDENCE: Leopold Muller is situated within the main building on the Poolemead site and is arranged over three separate floors. Residents have access to the grounds, which include well-kept attractive gardens. There are several features in the home to promote residents’ independence. These include tactile trails to enable residents to move around the home Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 19 independently, doorbell and flashing light systems mentioned previously in this report and several other tactile objects and picture symbols. The home has a shower and specialist baths installed, which are suitable for individuals with mobility problems. The small kitchen area on the first floor has adjustable height work surfaces and a low level sink unit. This promotes the independence of both wheel chair users and residents who have poor mobility or co-ordination. The home is well maintained and there remains an ongoing programme of redecoration and renewal, for example one lounge and kitchen area has recently has new laminate flooring fitted and has been redecorated. The home benefits from this process as it does suffer reasonably high levels of wear and tear due to the needs of residents. I viewed a number of the residents’ bedrooms. These were all very well maintained, decorated in different styles and colours and had wood effect laminate flooring laid. Each resident had many personal items, pictures and photographs which added to the homely feel. Residents spoken with said they liked the home and their own rooms. Those who responded by survey said the home was ‘always’ fresh and clean. One relative said in their survey “the home is very clean which I think is essential”. Some bedrooms are equipped with ceiling tracking hoists. Mobile hoists were also in use in the home. The manager and staff said that the size of bedrooms continues to make the use of hoists difficult at times. There are several improvements planned, which I discussed with the Manager and other staff members. These include the development of a private garden area (including a fish pond as requested by one resident), a new private entrance to the home, the relocation of the laundry facilities, establishing new office space on the ground floor and the development of ‘accessible’ toilet facilities. There is a large laundry room on the main Poolemead site, which provides a service to the home. However, two washing machines are accessible to residents, if they should wish to wash items of their clothing, or if this is part of their independence programme. The sluice area is clean and free from any offensive odour. There are handwashing facilities around the unit. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are in safe hands and their support needs are well met by the numbers of well-trained and competent staff. The home’s recruitment policy and practice supports and protects each person who lives in the home. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 21 EVIDENCE: There is a clear staffing structure within the home, with each level of staffing having their own roles and responsibilities as part of the team. There are both Registered Nurses and Support Workers working in the home, who are supported by domestic staff, who were seen working in the home during my visit. Each staff member’s role is clearly defined and staff spoken with are keen to provide a caring and responsive service to each resident. The home ensures its staffing levels during the day are kept under constant review. The rotas I examined showed that in addition to the general staffing, there home provides 1:1 staffing support to some residents. This is to ensure their needs are met and provide a consistent approach in supporting them. This is often supplemented by both the Manager and her Deputy working in the home during the day. The Activities Co-ordinator also works directly with residents to support trips out of the home or to use community facilities. Residents who responded by survey said the staff are available when they need them. The relatives and health professionals who responded by survey said the staff team have the right skills and experience to support each individual’s needs. One person said the staff “have a good knowledge and understanding of needs and appropriate skills to meet those needs” and another professional said “staff are caring and attentive, they demonstrate a high level of skill and patience”. During our last inspection, we did say that staffing levels at night should be increased. This has been acted upon, with three members of staff now providing waking night cover. The staff I spoke with said this is working well, provides more flexible support to residents and helps to keep them safe. This is a positive development. I viewed five personnel files of staff who had been recently recruited. These contained copies of staff application forms, at least two satisfactory references, interview questions, job descriptions, RNID contract of employment, Criminal Record Bureau enhanced disclosures and a photograph of the staff member. Each new staff member is also provided with an induction pack, which includes RNID induction details, General Social Care Council Code of Conduct, ‘Start to Sign’ Book and the local Protection of Vulnerable Adults Policy. