Care Home: London Road Neurological and Specialist Care Unit

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What the care home does well London Road Neurological and Specialist Unit provides patients with a safe and pleasant home to live in, with specialist facilities and support to promote the best quality of life for people who have complex physical and neurological needs. There is strong leadership by the Managing Director and Registered Manager that promotes a professional and caring environment. Staff are well trained and provides an excellent standard of care to meet the complex needs of the patients, and provides support for families with empathy and care. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? The service continues to provide a high standard of care and has made many improvements since the last inspection in June 2007. These include: New walk in bathrooms Two new specialist, whirlpool baths New bedroom carpets New specialist chairs (to enable otherwise bed bound patients to be moved) A New computer system Grab boxes containing equipment to support patient in case of emergency evacuation The provision of a new communication system to enable a patient to communicate who would not otherwise be able to do so. The list is not exhaustive. What the care home could do better: There have been no requirements or recommendations made on this visit. CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE London Road Neurological and Specialist Care Unit 362 London Road Leicester Leicestershire LE2 2PU Lead Inspector Mrs Carole Burgess Unannounced Inspection 14th May 2008 10:00 X10029.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 London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service London Road Neurological and Specialist Care Unit 362 London Road Leicester Leicestershire LE2 2PU 0116 2706991 0116 2707181 suelrnscu@hotmail.co.uk www.cheerhealth.com/ Cheer Health Limited Address 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 Judith Tart Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (33), Physical disability of places over 65 years of age (33), Terminally ill (6), Terminally ill over 65 years of age (6) London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person to be admitted to the home in categories TI or TI(E) when 6 persons in total of these categories/combined categories are already accommodated in the home. 27th June 2007 Date of last inspection Brief Description of the Service: London Road Neurological & Specialist Unit provides nursing care for up to thirty-three people, who are over 18 years of age. They provide specialist facilities for people with complex neurological diseases, acquired brain injury, respiratory disease, people who need palliative and terminal care, and care for a small number of older persons. London Road Neurological & Specialist Unit is situated on the main road on the outskirts of Leicester city centre and is within half a mile of the train station. It is in a large, converted Victorian House, which has been extensively developed and modernised by the present owners and provides suitably adapted facilities for the special and complex needs of the patients. There are lounges, dining rooms, a quiet room and a physiotherapy room. On the ground floor is a conservatory leading to a mature garden, which is accessible to the patients who live there. There are mostly single bedrooms with a small number of doubles with separate specially adapted shower rooms and adapted bathing facilities. Registered Nurses are on duty at all times supported by care and ancillary staff. A part time physiotherapist is employed together with an on call General Practitioner. A Consultant responsible for people with neurological conditions makes regular visits to the home. The service is easily reached by private or public transport and has parking in the grounds. They can be contacted by telephone, fax or email and have their own website. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 5 The Statement of Purpose, Service’ Users Guide & last Inspection Report are available (these provide information on how the home is organised and what services they provide). The Statement of Purpose and Service’ Users Guide are provided for all new patients and their families. At the time of the inspection, fees ranged from £950 to £2000 per week. Because of the individual and specialist care that is given the fees are assessed on an individual basis according to need. There are extra charges for aromatherapy hairdressing, chiropody, newspapers and personal items. London Road Neurological and Specialist Care Unit DS0000001915.V364318.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 3 stars. This means the people who use this service experience excellent quality outcomes. ‘We’ as it appears throughout the Inspection Report refers to ‘The Commission for Social Care Inspection.’ The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. The site visit was unannounced and took place over six hours. We selected three patients and tracked the care they received through a review of their records, discussion with them (where possible), other people who use the service, relatives, the care staff, and observation of care practices. We spoke with staff members regarding training and support. Planning for the inspection included assessing notifications of significant events, a review of the Annual Quality Assurance Assessment (AQAA) sent to the CSCI by the service, and reviewing surveys received from relatives, staff and health professional involved with the care of the patients. Throughout the report the term ‘patient’ is used, as this is the preferred title used by the Managing Director for the people who use the service. The Managing Director and other staff spoken with were positive and helpful during the inspection. What the service does well: London Road Neurological and Specialist Unit provides patients with a safe and pleasant home to live in, with specialist facilities and support to promote the best quality of life for people who have complex physical and neurological needs. There is strong leadership by the Managing Director and Registered Manager that promotes a professional and caring environment. Staff are well trained and provides an excellent standard of care to meet the complex needs of the patients, and provides support for families with empathy and care. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 7 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. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective patients and their relatives and/or their representatives are provided with detailed information about the service, and have their health, welfare and social care needs assessed, so that they can be confident that they will be fully met once they move into the home. