Care Home: Longbridge Road (148)

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What the care home does well The service is small and flexible and is able to respond effectively to the needs of the people who use the service. It offers a safe, secure living environment, with well trained staff support, which enables service users to take acceptable levels of risk in their lives. The home has good staff retention and this reflects in the care being provided, as the staff are very aware of the service users` needs. The manager and staff are working with the service users to enable them to retain a level of independence and to express their wishes and needs. All the residents have an independent advocate who has monthly meetings with all the service users, attends their reviews and assists and supports individuals to make decisions about their lives that they are able to understand.All of the service users have comprehensive care plans together with any associated risk assessments. All of the people who use the service are encouraged to participate in daily activities within the home and leisure activities within the community. Contact with families is also seen as a priority and service users visit their families regularly and are also encouraged to keep in contact with their friends and families via phone calls. People who use the service comments were "I like living here", "the staff are good to me" "they look after us well". As far as possible all people who use the service are supported to contribute towards the daily running of the home, primarily through service user meetings, informal discussions and key worker sessions. Staff training is given a high priority and 90% of the staff team have achieved NVQ Level 2/3 qualification. What has improved since the last inspection? The requirements set at the last inspection have been met. There is an on-going programme of refurbishment of the home. What the care home could do better: It was suggested to the manager that she uses the Key Lines of Regulatory Assessment (KLORA) to assist and continue to identify and evidence the excellent quality of the service provided. CARE HOME ADULTS 18-65 Longbridge Road (148) 148 Longbridge Road Barking Essex IG11 8SP Lead Inspector Ms Harina Morzeria Unannounced Inspection 5th February 2009 10:00 Longbridge Road (148) DS0000027905.V374053.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 Longbridge Road (148) DS0000027905.V374053.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. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longbridge Road (148) Address 148 Longbridge Road Barking Essex IG11 8SP 0208 594 7913 0208 594 7913 utel@outlookcare.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) Outlook Care Ms.Ute Liniker Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief Description of the Service: 148 Longbridge Road is a care home providing accommodation and support for five adults with a learning disability. The registered providers are Outlook Care. The home is situated in a residential area close to Barking Park and is within easy reach of the local shopping area, Barking Town Centre and there are many easily accessible facilities and amenities within the area. The home is easily accessed by public transport, bus, underground and rail. Parking is restricted as the area is in a residential parking zone. However, visitors may request a parking permit from the home for the duration of their visit. The home has its own transport. All five bedrooms are single and located both upstairs and downstairs. The home is friendly and operates as a ‘family’ type unit. The home aims to integrate the service users into community life and supports them to access and participate in mainstream as well as specialist resources in the community in which they live, within their individual capabilities. On the day of the inspection the fees for the home were £1,215.68 per week. A copy of the Statement of Purpose and Service User Guide are available in the home, together with a copy of the most recent inspection report. Longbridge Road (148) DS0000027905.V374053.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 that people who use the service experience good quality outcomes. This inspection was unannounced and was carried out as part of the inspection programme for 2008/09. The inspector spoke to the manager and staff as well as people who use the service, present at the time of the inspection. A tour of the premises was undertaken and a number of records were checked including staff records and services users’ files. The manager was asked to complete the Annual Quality Assurance Assessment. Some of the information provided in the assessment has been incorporated into this inspection report. Care staff were asked about the care that people who use the service receive and were also observed carrying out their duties. A tour of the home was undertaken and the rooms seen were clean and tidy. Service users’ files were case tracked; including risk assessments and care plans, together with the examination of staff files and other home records. These included staff rotas, menus, accident/incident forms, staff records and health & safety records. The inspector had a discussion with the manager on the broad spectrum of equality & diversity issues and she was able to demonstrate an understanding of the varied needs of the service users around religion, sexuality, culture, disability and gender. The advocate was also contacted. He stated that the care staff are supportive and are amenable to suggestions, making appropriate changes. He was very positive about the care service users were receiving in the home and considered that staff in the home make every effort to meet the individual needs of service users in relation to their age, interests and capabilities. What the service does well: The service is small and flexible and is able to respond effectively to the needs of the people who use the service. It offers a safe, secure living environment, with well trained staff support, which enables service users to take acceptable levels of risk in their lives. The home has good staff retention and this reflects in the care being provided, as the staff are very aware of the service users’ needs. The manager and staff are working with the service users to enable them to retain a level of independence and to express their wishes and needs. All the residents have an independent advocate who has monthly meetings with all the service users, attends their reviews and assists and supports individuals to make decisions about their lives that they are able to understand. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 6 All of the service users have comprehensive care plans together with any associated risk assessments. All of the people who use the service are encouraged to participate in daily activities within the home and leisure activities within the community. Contact with families is also seen as a priority and service users visit their families regularly and are also encouraged to keep in contact with their friends and families via phone calls. People who use the service comments were “I like living here”, “the staff are good to me” “they look after us well”. As far as possible all people who use the service are supported to contribute towards the daily running of the home, primarily through service user meetings, informal discussions and key worker sessions. Staff training is given a high priority and 90 of the staff team have achieved NVQ Level 2/3 qualification. 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. Longbridge Road (148) DS0000027905.V374053.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 Longbridge Road (148) DS0000027905.V374053.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, 3,4,5 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Prospective service users and their relatives have the information they need to be able to make an informed choice about moving into the home. The assessment of needs and other information received from health and social care professionals means that staff have detailed information to enable them to determine whether or not they can meet the needs of prospective service users. Prospective service users know that the home can meet their needs. EVIDENCE: A Statement of Purpose is available and the Service User Guide is comprehensive and in a pictorial format, which enables prospective service users to know what the home is like and what services they can offer. The Statement of Purpose and Service User Guide have been reviewed and updated. The service users have been living at the home since the home opened in 1991. The organisation have a detailed pre admission procedure which would be followed should a vacancy arise at the home. A thorough assessment would be Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 9 undertaken by a suitably qualified person to ensure that the home is able to meet the needs of the prospective service user and staff have the skills and ability to meet the assessed needs through the service delivered. The funding authority and health professionals would also provide assessments. Further information would be gathered from the prospective service user, their families and an advocate where required. The admission process would be designed around the needs of the prospective service user. The prospective service user would be encouraged to make several visits to the home and have overnight stays to ensure that they like the home and to meet the other service users. This transition period would also allow staff to get to know the prospective service user and to know whether they can meet the service users needs. Each resident has a License agreement/ contract, which is in a pictorial format. Longbridge Road (148) DS0000027905.V374053.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 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. All of the service users’ identified needs are reflected in up to date care plans and risk assessments. This ensures that service users’ needs are being appropriately met. Staff provide the service users with assistance and support so that they are able to participate in all aspects of life in the home and are enabled to make independent decisions about their lives. EVIDENCE: The manager and staff have ensured that the service users are involved in the decision making process about their lives. There is a care planning system in place that is clear and concise. Each service user has an individual person centred care plan. The care plans were completed with the involvement of the service user, key worker, manager and/ or deputy. These are comprehensive documents and cover areas of the service users’ lives, such as, ‘how I eat’, Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 11 how I communicate’, ‘my medication’, ‘my mobility’, ‘how I sleep,’ ‘likes and dislikes’, ‘things that are important to me’, ‘what I need help with’. Three service users in the home are non-verbal and staff have found various means of communicating with each individual to seek their views. This was evident during the course of the inspection. The PCP is reviewed regularly (six monthly), involving the service user, key worker, advocate and where agreed, their families. Each resident has a personal diary where they are encouraged to write their own account of what they have done each day. This was seen for one person, however it needs to be used comprehensively by both the people who use the service and staff. For non verbal people, innovative ways of communicating such as using pictures of actual activities undertaken and magazine cuttings as well as videoing activities would be an effective way of evidence activities undertaken. The inspector was informed that the entire PCP approach is being reviewed by Outlook Care with plans to formulate an individualised and evolving document which will be used as a working document by staff and service users. All of the service users have an independent advocate from Mencap who has a contract with the registered providers, Outlook Care. He carries out group monthly meetings with the service users, attends their reviews and assists individuals to make decisions about their lives that they are enabled to understand. The inspector was able to see the feedback he gave regarding the outcome of his sessions in the communication diary. The inspector was also able to have a phone conversation with the advocate who confirmed that he visits the home on a monthly basis sometimes with an independent lay person with a learning disability. They have made observations and comments mainly about the environment and activities offered to the service users as well as any individual matters which are generally taken on board and acted upon. He stated that the care staff are supportive and the home are amenable to suggestions, making appropriate changes. He was very positive about the care service users were receiving in the home. He considered that staff in the home make every effort to meet the individual needs of service users in relation to their age, interests and capabilities. The inspector viewed the risk assessments for the service users and these have been reviewed. For example, evidence was seen that risk assessments were in place for two people who self medicate and a monitoring form is used to assess their ability to self medicate on a monthly basis. The manager is aware that risk assessments must be continually reviewed to reflect changing needs and record how decisions have been made and who was involved. There is a focus on maintaining and promoting independence whenever possible, and individual staff were observed providing service users with information, assistance and support and were respectful of their right to make decisions. Each person has a teaching day when they work on a one to one Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 12 basis with staff on how to maintain their independence skills such as tidy room, change bed linen, do own laundry and make breakfast. The manager stated staff are being encouraged to engage with service users to further identify their individual interests and capacity and are attempting to motivate people to pursue these in order enhance the variety of activities provided and their level of independence. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17, People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Opportunities for social and leisure pursuits and personal development are actively promoted and supported by staff for all people who use the service to enable them to participate in the wider community in which they live. People who use the service are provided with appropriate, varied and nutritious meals, staff promote healthy eating and individual preferences are catered for. Visitors are made to feel welcome in the home and people who use the service are supported to maintain and establish family links and friendships EVIDENCE: The service has a strong commitment to enabling service users to develop and maintain their skills, including social, emotional, communication and independent living skills. Service users’ care plans identify lifestyle choice, such as local leisure activities, activities within the home and family contact. Three service users are non verbal and are fully supported by staff make their own choices about their daily activities. Each person has an opportunity planner listing various activities they like to do such as attending club Mencap Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 14 (heathlands), walk in the park, shopping and theatre outings. The home also have a minibus which is used to organise outings and activities especially during fine weather. The service users have some opportunities for personal development however more needs to be done to make service users’ leisure activities are more individualised and varied according to their individual interests. People who use the service are encouraged and assisted to stay in contact with friends and relatives. Most of the service users’ have some form of contact with their families/representatives who may visit them regularly and staff also help people to remain in contact with their families via phone calls. Staff stated, the home provides, independent living promoting relationship of service user and their family. Those service users spoken to indicated that they liked the food and there is sufficient choice. The staff prepare and cook meals with some involvement from the service users and staff know what each person likes to eat. The lunchtime meal was observed to be very relaxed, staff were patient and helpful, and some people prepared their own lunch. During the visit, the inspector checked the menus which constitutes a varied and nutritious diet taking into account personal preferences. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People who use the service are prompted and encouraged to take responsibility for their own personal care. Service users’ physical and emotional health care needs are monitored and this ensures that their needs are recognised and met. The medication policies and procedures are clear. Staff have undertaken medication training in order to ensure the safety of the service users. EVIDENCE: People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Personal health care needs including specialist health, and dietary requirements are recorded in each person centred plan or health action plan. Care plans and daily records were examined and discussed with the manager. The care plans clearly identify health and personal care needs and how these needs should be met. Most of the service users in this home require physical assistance with personal care and this is provided by staff as outlined in each individual care plan . The delivery of personal care is Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 16 individual and flexible, consistent, reliable and person centred. Service users were dressed in clothes that were appropriate for the time of year and which they choose. Records inspected showed that service users have very comprehensive personal health records and health action plans; all of these have been reviewed within the past six months. As stated above a health action plan has been developed for all service users. Most of the service users have a high number of specialist medical appointments and staff support them to attend these and follow up on actions required. At the time of inspection, the inspector was informed that the community learning disability team in health are carrying out a health needs assessment and are going to compile a hospital pack so that when service users need to be admitted to hospital all the health information about the individual is collated in one pack which they can take to hospital with them so that hospital staff know how to care for that person. The manager pointed out that they have good partnership working with colleagues in CLDT and advocates. Service users are supported to access dental care, opticians, chiropody, the community nurse and psychological support is accessed via out patient appointments or home visits by these professionals. Staff have access to training in health care matters. The aims and objectives of the home reinforce the importance of treating individuals with respect and dignity. There are policies and procedures for the handling and recording of medication within the home. Staff have received medication training and there is a list of staff (with their signatures) that are competent in the administration of medication. The manager is the medication champion within the organisation and regularly undertakes medication audits to ensure that staff are administering medication appropriately. Refresher medication administration training is provided to staff on a rolling basis. Two service users self medicate and staff monitor their ability to continue doing this on a monthly basis and appropriate risk assessments are in place. Feedback from the pharmacist is as follows, medication always ordered on time and record keeping very good ie MAR sheets. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The service users’ views are listened to and acted upon. Service users are protected by the home’s safeguarding adults policies and procedures and the monitoring systems within the home. EVIDENCE: The home has an open culture that allows service users to express their views and concerns in a safe and understanding environment. There is a clear complaints procedure, which is available in written and pictorial format which is easy to understand. It is available upon request in a number of formats (other languages, large print, audio). A copy of the procedure has been made available to all of the service users and is displayed in a number of areas within the service. A complaints DVD has also been made as part of the organisations plan to use different multi media formats to communicate with people. The manager is aware that this DVD should be shown to staff and service users and discussions held regarding this on an individual basis to ensure people using the service understand the purpose of this. Service users and others involved with the home do understand how to make a complaint and are clear about what will happen if a complaint is made. The manager informed the inspector that one verbal complaint was received which was investigated and resolved to the complainant’s satisfaction. This was logged. The manager is aware that all complaints, no matter how small should be recorded so that they can be evaluated over a period of time to establish any patterns and take action to remedy this. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 18 Service users were asked individually what they would do if they were unhappy with anything at the home, responses included “I would tell U-- (the manager)”, “I would tell my key worker”. The service users spoken to told the inspector that they were happy at the home and did not want to live anywhere else. There are weekly service users’ meetings, this ensures their views are listened to. The service users are encouraged to participate in decision making on issues, activities and events within the home. The advocate also liases with people to ask if they have any issues. The home has policies and procedures for the safekeeping and expenditure of service users’ money. Service users’ money, which is held in safekeeping by the home is checked at each handover at the end of the shift and monitored by the service manager during the monthly Regulation 26 visits. Service users are given support where appropriate to make purchases, receipts are kept for all expenditures and records of money held. Two staff have to sign for any money taken out. The Organisation has a comprehensive safeguarding adults policy and procedures; there was evidence that these have been read by the staff. All staff receive this training during their induction period and they complete refresher training periodically. Staff members are clear about what constituted abuse and their responsibility to report any potential or actual abuse. Staff files indicated that all members of staff have attended safeguarding adults training. The inspector is informed of any safeguarding concerns and the appropriate procedure is followed should any incident arise. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 19 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, 25,26,27,28,29,30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Service users live in a homely and comfortable environment. Bedrooms, living areas, toilets and bathrooms meet the service users’ needs. EVIDENCE: The home was toured at the start of the inspection and all communal areas were viewed with the manager. All the bedrooms are single. The home provides an environment that is appropriate to the specific needs of the people who live there. The home is decorated and furnished in a homely fashion and all areas of the home were well-maintained, clean, tidy and odour free. The bedrooms were individually decorated and personalised with their own possessions. There is a shared kitchen/ dining area as well as a large lounge which the staff and manager are considering to break up into small areas so that it allows for small clusters of people to live together in a non - institutional Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 20 environment and promote the privacy, dignity and autonomy of the service users. Some areas of the home have been redecorated and there is on going refurbishment of the premises as required. The advocate has made several suggestions to the manager regarding improvements to the environment to update the look in the home as well as make it more personalised and appropriate to the needs of people with learning disabilities. The bathroom, shower room, hallway and stairs are fitted with appropriate aids and adaptations and all are adequately maintained. Adaptations and specialised equipment are obtained for service users who require this to maximise their independence. The kitchen was clean, tidy and spacious. The kitchen is suitable for the service users to carry out domestic tasks, such as, washing up, making cups of tea and preparing snacks. The laundry room was clean and tidy and with clear instructions both written and pictorial format on how to use the washing machine, as some of the service users are able to use the washing machine independently. There is a garden to the rear of the home which has ramped access, that service users make full use of during the warmer months. Service users are able to receive their visitors in the lounge or their own bedroom, which have comfortable armchairs or the garden in the warmer weather. The service users are fully involved in decisions about the décor and any changes to the accommodation. The home is well maintained and there was evidence that all repairs are dealt with promptly. The carpets have not yet been replaced but are on the list. The home is close to community facilities and local services with good transport links. The home has a robust infection control policy and staff would seek advise from external specialist if and when required. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Service users are supported by qualified and competent staff. Staffing levels are satisfactory and there are sufficient staff on duty, who have the appropriate skills and training to meet the individual needs of the service users. The procedures for the recruitment of staff are robust and provide safeguards for service users living in the home. Staff receive regular supervision and annual appraisals, which is beneficial to the service users. EVIDENCE: Rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the people who use the service. Duty rotas were inspected and they correlated with the staff on duty, there were sufficient staff on duty to meet the needs of the service users. There are two staff on duty on each day shift and one waking night staff, as well as the manager or deputy manager during the day time. The staff rota is in a pictorial format which service users like. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 22 The staff work flexibly to support service users during outings or hospital appointments. There is always an on call person out of hours and the organisation have their own bank staff who are called upon to cover shifts, so they are familiar with the service users and how to meet their needs. In discussion with staff on duty, it was evident that that they understand and fully support the main aims and values of the home. Through discussion with service users and observation of staff interaction with individuals, it is evident that they have confidence in the staff that care for them, and that staff have a good understanding and knowledge of the particular needs of the service users. Staff were seen to have the skills to communicate effectively with all service users. There is a clear organisational recruitment policy and procedures. Two staff files were inspected and showed appropriate recruitment procedures had taken place; a completed application form, two written references, health screening questionnaire, copies of qualifications, driving licence, bank details and a current Criminal Records Bureau (CRB) check. Staff undertake external qualifications beyond basic requirements. The organisation encourage and enable this and recognise the benefits of a skilled, trained workforce. All staff have job descriptions and specifications which clearly define the roles and responsibilities of staff. There was evidence on staff files that an induction programme had been undertaken as well as health & Safety, COSSH, safeguarding adults, first aid, moving & handling, infection control, administration of medication, person centred planning, behaviour and anxiety awareness, dementia awareness, epilepsy and autism training, Mental Capacity Act training, positive behaviour management, equality and diversity training. Most of the staff have completed NVQ 2/3 qualifications. When asked what the service do well, staff feedback received states, staff undergo continuous improvement programme, regular training. Care for the people who use their service and see to their individual needs. Give staff important information to help them with their job, such as training, staff forums and meetings. Staff files indicate that they are receiving supervision regularly and annual appraisals have taken place, which staff were able to confirm. Every staff member has a training profile where training that has been undertaken is recorded and future training needs are identified. Staff meetings are also held regularly. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 23 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, 38, 39, 40, 41, 42, 43 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The home is well managed, which means service users’ health, safety and welfare are promoted and protected. Service users can be confident that their views underpin the self-monitoring, review and development of the home. EVIDENCE: The current manager is registered to manage this home and a similar home two doors away (144 Longbridge Road). She is well experienced to manage the home and demonstrates a clear understanding of the needs of the service users. She is supported by an experienced deputy manager who takes a lot of responsibility to ensure the home operates for the benefit of service users. Every effort is made to retain the independence of those people living in the home and for them to exercise choice and control over their lives. The Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 24 dependency levels of the current service user group are very variable, and are well considered by staff when providing the level of assistance and support needed by the individual. The home is run in a way which provides a safe environment. The manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They provide an increased quality of life for the service users with a strong focus on equality and diversity issues. The AQAA contains clear, relevant information that is supported by a wide range evidence. The AQAA lets us know about the changes they have made and where they still need make improvements. All records are held securely. Service users would be able to have access to their records. The home works to a clear health and safety policy and all staff are fully aware of the policy. The service users’ health, safety and welfare are met by the staff working in the home. Safeguarding is given high priority and the home provides a range of policies, guidance and training to underpin good practice. All accidents are recorded and appropriate action is taken when required. Induction training for new staff is being provided with further ongoing training being offered on a regular basis. One staff member stated, the induction process is in - depth and thorough. Health and safety checks and the associated records were appropriately completed in line with the Regulations. Individual risk assessments for each service user are now in place. As stated earlier in the report service users’ meetings take place and all are encouraged to have an input into these meetings. Minutes are kept of all meetings held. An annual development plan will be completed reflecting the comments and views from the surveys. Monthly Regulation 26 visits required to be undertaken by the responsible individual do take place and reports of these visits were seen. The reports identify action points which are acted upon by the homes manager following each visit. The standards that relate to health and safety were also well managed and information was readily available. Fridge and freezer temperatures are taken and recorded daily. Fire drills are taking place regularly. Fire extinguishers are annually checked and fire alarm call point is being tested and recorded weekly, a fire risk assessment has been carried out. The manager is aware that it is her responsibility to protect and promote the health, safety, welfare of the service users and carry out regular health & safety inspections as required by Regulation. Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 25 Longbridge Road (148) DS0000027905.V374053.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 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 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 3 3 3 Longbridge Road (148) DS0000027905.V374053.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. 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 Longbridge Road (148) DS0000027905.V374053.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Longbridge Road (148) DS0000027905.V374053.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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