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 22 During the last inspection, it was recommended that the home obtain written guidance from the RNID in respect of convictions or relevant information contained on Criminal Record Bureau Disclosures. The home now has the RNID policy, which contains this guidance. Staff receive both mandatory training and more specialist training to enable them to support residents and communicate with them effectively. There were records of staff attending training in First Aid, Fire Safety, Basic Food Hygiene, Manual Handling, Protection of Vulnerable Adults and NAPPI. In addition to this there was evidence of staff training in NVQs, CACDP British Sign Language Stage 1 and 2, Epilepsy, Diabetes, Loss and Bereavement, CACDP Level 3 in Deaf Blind Communication and Aromatherapy. Most staff have now also received training in Mental Health Awareness. The home now uses a training matrix to record all training undertaken by staff and to help plan future training events. The Manager told me this would be developed further with each supervisor maintaining a smaller matrix for each of the staff they supervise, as this will make this easier to manage. Copies of certificates from training events are also kept in each personnel file. Staff are encouraged to work towards a National Vocational Qualification (known as an ‘NVQ’) and the home has made significant progress in this area. Ten care staff have achieved NVQ Level 2 and seven NVQ Level 3. Six staff members are currently working towards NVQ Level 2 and three staff are working towards their NVQ Assessors Award. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home which is very well run, in their best interests, and they benefit from the ethos and management approach of the home. The home’s record keeping, policies and procedures safeguard residents’ rights and best interests. Each member of staff is appropriately supervised. The health, safety and welfare of residents and staff are promoted and protected. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager, Mrs.Harris, is suitably qualified and has significant levels of management experience, which enable her to lead the service and promote good practice within the home. I spoke with several members of staff during the course of my visit who told me they like working at the home, felt very well supported by the manager and said they found her easy to approach. One member of staff said the manager was “fantastic” and another member of staff said the manager has “always been excellent, she is a people person”. My discussions with the Manager confirmed the commitment to the development and improvement the service. This includes the plans to improve the environment, described earlier in this report, and the action taken to meet the requirements from our last inspection report. The home regularly conducts their own quality reviews. Questionnaires are completed by residents, relatives, funding authorities and other people involved with the home. These cover all aspects of the service including personal care, the environment and staffing. The results of these surveys are then collated and an action plan is devised where areas for improvement are identified. These measures continue to demonstrate an ongoing commitment to both reviewing and improving the service provided to the residents, which is good practice. The management structure and lines of accountability within the home are clear and straightforward. Registered nurses supervise support workers, and the manager, or her deputy, supervise all Registered Nurses. Staff are aware of this structure and of the senior management hierarchy within the RNID. All staff members are provided with formal supervision, each month. Each staff member I spoke with found supervision useful and supportive and they felt able to talk about any issue with their supervisor. A clear record of each supervision session is kept, which both people sign. The RNID have comprehensive policies and procedures to support the home, which are designed to ensure it complies with the law and remains aware of good practice guidelines. Full details of each policy were provided by the Manager as part of the AQAA she completed for us as part of this Key Inspection process. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 25 The registered provider’s representative makes regular visits to the home, and produces a comprehensive report of his findings. Although these are no longer routinely sent to us, they are available for inspection in the home. The management systems and structures are efficient. The record keeping is of an excellent standard. Files and documentation are well-organised and easy to access. There are recording systems in place to support Health and Safety within the home, which are being used consistently. The home also conducts weekly health and safety checks, which covers visual checks on the environment, lighting, furniture and other equipment. I examined the home’s fire log, which shows that staff are provided with regular fire safety training and take part in fire drills. The tests on the fire alarm system should be conducted each week, although seven weekly tests had not been recorded as being carried out since July 2007. The area number of general risk assessments in place to support safe working practices within the home. These are all reviewed regularly. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 2 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 4 2 Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 27 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. 1. Standard OP38 Regulation 23(4) Requirement Timescale for action All fire safety equipment must be checked regularly to ensure residents would be alerted in the event of a fire. 28/11/07 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. Refer to Standard OP7 OP23 Good Practice Recommendations The home should continue to review its progress in providing information to residents in accessible formats. The home should continue to consider plans to develop communal space within the home and create a private garden area. This would provide an improved environment for residents. Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Regional Office 4th Floor, 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 Leopold Muller Unit DS0000020297.V355264.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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