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 10 EVIDENCE: The service provides prospective patients and their families with a Statement of Purpose and Service Users Guide (both give information about the service) to help them decide if the home is the right one for them. The company has an excellent web site with a link to their most recent CSCI report, which ensures that prospective patients and families have up-to-date information about the quality of care provided by the service. Three patients’ care plans were reviewed and contained detailed pre-admission assessments to show that the service could meet their specific health, welfare, and social care needs. They included personal details, relative and GP contact numbers, past and present medical history, current health care requirements, including specialist nursing needs, medications, personal preferences, previous social interests and hobbies, to ensure that the staff have the relevant information to enable them to meet all of a prospective patient’s needs. Residents’ families said that they were visited by the Registered Manager before their relative moved to the home and were able to visit the home prior to admission. Staff said that they received information about patients prior to their admission and were given any additional training that they may need to care for an individual patient’s needs, such as the care of patients requiring the use of a ventilator to assist with their breathing. A relative told us that she was sure that the family had been provided with all of the necessary informatiom at the time their relative moved to the home but could not remember what this was as it was some years ago. The service does not provide intermediate care. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Patients are well cared for by dedicated staff ensuring that all of their identified health, personal, emotional and social care needs are fully met. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 12 EVIDENCE: Patients’ care plans were detailed and gave nurses and carers thorough information about the health, personal, social and emotional care needs of the patients. Care plans had been signed by the resident’s representative following each regular review to ensure that they remain fully involved and agree with the personal plan of care where patients were unable to do so. Contact with healthcare professionals such as GP’s, hospitals, Chiropodists, Nutritionists, Physiotherapist, social workers and advocates were recorded in the patients’ files to ensure that that all of the patients’ complex care and emotional needs were addressed. Risk assessments were recorded, where required, both to protect patients and support them in making individual choices in their day-to-day lives; they identified acceptable risks that promoted independence and autonomy, where this was possible such as enabling patients who required significant medical and nursing support to go on short visits outside the home. Medication policies and procedures were sound. Only trained nurses administer medication. Many of the patients receive their medications via their percutaneous endoscopic gastostomy (PEG) feeding tube – these had all been risk assessed with the appropriate procedure in place to ensure the safety of the patient. The nurse on duty said that the manager assess them annually to ensure that they continue to administer medications safely. There were no patients with the capacity to self medicate at the time of inspection. Observation during the inspection showed that all staff had a good awareness of how to protect the patients privacy and dignity. Staff spoke to patients and visitors in a respectful, friendly, quiet and supportive way. One patient, and three relatives, spoken with during the inspection said that the patients were very well looked after in every way and that staff were kind, caring and very professional. A new member of staff told us that the service to the patients was ‘second to none’. A health professional that regularly visits the home told us, ‘everyone is treated as an individual and are cared for to a very high standard’. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 13 A relative told us that the service ‘provides excellent care for people with complex needs’. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff ensure that the patients, with the support and involvement of their families, are enabled to maintain their self-determination and make decisions in all areas of their daily living within their capacity to do so. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 15 EVIDENCE: Visitors came and went throughout the day and spoke to the staff about their relatives and any concerns they had. Relatives said that they were well supported by the staff and were always made to feel very welcome at any time and that there were no restrictions on visiting times. One relative said that this was good because it showed that a standard of excellent care was always provided whether a visitor was there or not. Specific needs and risk assessment relating to personal and sexual relationships were well documented, supported and agreed to enable patients to continue to meet their individual expectations, whilst ensuring that this did not impinge on other patients or the staff. Most of the patients have restricted cognative awareness but suitable activites were available to meet their individual abilities. A mobile ‘snoozulum’ system was used and could be moved from patient to patient. This provides patients with sensory stimulation with music, coloured and fibre optic lights. Entertainment and music were provided through the TV, radio and CD/tapes with occasional visits to the home by a singing group. A hairdresser visits once a fortnight and an aromatherapist is available to provide therapeutic massage. The pastoral care needs of the patients are met and that all faiths are provided for and made welcome. A relative said that there were regular visits by the priest and the home supported differing cultures and faiths. The home works closely with the speech and language therapist (SALT) to help communication with patients. Staff were seen to talk with patients who were unable to communicate verbally or respond in any way. The Managing Director said that this was positively encouraged and staff were aware of patients previous interests and hobbies so that their conversations were relevant to the experiences of the patient whether that was footbal of knitting. A number of staff speak other languages but staff also use sign and touch to communicate with non-verbal patients and patients who’s first language was not English. Interpreters and independent advocates are also used to support patients. Many of the patients were fed via PEG (tube) feeds. Their special nutritional requirements were monitor by their GP and recorded on fluid balance charts to ensure that staff can monitor that they receive the correct nutritional and fliud intake. Patients who were able to choose had a choice of meals every day and the cook provides alternatives according to their needs. Specialist diets such as ethnic, diabetic, soft and liquidised diets are catered for. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 16 Relatives and a patient told us that the meals were very good, there was always choices and always fresh vegetable. Families also said that they were kept well informed and involved with their realtive’s care. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are sound resulting in satisfactory protection of patients’ rights. EVIDENCE: Relatives and staff comments showed that people feel at ease discussing any concerns with the managers or other staff. Information regarding advocacy services was available if patients required independent support and advice. One patient had both an independent Social Worker and an independent advocate to provide additional help and support to a patient’s whose first language was not English. There is a complaints policy and procedure that provides details of how to complain and to whom. The complaints book was looked at and there was a record of a number of minor concens raised by relatives. These had been London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 18 resolved quickly, and complaints received by the home had been dealt with in a professional and efficient manner. The home’s complaints process reflects the Safeguarding Adults policies and procedures and staff were provided with appropriate training and were able to demonstrate the correct procedures for safeguarding the patients from harm. Staff spoken with were aware of the home’s ‘safeguarding vulnerable adults’, policiy and procedure and new what to do and would be prepared to ‘whistle blow’ to safeguard the patients from harm. Staff said that they had had training in safeguarding vulnerable adults, both during their first three months probationary preriod and annually thereafter. Relatives spoken with said that they were aware of the procedure to complain and would have no concerns about doing so. But all said that they had no complaints about the service. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A comfortable, clean, safe, well-adapted and high standard of accommodation is provided for the patients. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 20 EVIDENCE: The home is clean, safe and well maintained with adaptations to suit the patients’ specific needs. It is decorated and furnished to a high standard that creates a comfortable, light, spacious but homely environment. Patients’ bedrooms were personalised with family photographs, ornaments, televisions and hi-fi eqipment, and contained the necessary equipment to support their complex physical and neurological needs. New walk in shower rooms and new specially adapted whirlpool baths have been installed to enable patients to be bathed more easily. The bathrooms were clean, tidy and free of any hazards. There was evidence of a range of equipment such as hoists, mattresses, suction equipment, humidifiers, and specially designed chairs, that enable otherwise bedbound patients to be moved out of bed, to help in the care and comfort of the patients. There was an excellent infection control programme in place and air cleaning filter machines had been provided to minimise the spread of infection. The management have recently re-appraised their fire policies and procedures. They have recently purchased new evacuation ‘drag mats’ and ‘grab boxes’ containing necessary equipment to support patients’ care and in the event of fire each patient has an individual evacuation plan known by all staff. The home’s health and safety arrangements such as regular maintenance and servicing of equipment and monitoring heat control valves on hot water taps throughout the home show that the Managing Director (Registered Provider) and Registered Manager are mindful of their responsibilities to make sure that patients live in a safe, well maintained environment. Relatives praised the staff for the high standards of cleanliness in the home. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The patients’ needs are well met and their safety protected by the home’s recruitment policy and procedure. All staff at the home were well trained and sufficient in number to meet the patients’ complex needs. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 22 EVIDENCE: Staffing levels, at the point of inspection, were in line with those suggested by the Department of Health Residential Forum Guidelines and were sufficient in number to meet the patients’ needs. During the day and night there are both trained nurses and carers. In addition, during the day, there were also cooks, cleaners, kitchen and laundry staff and maintenance personnel. Relatives said that there always seemed sufficient staff on duty. Three staff files were checked during the inspection and showed that there is a satisfactory recruitment process to ensure that patients are well protected. New staff have a probationary period of three months, which includes an induction programme, and thereafter annual, mandatory training is provided and for all staff. This includes training in specific areas such as fire safety, hand washing, bed making, use of specialist equipment and safeguarding vulnerable adults to ensure that staff have the necessary skills to care for the patients. Care staff are supported to undertake a National Vocational Qualifications (NVQ) in Care and at least 50 have this qualification to ensure that they have additional knowledge to help them care for the patients. A new member of staff told us that she was treated very well and ‘respected even though a new member of staff’. Staff also told us that they were well supported by the manager and provided with good information and training to help them care for the patients. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 24 31, 33, 35 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Managing Director and Registered Manager provide strong and supportive leadership to staff, with excellent communication between them, the staff, the patents and their families and other professional staff involved in patient care. EVIDENCE: The Registered Manager was on annaul leave but the Managing Director was available throughout the visit to the home and plays an active role in overseeing the management of the home. Both the Managing Director and the Registered Manager are registered nurses with many years of experience. They work in a supernumerary capacity and are dedicated and committed to supporting families and giving the patients the best possible care. Staff receive regularly supervision (a regular review of staff’s personal and training needs in relation to their work) by the Registered Manager to ensure that they continue to perform their nursing and care tasks to the required standard. Extensive training, and regular, recorded supervision ensures that staff have their training needs identified and that they have the necessary skills to provide a good service for the patients. There was excellent communication on all levels between senior management staff and patients’ families. This was confirmed by all the staff and visitors spoken with and was observed by us during the visit. The Registered Manager attends regular, review meetings with the patients and/or their families, as well as having daily contact with visiting families, which provides an opportunity to pass on information and to listen to their views and opinions. A newsletter and an excellent website provide additional information. The home does not hold any personal spending money on behalf of any of any of the patients. This is managed by their families or solicitors. A GP described the home as, ‘A well organised and well run care service providing a high standard of care’. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 25 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 4 2 X 3 X 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 ENVIRONMENT Standard No Score 19 3 20 X 21 X 22 X 23 X 24 4 25 X 26 4 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No Score 31 4 32 X 33 4 34 X 35 4 36 X 37 X 38 4 London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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. Refer to Standard Good Practice Recommendations London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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. London Road Neurological and Specialist Care Unit DS0000001915.V364318.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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